Race, the new genomics, and lung function measurements
Monday, November 4, 2013
: 4:50 p.m. - 5:10 p.m.
The spirometer is an instrument used routinely in many clinical and public health settings to measure the capacity of the lungs. An important feature of the device is that numerical values produced with the device are routinely corrected for race and sometimes ethnicity. Correction factors for race and/or ethnicity, most commonly for people labeled black, or population-specific standards are embedded seamlessly in the software and hardware of the spirometer such that operators are often unaware that they are correcting for race/ethnicity. Adjusted lung function measurements are widely used in research investigations for clinical diagnosis of pulmonary diseases, such as chronic obstructive pulmonary disease; medical surveillance of industrial workers; pre-employment physical examinations; and disability assessments in compensation cases. This paper uses historical methodology to explore the following questions: how did the idea that the lungs of blacks were different than the lungs of whites first develop? What are the consequences in present-day practice for the naturalization of difference? What is the relationship between the racialized history of lung function testing and new genomics? I will show that race became a key organizing principle in spirometry beginning in the mid-19th century US -- in dialogue with other categories of difference, including occupation, social class, gender, and disability. It quickly became a transnational project, becoming more deeply and invisibly incorporated into the machinery over time. With complex new genomic technologies and renewed cultural enthusiasm for race-based medicine, another era in the use of race in spirometry--centered mostly on African Americans--looms.
Advocacy for health and health education
Diversity and culture
Occupational health and safety
Public health or related research
Describe the history of use of race in biomedicine with a focus on lung function.
Analyze the contemporary debate over race, genetics, and health.
Assess the relationship between race and class in health
Keyword(s): African American, Health Disparities
Presenting author's disclosure statement:
Qualified on the content I am responsible for because: Lundy Braun is Royce Family Professor in Teaching Excellence and Professor of Medical Science and Africana Studies and a member of the Faculty Committee on Science and Technology Studies at Brown University. She did her graduate work at Johns Hopkins University School of Hygiene and Public Health. Her research focuses on the history of race in public health. Her book Measuring Vital Capacity: A History of Race, Labor, and Fitness is forthcoming.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines,
and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed
in my presentation.