Antiracism in biomolecular research

While most scientists reject overt racism, systemic racism remains ingrained in biomedical research and influences scientific priorities, study design decisions, and interpretation of research findings. Race is a socio-political construct designed to reinforce a hierarchical social structure; scientific racists attempted to then justify this hierarchy with false claims about the biological basis of differences observed between these groups [1]. The diversity within a racial group is generally far less than the diversity between racial groups. Yet, the belief that race has a biological basis remains a prevalent misconception despite clear genetic evidence to the contrary [2].

Racial and ethnic groups exhibit substantial differences in disease incidence, severity, progression, and treatment response [3]. Based on considerable evidence, these health disparities arise through racism (both interpersonal and systemic), poverty, health care access, behaviors, toxic stress, and other socially mediated effects. However, most large research studies aimed to investigate disease etiology and progression have employed primarily populations of European origin [4]. This lack of diversity has made it difficult to weigh the relative influences of genetic variants, environmental differences, and systemic stressors on health disparities.

A common error in assessing differences between groups of people is conflating observed external differences (e.g. hair texture and skin tone) with an idea that there are similar internal biological differences between groups. People tend to believe that an underlying genetic essence causes natural entities to be what they are by generating the apparent shared characteristics of the members of a group [5]. Even with a background in science, many tend to judge behavior of social groups to have different innate capabilities. This allows people to make erroneous causal inferences from the perceived essence to observed group characteristics without needing to give the essence a concrete, scientific description. Genes often serve as a placeholder for this imagined group essence, and this has important implications for design of biomedical experiments. It is easy for scientists to use oversimplified concepts informed by genetic essentialism when considering race as a biological variable. Thus, there is a tendency in biomedical research to incorrectly assume that groups share a common genetic makeup that explains disease associations.

The tendency to believe that genes provide the full explanation for observed traits and differences is known as genetic essentialism. Genetic essentialism biases understanding of genetic findings by overlooking the complex role of social factors in influencing outcomes and can exacerbate stereotypes [5]. The tendency to infer the characteristics and behavior of an individual from their perceived genetic makeup reduces individuals to molecular entities whereby the social, historical, and cultural complexity of humans is attributed exclusively to their genes. This leads to the erroneous conclusion that all members of a group defined by genetic essence have the potential to possess a condition that is not observed in those who do not share this genetic foundation. Complex conditions where phenotypes result from interaction of many genes, social influences, and environmental effects, defy a genetic essentialist explanation. Furthermore, we know that conditions that may be prevalent in some populations are not absent in other populations. While there may be differences in frequencies of genetic traits and conditions across populations, there are vanishingly few variants that are unique to a single population [6].

Strong genetic explanations exist for diseases where genes have a large influence on phenotypes, for example monogenic diseases or those caused by a small number of genes. However, these conditions are more the exception than the rule for human diseases. Multifactorial genetic explanations apply to conditions that have a complex genetic basis, the mechanisms of which are not fully known. Thus, much of the challenge of correlation of genes with human conditions involves weighing the contributions of weak, complex genetic contributions against other factors that influence disease etiology. Essentialism tends to give more weight to genetic explanations for complex conditions than is reasonable.

Racism is the system of oppression written into laws, policies and institutional practices based on social and political constructions of race, that advantages the dominant group and disadvantages non-dominant groups. Antiracism, the conscious effort to identify, describe and dismantle racism, has deep implications when trying to understand health disparities [7]. Disparities reflect complex social, economic, political, justice and equity influences that do not reduce to simple genetic explanations for many diseases. Health disparities exist because of racism inherent in society and its institutions. Thus, wealth, opportunity, economic resources, education, and environment are distributed inequitably, negatively impacting the health and well-being of minority groups. In science, this has resulted in the use of European ancestry populations in biomedical research and exclusion of other groups, under the assumption that the results will be equally applicable to all groups, ignoring the prevalence of disparities that result from structural racism.

The issue of how to use population descriptors in research is a complex one because while it is important to carefully assess health disparities, it is also equally important not to reify notions of scientific racism. The National Academies of Science, Engineering, and Medicine recently took up the question of how to balance these goals and responsibly use population descriptors [8]. Race should not be used as a proxy for genetic variation. Genetic ancestry should not be used as a surrogate for sociopolitical race and vice versa. Also, labels should be consistent across groups, not mixing some racial identifiers, some ethnic labels, and some ancestries. Importantly, continental ancestries are at risk of recreating racial groups, so we cannot allow the word ancestry to simply replace race [9]. Socially constructed race plays a large role in health-care delivery and outcomes. There must be a clear scientific justification for utilizing race as a variable, and whatever labels are chosen, the process of selecting them should be transparently articulated as part of the research methodology. In the absence of these guardrails, the research design may perpetuate racial essentialism and may frame health disparities in reductive terms.

It is critical for scientific investigators to educate ourselves regarding the modern understanding of race as a socio-political construct to best inform experimental design and avoid mistaken racist assumptions. Part of developing this understanding will necessitate consideration of historical harms science has visited on marginalized communities and the damaging terminology associated with scientific racism [10, 11]. These terms must not make their way into our studies. As scientists, we have a responsibility to structure our science to benefit all equitably and not further exclude marginalized communities from the benefits of research; we should and can and do better.