When is ‘race’ a race? 1946–2003

Stud. Hist. Phil. Biol. & Biomed. Sci. 39 (2008) 437–450

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When is ‘race’ a race? 1946–2003 q Snait B. Gissis Cohn Institute for the History and Philosophy of Science and Ideas, Tel Aviv University, Ramat Aviv, 69978, Israel

a r t i c l e

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Article history: Received 18 January 2008 Received in revised form 29 May 2008

Keywords: Race Genetic Medical Environment Individual Group

a b s t r a c t There has been a widely perceived sense of a contemporary resurgence of the category of race in western genetics, epidemiology and medicine. In what follows, some important American and British journals in these fields are surveyed for their content from 1946–2003, with the aim of comparatively tracing the use of the race category among American, British and Israeli authors. Three crucial stages are delineated along this time line, and the correlations between the use of the race category and developments in genetics, as well as the changing guidelines for researchers in the USA, are examined. Concepts of individuality and collectivity in the three fields are analysed in relation to the use of ‘race’ in the surveyed journals; there follows also a discussion of some recent critical reflections on that use. It is concluded that there has been both continuity in, and reconstruction of, the roles of ‘race’ within the genetic/medical discourse. Ó 2008 Elsevier Ltd. All rights reserved.

When citing this paper, please use the full journal title Studies in History and Philosophy of Biological and Biomedical Sciences

1. Introduction The widely perceived sense that the use of the category of race in sciences dealing with humans has markedly increased during the past twenty years, after it had almost completely disappeared soon after the end of World War II, is the point of departure of the present investigation. It raises the following historical questions: What role, if any, has the category of ‘race’ played in Western genetics, epidemiology, and medicine since the end of World War II? What have been its uses? Could these uses be mapped along a timeline and divided into stages? What could such a timeline be correlated with? Has there been critical reflection on the role it has played? My work should be viewed within the context of the recent debates on the usage of ‘race’ in genetics, medicine, and epidemiology. These have primarily focused on two concerns. One is empirical: Who has used this category, when, where, and to what purpose?; and the second ethical–theoretical: Is the use of this

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category conceptually useful and/or necessary, or conversely, is it socially harmful and superfluous?1 I have approached the issue from a comparative, diachronic– historical perspective. In order to analyse cases in three countries—the United States, Great Britain, and Israel—I have chosen as sources influential and respected American and British journals in the fields of genetics, epidemiology, and medicine. I have included the Israeli case for the following reason: Given the history of the Jews during World War II and the destruction of European Jewry, the various modes of using the ‘race’ category by Israeli Jewish authors should prove to be particularly interesting. In order to track the processes of change and to perceive a stable state of affairs in the sciences at large, I have considered the publications of a large number of people working in those fields, rather than only a few top names. My aim was to gain insight into the broadly accepted implicit assumptions, modes of thought and analysis, and manner of discussion and communication. I have used as source material international journals that are considered

In case of any ambiguity in the title, I mean: when does the term ‘race’ signify that there are human races? E-mail address: [email protected] I discuss the main positions found in the journals I surveyed up until the year 2003. For more recent debates, see, for example, articles in the January issue of the American Psychologist (2005, in particular Shields et al., 2005); articles in Daedalus (2005); Duster (2006a,b); Gannett (2004); articles in Goodman et al. (2003); Kerr (2004); articles in Gilman (2006); Race, Ethnicity and Genetics Working Group (2005). 1

1369-8486/$ - see front matter Ó 2008 Elsevier Ltd. All rights reserved. doi:10.1016/j.shpsc.2008.09.006

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central to the scientific research and controversies in their fields and also those journals that reflect local professional communities, particularly in medicine. Based upon my findings I argue that the category of race only seemingly disappeared from scientific discourse after World War II and has had a fluctuating yet continuous use during the time span from 1946 to 2003, and has even become more pronounced from the early 1970s on. Section 2 gives a brief historical overview of the use of the category of race from 1946 to 2003. Section 3 discusses the methodology used. Section 4, entitled Timelines, presents synopses of selected postwar journals in genetics, medicine, and epidemiology. In Section 5, Correlations, I show first how the findings of timelines correlate with developments in the relevant research fields, and then I discuss the relationship between the National Institutes of Health (NIH) guidelines that govern funding and the use of the category of race in the American journals. Section 6 discusses how individuals and collectivities are conceptualised in the entanglement of genetics and medicine. Section 7 considers journal articles by Israeli authors as a particularly enlightening case in comparing the continuous use of the race category. Section 8 discusses the critical–reflective positions on the use of and the need for ‘race’ found in genetic, medical, and epidemiological research journals. 2. ‘Race’ in historical perspective I have assumed that from the late eighteenth century the concept of ‘race’ in science has been a non–stable, hybrid, contextual category, which has operated primarily within the sciences that lie at the interface of the social and the biological. I have assumed that ‘Nature’ and ‘Culture’, the latter referring to the social at large, do not constitute two disjoint ‘cosmologies’. In the present context they are represented by biology–genetics and the medical sciences on the one hand, and by sociology, anthropology, and political theory on the other.2 I begin my overview in 1946. Some historians have argued that at the beginning of the twentieth century the use of the category of ‘race’ started to disappear from scholarly works authored by biologists and anthropologists. They claim that this trend is more noticeable after World War I and particularly so after the Nazi seizure of power in Germany. These historians further argued that in the decade immediately following World War II the use of ‘race’ could be found only in the works of blatantly racist scientists. Most of the histories on ‘race’ published in the second half of the twentieth century narrate the history along similar lines.3 There is no doubt that during the first decade after World War II there was a concerted effort by the majority of scientists dealing with humans to delegitimise the former ‘typological’ use of ‘race’ either as an analytic or as a substantive category, and to insulate scientific work from any legitimisation of racist practices. By substantive I mean either relating to race in an essentialist mode, or assuming that ‘races’ are entities with well delineated and clear

boundaries, or that races possess properties in an essential manner, or that they can be used in an explanation as efficacious entities, that is as causal forces. This was true both in the Eastern and the Western bloc nations. In some countries, the use of the term ‘race’ to refer to the differences among human groups became anathema in both the sciences and the cultural sphere. This gradually gave rise to substitute terms such as ‘ethnic groups’ and ‘labour immigrants’, a term that usually referred to groups of people coming from countries outside the Western world, or from its geographical and cultural boundaries. Some researchers claim that a new racism ‘without race’ has appeared as a result of this.4 Moreover, ‘cultural differences’ and a host of substitute terms derived from ‘ethnicity’ can be as essentialist in their racist use and implications as the use of ‘race’. The fact is that after World War II the door to some versions of a classificatory view of ‘race’ had been left ajar. In recent years a number of corrective or alternative narratives have argued that the category of race had not been totally eliminated from science5, and also that ‘populations’ could not serve as a substitute of a reformed category of ‘race’ (particularly if the intentions of the founders of population genetics—Sewell Wright, John Burdon, Sanderson Haldane, and Ronald Fisher—are to be taken into account).6 Thus Gannett (2004) has offered a thorough analysis of the various dimensions of the type–population distinction, originally constituted by Dobzhansky, and has convincingly shown that ‘populations’ were believed to be genuine biological objects, delineated by more or less discrete natural boundaries, represented by geographical and/or social—and thus also culturally constituted—barriers to gene exchange. In spite of the fact that populations are genetically heterogeneous, there is room for the stereotyping of individuals based on the statistical properties of the group. Races have thus been reconceptualised as ‘populations’ in serious ways. It is surely the case that in the controversies that took place over gene determination during the 1970s and 1980s, it was tacitly assumed that there were ‘races’. For example when the following topics were then dealt with: blood pressure and hypertension, cardiovascular diseases, low birth weight of babies, the functioning of the immune system (particularly among children and young adolescents), hepatitis, diabetes, with HIV–AIDS the major addition from the mid 1980s on. The majority of the articles published in the American Journal of Epidemiology during this period checked the affected populations by ‘race’ and used ‘race’ as an explanatory category. Whether analytic–etiological, or descriptive, or dealing with the natural history of a disease, most of the articles treated ‘race’ as a stable category referring to homogenous populations. From the 1980s on there were a few articles in the New England Journal of Medicine that presented the ‘white– black’ distinction as a sharp one between two races. The ‘diseases of the black’ in the 1980s (and until late 1990s) were mainly hypertension and other cardiovascular illnesses, sickle cell anemia, diabetes, eye diseases, renal diseases, and the phenomena of pre-term births, low birth weight, and infant mortality among ‘black’ mothers. Efforts to launch the project of sequencing the human genome began in 1986.7 In 2000 (a version of) the human genome was se-

2 There is a vast literature on eighteenth-century differentiations; Wheeler (2000) discusses the most prevalent positions in this debate. Given space limitations I cannot here offer a more specific narrative on how and in what historical contexts ‘race’ emerged as a scientific object that became so central to the sciences dealing with humans during the nineteenth century, and how it became entwined with both medical and social categories of normalcy, pathology, disease, and degeneration, as well as with a naturalistic view of heredity. 3 See for example Barkan (1992), Provine (1973, 1986), Rose (1975), Stepan (1982) and the bibliographies therein. On UNESCO statements from the early 1950s until 1978, and for the writings of geneticists and anthropologists, see Klineberg (1951); Lewis (1951); Lévi-Strauss (1952); Montagu (1951); Morant (1952); Shapiro (1953); UNESCO (1950, 1952, 1969, 1978). See also Proctor et al. (2003). 4 See for example Balibar & Wallerstein (1988). On the anthropological concept of the ‘ethnic group’ see Macbeth (1997); on the biological one, see Sharma (1997). On ‘race’ and racism in contemporary Europe in this context, see Small (1993), and articles by Solomos & Wrench (1993) and Wrench & Solomos (1993). 5 See for example Gannett (2004); Gayon (2003); Kohn (1996); Reardon (2005); Ekberg (2007). 6 In the interwar period this was more conspicuous in certain aspects of physical anthropology. 7 In 1991 a proposal for a human diversity project was advanced by a group of American geneticists headed by L. L. Cavalli–Sforza. The project in its original conception never materialised, but partial implementations did take place from the mid 1990s on (see most recently Reardon, 2005).

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quenced and assembled and its results were published in 2001.8 In the autumn of 2002 the project to map human genetic variation— the haplotype map (Editorial, 2005)9—began and its results were officially published in October 2005. The impact of the genomic tools in fields outside genetics, though with a certain time lag, was felt before the actual publication of the human genome sequence. I end my survey in 2003 with the first wave of deployment and reactions.

3. A comment on methodology An implicit assumption of reductionism in the various sciences has been that they reliably reflect the carving of the natural world at its joints. The decision about the ultimate units and categories is theoretical, but the decision often turns these units from epistemological ones into substantive ones. The more these units and categories are incorporated into successful theories, the more they accrue robustness. The categories of race and ethnicity have played such a role within the complex of ‘nation’, ‘science’, ‘culture’, and ‘state’. Ideas about physiological, psychological, cognitive, and genetic structures have been intertwined with large-scale implicit socio–cultural assumptions about the characteristics of collectivities and individuals. The ways in which the category of race has been used in administrative and in former scientific practices have endowed it with a measure of factuality and stability. Thus the category of race was transformed into a tool whose use in the biological and medical sciences did not seem to call for any reflection. This in turn lent further ontological robustness to state and national practices whose race category–making were being used directly and indirectly by scientists, especially those who relied on the various governmental statistical data bases. In my survey I examined the mode in which the category of race was used in the discourse of genetics, medicine, and epidemiology.10 I asked the following questions: Was it only referred to, or actually used? If used, in which contexts? Did it serve as an analytic category, a classificatory one, an explanatory one, or was there a further substantive use, that is, was ‘race’ essentialised by assuming that ‘races’ were well delineated bounded entities, or that they possessed essential attributes, or that they were efficacious, for example used in causal explanations of the bio-medical phenomena discussed? The journals I surveyed include some fairly recently established journals and some long-standing ones. In genetics, I used Nature Genetics (NG), which began publication in 1992, and the longstanding Science, Genetics, the American Journal of Human Genetics (AJHG). In medicine and epidemiology I surveyed Genetic Epidemiology (GE), which started publication in 1984, and the American Journal of Epidemiology (AJE) (which began in 1965), (formerly the American Journal of Hygiene), and some long–standing journals, the New England Journal of Medicine (NEJM), Lancet, and the British Medical Journal (BMJ). I surveyed publications dating from 1946, after the end of World War II, till 2003. Though this sample is perhaps not representative in a strict sense, it does include some of the principal American and British locations in these three fields; it does indicate the mainstream topics, the questions, and the category uses, and it allows some generalisations to be drawn from its contents. In addition I have examined the use of the category of race by Israeli authors who published articles in the selected journals.

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Most of the scientific articles surveyed had a generally uniform structure with an abstract, a description, an explanation of methodology, some discussion, and conclusions. I examined which part of the article the category of race was used in, and in which mode (in contradistinction to being solely referred to). Crossing the various modes with their prevalence in the various parts of the scientific articles’ general structure enabled me to expose the implicit assumptions of the authors. I compared the frequency of the various modes in which ‘race’ was used according to time period and I compared the answers to the questions mentioned above according to the field of research and the country (British or American). With the exception of the journal Genetics and the journal Science, which are fully available online, most of the journals’ online availability only begins in the late 1990s. Surveying the printed journals was carried out by a search according to title, table of contents, and a list of terms. This list differed somewhat according to the character of the specific journal surveyed and the time period in question. The list of terms was also used for online articles. The overall list of terms was arranged by topic, order of significance, and frequency of appearance throughout the period surveyed. The list included the following groups:  race, racial, ethnic, ethnicity, blood groups, human genetic, human population, human diversity;  all the appellations used for ‘races’, religious, and ethnic groups; all the appellations relating to groups defined by diverse geographical locations; all the appellations relating to immigrants defined as of geographical or ethnic diversity;  polymorphism, marker, mutation, variation, site, genomic, haplotype;  TB, sickle cell, thalassemia, hepatitis, cancer, AIDS, HIV, HTLV, syphilis, diabetes, renal, hypertension, blood pressure, weight; all the terms used to describe cardiac and coronary diseases;  birth-weight, term of pregnancy and premature delivery, children’s vaccinations. Although I have worked on the history of the category of race during the eighteenth, nineteenth, and early twentieth centuries, especially in the sciences, I came to the present study somewhat in the manner that anthropologists approach the investigation of little-known cultures. To do so they have to learn their language, study their customs and belief systems, and make observations in the field, preferably participant-observations. To a great extent, my going over the journals was analogous to such ‘in-the-field’ observations. Being neither a geneticist nor a physician, I had to make sense of the cultural and linguistic customs represented in the material and decode their meanings. The articles and the journals were my ensemble of anthropological texts to be analysed for their scientific-and-medical-culture meanings. Rather than come to the material with a prior definition of ‘race’, I tried to decipher the meanings-in-use embedded in the investigative and linguistic practices that produced the scientific artefacts, the articles, along a time line, layered in three scientific fields. The hard part has been to see and decipher whether one is dealing with another, perhaps novel mode of thought, and if so to see how much it harbours within itself the trappings of an older one. Comparing three cases—the United States, Britain, and Israel—allowed me to see more sharply the common and diverging elements in the collective ‘race carving’ of the investigated world of practitioners in genetics, epidemiology, and medicine.

The results were published in Science, February 2001; see also Dupré (2004), and Teich (1997). Some of its common uses have been in reconstructing genetic genealogy and in the genetic investigation of widely spread diseases. For discussion of issues related to these, see Beckwith (1997), Cavalli-Sforza et al. (1993), Cavalli-Sforza (1997); King (1997); Zilinskas (1997). 10 The last few years have seen the growth of a rich literature on ‘race’ and its role in the life sciences. A summary of the discussions from 2002 onwards can be found in the 2005 article by the Race, Ethnicity and Genetics Working Group. The controversy discussed there forms the context of my article. 9

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4. Timelines Based on my survey, I have delineated three crucial periods along the 1946–2003 timeline: from 1946 to the early 1960s; from the late 1960s to the early 1980s; and from the late 1980s to the present. There are some differences between the periodisation for the journals primarily concerned with genetics and those of a primarily epidemiological–medical nature, a fact that explains the time gaps among the three periods. These differences will be dealt with below in Section 5 on ‘Correlations’. I approached my materials without a preconceived time scheme, but the more I progressed in my parallel survey of genetic and medical epidemiological journals, the more it became clear that the early scarcity and the later growing abundance of articles using ‘race’ in one form or another fell into definite, though not sharply defined, periods. Rather than sampling a fraction of the journals, I surveyed all the issues of the journals from 1946 until 2003. I later correlated my qualitative and quantitative findings with some extant, primarily statistical, works that had sampled some journals in a continuous manner—that is, that had not divided the time frame—and found my periodisation strongly confirmed by these studies.11 4.1. The first period: from 1946 to the early 1960s Beginning in 1946, the major publications by geneticists and anthropologists (some sponsored by UNESCO) discussed how to deal with the concept of race in the light of what had happened during World War II. The American Journal of Human Genetics was founded in 1949, and H. J. Muller wrote the preface to its first volume (Muller, 1949). Already in 1951, in his now classic essay, ‘Our load of mutations’, Muller gave a broadly conceived picture of the relationship between genetics and medicine in which ‘race’ has no part. (Muller, 1951). Yet he had been one of a number of geneticists who had opposed the first UNESCO statement in 1950 on ‘race’, believing that there would be mental differences when there were physical differences associated with ‘race’. One can readily find articles in genetics journals explicitly shunning the use of ‘race’ as type (Dobzhansky, 1951, pp. 264–266), or clearly striving to present both basic and applied research with no eugenicist echoes.12 On the other hand, explicit reference to ‘race’ as well as use of the term can be found in discussions about blood groups; in the elaboration of ideas concerning ‘human race variations’; and when indicating the geographical origin of either individuals or families (Gannett, 2001). Let me indicate in a slightly more detailed fashion another example. In 1950, W. C. Boyd, committing himself to a methodology that adhered to differences in gene frequency, investigated genes that are relevant to blood groups that are inherited and traceable by serological tests, and came up with a division into six groups that, though not quite clear cut, turned out to be in agreement with geographical lines that corresponded to a large extent with traditional racial divisions (Boyd, 1950). The groups were in fact given similar names, such as negroid instead of negro, Caucasoid instead of Caucasian, and so on. Boyd suggested a thought experiment in which genes related to blood groups

were to be considered as conferring visible skin-colour differences (for, as he said, geneticists at the time still did not know how genes actually affected some of the traditional morphological differences). The outcome of this experiment would indicate colour gradations within the classified groups, but would more than partially overlap with traditional classifications (ibid., pp. 187–196). Indeed in a later article Boyd argued for gene frequencies as supplementing morphological characters in defining ‘race’ (Boyd, 1963, pp. 1057–1064). Moreover, he viewed the serological classification as using objective quantitative methods, allowing for prediction of results of admixtures. At this point he actually used some of the harmony–disharmony rhetoric later analysed by Provine (Provine, 1973, pp. 790–796). Incidentally, Boyd ended his 1950 article by indicating that he had found ‘no indication of the existence of any racial superiority or inferiority’ (Boyd, 1950, p. 196). Mourant, who had worked with Boyd, emphasized that using the genetic method would, indeed, produce a serological phenotype somewhat different from the traditional racial markers division (Boyd & Mourant, 1954, pp. 767–777; see also Gannett & Griesemer, 2004). In epidemiological–medical articles there was little or no direct mention of ‘race’. In the United States, ‘non-whites’ were referred to by their geographical–social location. Thus, until around the mid 1960s in the New England Journal of Medicine ‘non-whites’ were identified as ‘reserve Indians’, ‘inner city blacks’—or racially identified when discussed in hospital cases. In Great Britain nonwhites could be identified under the category of immigrants. For example, in the Lancet starting in 1948 and during the 1950s and early 1960s, there appeared follow-up statistical articles as well as nationwide reports on diseases—particularly TB—among ‘work immigrants’. 4.2. The second period: from the late 1960s to the early 1980s The implications and consequences of the various new technologies related to the DNA revolution for biological and medical research and pharmaceutical use/production gradually became apparent, and particularly so in 1972 and 1973. The majority of articles in the genetics journals during this period were oriented towards molecular–biochemical and cytogenetic research, at times combined with statistical investigations, for example dealing with site location, mapping, linkage, mechanisms of genetic variations, and mutation.13 But whatever the orientation, the research on families, twins, siblings, and individuals within groups used ‘race’ as a classificatory, and/or analytic, and/or explanatory category. This is how hemoglobinopathies in general and sickle cell anemia in particular were perceived. The same applies to the analyses of term-ofpregnancy and blood pressure. ‘Race’ appeared in the following sections in the articles: description, methodology, discussion, and conclusions. Furthermore, it should be noted that in almost all the articles, analyses of diseases were perceived as genetically related or genetically caused,14 and were carried out in terms of ‘racial membership’—the most frequent comparison made between ‘blacks’ and ‘whites’, with at times ‘Japanese’ or ‘Mexican Americans’ added to the comparison—without any account given of either the environment (including socio-cultural environment) or of environment-

11 General ones such as Jones et al. (1991), Race, Ethnicity and Genetics Working Group (2005), Ahdieh & Hahn (1996), and more specific ones such as Anderson & Moscou (1998). 12 For example, the declaration by the American Association for the Advancement of Science (AAAS) on science and the race problem (AAAS Committee on Science in the Promotion of Human Welfare, 1963). It called for a separation of issues of ‘culture’ and of ’nature’ referred to by the 1950s UNESCO declarations (AAAS, 1963). 13 There was some work, such as Napoleon Chagnon’s work on the Yanomamo Indians, which tried to relate genetic and linguistic indicators (see Neel & Chagnon, 1968; Chagnon & Irons, 1979). Genetics was the exception. The topics and questions discussed were similar to the rest of the journals, but research was predominantly carried out on non-human organisms, primarily on the ‘model’ ones (see Ankeny, 2000, pp. 251–261). 14 From the early 1980s on, some of the issues concerned with ‘race’ and with African Americans as a separate ‘race’ reappeared under the topic of genetic counselling, especially in relation to counselling for sickle-cell anemia screening. This disease was discussed already in the 1950s in the British journals as affecting both black and Mediterranean populations, and somewhat later as affecting also Indian ones (see a critical discussion of this in Wailoo, 2001, and from a different perspective, in Wailoo & Pemberton, 2006).

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genetics interaction.15 The interesting exception to the above broad generalisation were numerous articles in Genetic Epidemiology (GE) where ‘race’ classifications referring to families within a comparative research appeared mostly in the statistical tables, and not in the analytical parts. During this period the impact of advances in genetics soon permeated research in the epidemiological-medical journals, in which the divergence between British and American journals became more conspicuous. The American Journal of Epidemiology and the New England Journal of Medicine conceptualised their research methodology and causal explanatory mechanisms mostly on the basis of comparison of individuals who were considered members of ‘races’. For example, in a reply to criticism of an article on Alaskan children the author explained that by Alaskan registry standards ‘1/8 or more of native heritage in mixed-race parents is classified as native’ while the author looked upon it ‘as biologic characteristic based on the mother’s self report’ (Adams, 1986, p. 492).16 In the American journals, ‘race’ was conceptualised as a stable category of homogenous populations, particularly from the mid to late 1970s. Genetic Epidemiology began publication in 1984 as an organ of a newly constituted sub-discipline that programmatically intended to occupy a midway position between genetic reductionism and epidemiological emphasis on multi-factorial analysis of environment, the latter from the perspective of the specificity of individuals. Yet even in the epidemiology journals, environment was ‘translated’ through ‘race’ and when environment did form part of the discussion it included only education and income as factors. This poverty of the environment concept and/or its exclusion from explanation of disease in the American context made non-environmental differences among populations of the utmost importance and thus could, and did, lead to an increased use of ‘race’ as a causal factor. This is to be compared with the richer concept of the environment in the British journals surveyed. The articles checked the affected populations by ‘race’ and used ‘race’ as an explanatory category, primarily, though not solely, with ‘black’ and ‘white’ as analytic-etiological, or descriptive, or both. During the mid to late 1970s these constituted over half of the total published articles, rising to over three-quarters from the late 1980s on.17 In comparison with the American journals, comparisons in the British Journal of Medicine and in Lancet were drawn primarily in terms of ‘class’ with individuals discussed as members of a given class (the poor had been a traditional nineteenth and twentieth– century category of British social discourse).18 The explanatory causal mechanism was based on a rich concept of environment.

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When combined with ‘life style’ it included (in alphabetical order): clothing, education, family organisation, habits and customs, income, leisure, housing conditions, modes of outdoor diversions, neighbourhood characteristics, nutrition, occupation, psychological stresses, and unemployment. However, those who were not born in Britain, or who were the offspring of immigrants, were discussed under ‘class’, and were classified as members of immigrant (usually commonwealth) communities as well. Comparisons were drawn between the British immigrant communities and parallel communities in countries of origin. Yet statistics were not broken down by ‘racial origin’.19 One did find a growing realisation that Britain was becoming a country of diverse cultures and populations, with ‘ethnic minorities’ a significant sector of the poor, and furthermore, that there existed a growing quasi-institutional discrimination in the delivery of health care to these minorities, which by the mid 1980s was (for the first time) openly called ‘racism’.20 4.3. From the late 1980s to 2003 All in all, from the late 1980s and early 1990s until 2003 the same tendency as discussed above was in force. In the late 1980s, articles began to appear that reconstructed human evolutionary history, diversity, migrations, and so on, at first using nuclear and mitochondrial DNA analysis, and later on also making use of the (non-recombinant part of the) Y chromosome. In this context, some perceived the genome as including within it chronology as a ‘racial historical archive’. These genetic reconstructions of human evolutionary history were to a large extent based on an uncritical acceptance that classification of ‘races’ corresponded to geographical origins.21 Often they were devoid of any reflection on the possible contemporary political and cultural implications of such reconstructions. The assumed reality of such genetic reconstructions of human evolutionary history stemmed from the science in which they were produced, though implicit in it were also historical-cultural sources. Though there were some articles which discussed forensic uses of genetic research, it was only in the 1990s that possible ‘racial’ identifications became a component of such discussion and research.22 Most of the discussions of ethical issues related to counseling did not relate to ‘race’. During this period the Human Genome Project turned out to be a success. It is striking that the use of the category ‘race’ seems to have been much more prominent during this last period that I surveyed. In discussions of the genetics of behaviour,23 in articles on genetic counseling, or references to complex versus ‘one-gene based’ diseases, as well as in discussion of ‘admixtures’, ‘race’ came up in

15 There were some marked exceptions, such as Provine’s classic article on race-crossing (Provine, 1973, pp. 790–796); Neel’s published lecture (1974) in which he called on geneticists to turn their attention to such interactions, and particularly to nutrition. 16 Noteworthy exceptions were two articles in New England Journal of Medicine on sickle-cell anemia—a co-editorial (Desforges, 1971), and Motulsky (1973). 17 In the American Journal of Public Health, over half of the articles published on human populations between 1980 and 1989 used ‘race’ and ‘ethnicity’ (see Ahdieh & Hahn, 1996, as quoted by Trostle, 2005, p. 56). 18 From the late 1960s on there appeared, more so in Lancet, a much larger percentage of research articles that combined laboratory and clinical work, and ones that considered the issues involved in genetic screening and genetic counseling. 19 In one of the most impressive articles analysing the combined effects of class and poverty, J. N. Morris remarked on the dearth of information available on the other/additional sources of disadvantage, such as being a member of an ‘ethnic minority’, or becoming ‘new immigrants’ (Morris, 1979). 20 This becomes apparent in the discussions of inequality or discrimination in the health care system, in the notes on the health status (or rather non-status) of gypsies and ‘other travelers’, or the stipulation of immigration health examination rules of persons of ‘other colours’ than white. In 1980, already under Margaret Thatcher’s government, the health services report by Sir Douglas Black, and later by Marmot and McDowall, addressed these issues critically. This was reflected in a number of articles both in Lancet and in BMJ. The demographic context can be gleaned from a comparative essay (Tienda, 2005, particularly pp. 22–29). 21 L. L. Cavalli-Sforza’s project of Human Diversity can also be seen as part of this (see Cavalli-Sforza et al., 1993, pp. 639–646). See for example articles by Cavalli-Sforza, Zilinskas, King, and Beckwith, all in Smith & Sapp (1997). Even in Genetics there was a sharp increase from the mid 1990s in articles related to human genetics (more than forty annually) of which about a third dealt with genetic diversity and reconstructed evolutionary history, yet no rhetoric or classification which fitted with the conventional ‘race divisions’; see note 56. 22 Note a critical article by Lewontin and Hartl on the ethnic bias in misusing population genetics for forensic purposes, an issue that has become the subject of sharp debates up to the present (Lewontin & Hartl, 1991; see also Duster 2006a, b). 23 See for example the editorial in New Genetics in 1995 (Editorial, 1995); see also more recent articles in Parens et al. (2006). See also Allen (1999, 2001).

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genetics journals both directly and indirectly.24 It was only from late 2001 onwards—after another decade of enhanced use of the category of race—that a significant number of reflective and critical articles began to appear on the use of ‘race’ as a classificatory, analytic, and explanatory category, with some critics arguing that a connection existed between adopting genetic reductionism and the use of ‘race’. In the epidemiological and medical journals there was again a noticeable divergence between the American and the British journals.25 In the latter, ‘class’ and ‘environment’ remained at the core of the conceptual grid, though disease started to be related to ‘ethnic identity’ as well, and was perceived to be the result of primarily social and environmental factors, given that minorities were at the bottom of the social ladder in terms of housing, employment, income, education and environment, and in addition suffered from racism. In the American journals from sometime in the mid 1990s onwards, ‘race’ served as a principal factor in comparative studies. The case of infant low birth weight could serve as an illustration for the process whereby ‘race’ became not only a descriptive category, but also a causal substantive one, standing independently beside education, income, smoking, and lack of prenatal care. Note that eighty per cent of studies of infant mortality in the USA between 1990 and1996 made use of ‘race’ or ‘ethnicity’, in contrast to twenty-two per cent of those outside the United States (Anderson and Moscou, 1998, pp. 224–227). High risk factors were related to ‘race’, either via genetics or via epidemiology or both. This state of affairs reflected medical practices and serious inaccessibility to healthcare by this segment of the population— which often slipped through the Medicaid net. In fact, ‘race’ at times turned into a substantive category, to be included within the genetic grid. Some reflective critical articles were published in all the journals from the very late 1990s on. In most journals (with the partial exception of Lancet and to a lesser extent the British Medical Journal) there was little or no discussion of Third World diseases or the global health situation. 5. Correlations In this section I first present correlations between the findings of timelines and developments in the relevant research fields, and then address the relationship between the National Institutes of Health (NIH) guidelines that govern funding and the use of the category of race in American journals. 5.1. Developments in molecular genetics, epidemiology, and medicine When we correlate the journal articles in genetics, epidemiology, and medicine with the scientific developments in genetics, we see a common pattern: the implementation and ramifications of genetic discoveries in terms of research questions and research methods play an important role. Moreover, in genetics, there is a delay from the time of an actual innovative step until it is applied in run-of-the-mill research work. There is another

time lag—of some six to ten years at the beginning of the time span, but narrowing to a mere couple of years in the later part—before advances in genetics are carried over, transferred, and translated into medical/epidemiological research. This time lag is attributable to the fact that medical researchers had to begin perceiving genetics and its tools as relevant, usable, and applicable to their own practices, and learn the novel idiom. There were two crucial ‘tool inventing periods’: the decade from the early 1960s to the mid 1970s, and that from the early 1980s on. The decade from the early 1960s to the mid 1970s was crucial to the kind of investigations surveyed here. The genetic code was first deciphered and elucidated by Nierenberg and Matthaei (see Keller, 2000) and the first restriction enzymes were introduced in 1968. These were the first tools that made it possible to recognize and cut specific short sequences of DNA, and later on made it possible to map genomes. Several other important tools were added when the first recombinant DNA techniques were introduced and the first animal gene was cloned in 1972 to 1973. Immediately thereafter methods for rapid DNA sequencing were developed in 1975 by Sanger and his co-workers in England, and Maxam and Gilbert in the USA (see Kay, 2000). As indicated, another crucial period from the perspective of this paper was the early 1980s, both in terms of discoveries and of creation of tools. The implementation of the polymerase chain reaction—allowing the production of innumerable copies of a specific segment of DNA—and the method for positionally cloning a gene, and the creation of the first transgenic animals were of particular importance. New tools and methods proliferated during the 1990s in particular chips, as the central role of computing was enhanced. Though very innovative, these developments, from the perspective taken here, can be viewed as extrapolations from the preceding ones.26 They correlate with the somewhat rough periodisation suggested. They thus indicate the almost complete adoption of the ‘genetisation programme’. The predominant place of the ‘genetisation programme’ has meant that genes were perceived as the causal agents that constitute the foundation of all aspects of the lives of living organisms, including humans. Adopting the programme implied a certain view of human diversity, of development, and of the social-cultural world at large.27 As the programme dealt with isolated states of discrete individuals, it was instrumental in the disappearance of ‘environment’ as an explanatory factor within both the genetic and the epidemiological–medical conceptual grids traced primarily in American journal articles. Even when used as one of the variables, ‘environment’ became a much truncated concept, devoid of multifactorial social and life-style content. Furthermore, the ‘genetisation programme’ meant that human disease was viewed from the perspective of genetics. Thus scientific, social, educational, and economic institutions, as well as the complex of morals and moralia that form part of how human diseases are set within societies embracing medical care, diagnosis, and cure, were refashioned by genetic ideas, prac-

24 One interesting exception was a cluster of articles in Science in the late 1980s on the very eve of the upsurge of articles oriented toward genome mapping. These examined critically and reflectively the relationship between what was ‘genetic’ and what was broadly defined as ‘environmental’. They pointed to the long term, possibly intergenerationally transmitted, effects of poverty and to the possibly biased statistics on AIDS, implying that social-racialised views could count as the cause of such bias. On the exception of Genetics see note 56. 25 It is of interest to note that from around the mid 1990s, one could find numerous methodological articles in both Genetic Epidemiology and in the American Journal of Epidemiology. Dissatisfaction with solely epidemiological models in the investigations of complex diseases, the difficulty of amalgamating the genetic framework in such models, and discussions of causal attribution were topics often raised. 26 Susan Lindee (2005) claims that human genetics was transformed into an appealing field of medical research between 1955 and 1975, but that for some fields and institutions it was a much shorter period: genetic disease by mid 1950s; public health genetics, behavior genetics, cancer genetics, and biochemical genetics by the early 1960s; and human cytogenetics by mid 1960s. 27 Genetic reductionism and the ‘genetisation programme’ are discussed in the following: Allen (2002); Keller (1995, 2000); Hubbard (1997). See also Beurton (2000); Falk (2000); Griesemer (2000); Rheinberger (2000). Also see the discussion of these issues from other angles in Ankeny (2002); Kitcher (2003). Historically, Abby Lippman is credited with coining the term ‘geneticisation’ (I am grateful to Diane Paul for this information). On genetic causation see Cranor (1994); Gifford (2002). The implications for the social and the cultural are discussed from various angles in the following: Duster (1984, 2003); Kaestle (2003); Kittles and Royal (2003); Goodman et al. (2003); Templeton (2003); Wade (2002).

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tices, and technologies, including the individuals, their bodies, the family, and intergenerational relationships.28 Abstractly speaking, genetisation need not have enhanced the use of the race category. In the section below, ‘Individuals and collectivities’, I address this question. Another correlation came out clearly from the journals surveyed, one corroborated by the medical history literature; it seems that as the model of disease based on the germ theory was waning in importance once the load of these diseases became lighter for the West (and highly industrialised countries in general such as Japan), another model of disease, genetic disease, was rising in importance. In proportion to the rise of the genetisation of medicine and disease, scientific and political–institutional interest in those diseases that were not genetic but were devastating for the non-Western world subsided dramatically, unless they were conceived as an imminent danger to the West itself. By the third period in my survey, genetic disease has become ‘the only disease model’ even though genomic medicine has not yet quite delivered the cures, or even the diagnoses, hoped for.29 5.2. The relationship of the findings to NIH guidelines In this subsection I shall discuss how the timeline findings are related to governmental guidelines, such as those of the NIH, that direct the funding of research. I shall dwell in particular on the possibility that the frequent use of the race category in the American journals I surveyed was primarily (or even perhaps principally) the result of these guidelines. Going over the guidelines for researchers from the early 1970s onwards, I found that only in 1987 is the following recommendation encountered: ‘The inclusion of young women and minorities in the study populations, when appropriate, is encouraged’ (National Institutes of Health, 1987). Somewhat later such inclusion was recommended or urged. The 1991 guidelines changed ‘encouraged’ to ‘will be required to include’. This was once again reworded in June 1993 in the National Institutes of Health [NIH] Revitalisation Act signed by President Clinton. The 1993 formulation emphasised ‘differential effects’, namely, that women and members of minority groups and their subpopulations must be included, and added a list of racial and ethnic categories, to which ‘individual members belonged’: ‘American Indian or Alaskan Native . . . Asian or Pacific islander . . . Black, not of Hispanic origin . . . Hispanic . . . (regardless of race) . . . white not of Hispanic origin’.30 The NIH categories can be better understood in the context of the Office of Management and Budget (OMB) categories and their impact on the census, on the collection of statistical data, and thus

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on public health and medicine. The practice by federal authorities since 1790 of collecting racial data turned these vital statistics into self-evident ones. Though the census categories had changed since the first census of 1790, and were entwined with those of the OMB, they have always been considered as ‘racial/ethnic’. The 1994 NIH five race categories are a reflection of the process these categories had undergone during the 1980s. In the OMB usage the categories of ‘races’ are presented as reified distinct entities, though it is not clear whether they are so genetically, medically, socially, or whatever else. They thus created these very groups as objectively factual; however, examining the parameters reveals a medley of distinctions such as colour, culture, country of origin, race, ancestry, and ethnic origin. They are then made robust by public health data collections, which in turn serve as reservoirs of data for researchers, who unreflectively organize their work on this foundation.31 Furthermore, both in the census and in the majority of the articles of genetic, medical, and epidemiological research they were conceived and treated as referring to homogenous groups of similar individuals, which were then investigated and sometimes found to harbour differences or diversities—genetic, medical, or others. Though many articles claimed that these categories were merely pragmatically heuristic, yet as often as not, convergences between genetics and the OMB and census categories tended to be claimed, thus donning scientific robustness to administrative distinctions.32 Most researchers looked for differences rather than for common denominators, and these supposedly were to be organised along the axis of populations, but as a matter of fact they were organised along ‘races’, primarily in terms of mapping single nucleotide polymorphisms (SNP) (Sismondo, 2004; Turnbull, 2004). Presumably the Genome concept allows for individualised aggregations, but the search there too is for genomic variation, and there has been an emphasis on ancestry. Perceptions of ancestry were used as a guideline for classification into groups that were then presented as supporting racial divisions. Both variation and ancestry were often presented genetically along OMB/NIH ‘racial’ categories—supposedly for economic (mostly pharmaceutical) considerations— particularly when discussing drug reaction and disease susceptibilities. The OMB categories (and derivatively the NIH ones) have not been indicative of social processes, or social stratifications. Being administratively fixed, they can easily be perceived as indicating ’real’ divisions—simultaneously biological and social. The use, therefore, of ‘ethnic’ by American authors often concealed a perception of clear cut divisions into ‘races’33, which were related at times to hereditary traits, sometimes to racialise, sometimes to advance the interests of a discriminated sector. In the British use, on the contrary, ‘ethnic’ belonged to the discourse

28 ‘If the genome begins to override culture, then all citizens must rise up and insist that social bonds are what make us people. But we must also understand that knowledge of genetic ‘‘identities” will forge social ones, creating new communities of shared recognition based on partial science’ (Hacking, 2006, p. 87). 29 Lindee (2005) argues that technologies played only a partial role in the development of the mapping, and that the ideological drive of both scientists and physicians to constitute a coherent narrative of the persistence of particular diseases in human populations was also important (Lindee, 2005, pp. 88–89). However, by its construction of plastic futures, this development has allowed both massive state intervention and intertwining of corporate culture. On the complex issue of genomic medicine, see Wailoo and Pemberton (2006). 30 See the following guidelines for researchers: NIH (1980, 1982, 1987, 1989, 1995). The 1989 formulation, though stronger, was still typical of the non-obligatory rhetoric; the 1995 formulation is more detailed. An enlightening discussion on the preliminary debates around the census categorisation of 2000 can be found in Wright (1994); see also State Office of Financial Management (2001). Present-day discussions of these categories in the next census can be found in the Winter issue of Daedalus (2005) that was dedicated to ‘race’. A detailed discussion of the Office of Management and Budget (OMB) categories, their past history and contemporary debate can be found in Yanow (2003), particularly in Chapters 2 and 3. The main point relevant here is that from January 1980 on, formulated in OMB statistical Policy directive no. 15, these categories were defined universally and uniformly codifed to be applied to all federal agencies, including the Bureau of Census. A correlation between these categories and the guidelines categories is apparent. The main difference between the 1990 and the 2000 categories is the significant addition of the category of ‘other’, allowing the respondents to the questionnaire a measure of selfidentification, and also the choice of more than one category. 31 Unless they initiate their own categories for independent data collection, at least from the 1960s until the late 1980s, it seems that in many cases the vital statistics provided were broadly inaccurate in the case of ‘blacks’, yet were judged to be reliable for ‘ethnic comparisons’. Laumann et al. write: ‘The General Social Survey estimates for AIDS cases suggest that the data provided to the Centers for Disease Control may underestimate by a substantial margin the prevalence of AIDS in the white population of higher socioeconomic status, overstate the relative prevalence of the disease in the minority populations, underestimate the prevalence of the disease in the Midwest, and overstate it for the East’ (Laumann et al., 1989, p. 1186). 32 See articles in Daedalus (2005), as well as Gates (1997); Graves (2001); Smedley (1999); Trostle (2005); Wright (1994); Yanow (2003). 33 Helen Macbeth argues that ‘Ethnic groups are not only hard to define socially but cannot be delineated biologically’ (Macbeth, 1997, p. 64).

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concerning ‘nation’ and the boundaries of inclusion-exclusion in it (Anthias & Yuval-Davis, 1992). Looking at the NIH in that context one notes the de facto double message of the guidelines. Originally they were created by virtue of an individualised-liberal point of view (and thus on the one hand the strong emphasis all the way through on ‘individuals’ rather than on groups, on the other hand the injunction to include a variety of populations) in order to include populations that did not form a self-evident part of the research. But in fact, the guidelines furthered the division and segregation of populations, partially because they refused (by virtue of the selfsame perspective) to take into account class, environment, and styles of existence as dividing/classifying categories. Instead, like the OMB, they applied the same medley of parameters that were applied in a socially preselective manner. These categories were constructed from a specific perspective of comparison, a perspective that points back to the authority which has the power to prescribe the social and legal construction of difference. The guidelines of the NIH and of other funding agencies were not responsible for initiating the frequent use of the category of race in the research articles. One should distinguish between including a variety of populations and looking upon this variety as falling under an appellation of ‘race’ as a classificatory, and/or analytic, and/or explanatory, and/or substantive category. The guidelines joined and linked with other factors in enabling an already widely used existent grid to be indirectly vindicated.34 One should perhaps add a sequel: In October 2001, the NIH amended the ‘Policy on inclusion of women and minorities in clinical research’. The NIH adopted the 1997 OMB ‘revised minimum standards for presenting data on race and ethnicity’ both in recruitment and in statistical analyses (National Institutes of Health, 2001), that is, the new census regulations of 2000 that allowed for self-identification and choosing more than one category. 6. Individuals and collectivities This section discusses the conceptualisation of individuals and collectivities in the entanglement of genetics and medicine. In the mid 1940s there was an attempt both in Britain and in the United States to establish a nationwide public health system. It failed in the United States, but was successfully carried out in Britain. Both success and failure had a deep impact on the modes by which health and disease were investigated, conceptualised, and causally explained. This has to be factored in addition to other findings mentioned earlier, such as the predominant role of ‘race’ as a constant component in the identity of individuals within the conceptual grid used in American-authored articles and the observed tendency of British authors to use ‘class’ (and ‘environment’) within their grid. In American-authored articles there was a consistent use of ‘race’ as a mere aggregation of similar (racialised) individuals.35

Note that in the historical process of constructing ‘race’ as type—that is, casting human diversity into types called ‘races’—individuality and fine-grained variety became effaced and ‘races’ were turned into groups of ‘similar individuals’ identified by common specific external traits that became markers by being selected to fulfill that function, such as skin colour. British-authored articles dealt mainly with communities, that is, groups with inner relationships, social, and cultural ties, and a certain level of cohesiveness. Medicine and epidemiology in the United States were geared towards the treatment of discrete individuals, as was (and still is) the pharma-genomic rhetoric of individualised medication. Articles on community-based medicine in all the American journals were by British and Canadian authors (Canada has a nationwide health system). The vast majority of American-authored articles dealt with isolated states, with discrete individuals, rather than dealing with cases from a life course perspective or within an interrelated social environment. Articles that dealt with groups as complex systems in given environments, and considered intragroup interactions, were extraordinarily rare, even in epidemiology-oriented articles. No attention was paid to population/group attributes that could not be reduced to those of individuals. The only grouping concept found was that of ‘race’. Thus, ‘race’ was a powerful determinant of health, defining both class and environment. Until the 1990s one could find in American-authored articles suggestions that, given the discrepancy between those groups with statistically ‘good results’ and those with ‘bad ones’, perhaps one should have factored into the analysis varying ‘racial standards’ that would then account for the gap. Examples of this include the gap in pre-term deliveries, in low birth weight, in hematological parameters, in renal diseases, in early hypertension, in cardiovascular diseases, in susceptibility to various diseases such as tuberculosis and syphilis, in the frequency of ‘abnormal genes’, in being the carriers of ’bad genes’,36 and in the overall effectiveness of various childhood vaccinations, in ‘black’ and other groups. In spite of the fact that the issue of risk37 has been central to epidemiological thinking (in contrast to medicine), both in terms of individuals (in which case one speaks of relative risk), and of groups (in which one speaks of attributable risk), and that the genetic perspective is inherently related to the estimate of risk, there was little mention in American-authored articles of relative risk, and even less of attributable risk. Their number (even in the American Journal of Epidemiology) went down after the mid 1970s. Furthermore, discussion of ‘risk’ usually did not appear whenever a ‘race’ classification appeared.38 The idea of a distributive supply of health care—according to risk—was never raised there. In Genetic Epidemiology it was related to modern societies or to those undergoing rapid industrialisation through a globalised economy. From the late 1980s high risk factors were related to ‘race’, either via genetics or via epidemiology or both. Geneticists have looked for differences within populations and differences among populations, and how they were transmitted.

34 ‘The dilemma of difference grows from the ways in which this society assigns individuals to categories and on that basis determines when to include in and when to exclude from’ (Minow, 1990, p. 21). ‘The meaning of difference cannot be eradicated . . . as long as the majority locates difference in a minority group that does not fit the world designed for the majority’ (ibid., p. 24). Though the grid referred to is one of scientific practice, I argue that its roots were to be found in social-political practices described by Minow. 35 Troy Duster in one of his articles (2003) argues that the trouble with the forensic use of DNA for ‘race identifications is that DNA analysis came out as a real entity, while social relations were problematic in terms of the identity of individuals (Duster, 2003, p. 267). 36 One exceptional article by Muntaner et al. appeared in 1996 in the American Journal of Epidemiology (Muntaner et al., 1996; see also Muntaner et al., 1997). It got very critical responses and the authors re-emphasised their points in an additional letter claiming that ‘we view the pragmatic, consensual, and theoretical use of ‘race’ in epidemiology as a case of implicit genetic determinism’ (Muntaner et al., 1997, p. 607). They argued that this was popular among authors, because they preferred ‘short term practical success over the quest for deeper but less popular explanations such as racial discrimination or social class exploitation’ (ibid.). On aspects of reproduction and its investigation, see Strathern (1992). The authors who suggested this line of reasoning concerning ‘blacks’ and TB were criticised in letters to the editor. They replied that ‘we realize that our observations have served to help unravel the vagaries of host-parasite relationship’ (1990, 1672). 37 Even though this is one not necessarily of our own making. On the connection between risk and contemporary societies, see Beck (1992); Giddens (2000); Douglas & Wildavsky (1982); Strathern (1992). See also, from a very different angle, Jasanoff (2005). 38 See also Hacking (2006), p. 89, ‘The genetic imperative is the drive to find genetic markers in humans. It commands out of its own intrinsic strength, but it fits in neatly with our ‘‘risk” society’. In medico-genetic articles, ‘race’ could come up in analysis as a risk factor. Rather than indicating ‘race’ as a biological cause, it indicates that social environments where racism is rampant may have biological consequences.

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That search was ordinarily formulated in terms of discrete, individualised, reductive units (such as that on genetic linkage) divorced from issues such as interactive processes over time, for example with environments. This epistemological perspective (and its ontological consequences) have permeated medical and epidemiological thinking and practice.39 It coincides with both the individualised liberal perspective (as expressed, for instance, in the formulation of the NIH guidelines) and that of methodological individualism in social thought. The differences in human genetic variation have been assumed by numerous researchers to fall into ‘big clusters’ that were regarded as corresponding either to continental-geographical origins and thus as situated on a continuum, or else to clear divisions into naturally bounded entities. Both these modes of regarding groupings of individuals were called ‘race’ by American authors. Moreover, they were named in accordance with some version (depending on time and place) of the OMB categories mentioned earlier, all of which assumed similarity among individuals to be understood in scientific contexts as genetic homogeneity. Somewhat analogously, articles on evolutionary history assumed that observed differences among individuals would be explained by differences on the DNA level, yet the human genome was assumed to be common to all individuals,40 and yet again these reconstructions of some evolutionary past created new collectivities, based on ‘genetic common ground’. I suggest that in Great Britain and in the USA authors felt the need for some ‘grouping together concept’ on the various levels of their work, the classificatory, the analytic, and the explanatory. This need was differently addressed in the two countries and in the various fields of investigation. In genetics and medico-genetic journals where most of the research was carried out based on individualised assumptions, ‘race’ supplied group frameworks of presumed similar individuals with identical abnormalities. Alternatively ‘isolates’ could furnish an ideal-type model of grouping, clearly bounded and delineated, which could underpin the actual use of ‘race’, though clearly no correlation could be found between such groups and the ordinary race category. In British journals ‘class’ concepts furnished the sought-after group framework in medical/epidemiological work. These were modified by being checked against concepts such as ‘immigrantcommunity’ and ‘country-of-origin community’. It may seem that after 1945 the rhetoric of individualism and of ‘equal opportunity’ in the US, and that of ‘equality of access to services’ in the UK, served a somewhat similar function in the practices and self-image of either ‘republican democracy’ and of the ‘welfare state’, and was intertwined with the genetic, medical, and epidemiological research discourse of ‘race’.41 7. Journal articles by Israeli authors This section discusses articles authored by Israelis as a particularly revealing case in comparing the continuous use of the race

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category in the journals surveyed.42 Since it was established, Israel has been a country of an almost constant influx of immigrants, with some coming as part of large groups, with emigration from their native land supported by the state, and others coming as individuals. Also relevant is the fact that until recently the organisation of the Israeli health system bore many similarities to the British one. Moreover, since the end of World War II, Britain at first—but soon thereafter the US (instead of Germany)—became the role model in research and the sought-after place of specialisation for Israelis in genetics, epidemiology, and medicine. Publication in the journals surveyed came about some ten years later. From the late nineteenth century until the late 1930s the terms ‘race’, ‘races’, ‘racial stocks’ and so on, were used by Jews in much the same way as by many non-Jews.43 They were applied by Jewish authors either to the collectivity of Jewish communities as distinct from non-Jewish groups, or to groups within that general body. In the latter case a distinction was made between individuals according to birthplace or ancestry—Asheknazi or Sephardi.44 From the the late nineteenth century onwards there had been an ongoing, rather divisive, debate among Jewish physicians, Jewish thinkers, and Zionist activists regarding the validity of following set of statements: a) All the communities identified as Jewish stem (do not stem) in one way or another from the original Jewish communities living in ancient Middle East. b) There is (is not) much more in common among members of such a community than between any such Jewish community and the non-Jewish people among whom they lived. c) The difference between the two main components of the Jewish Diaspora—Ashkenazi and Sephardi—is mainly cultural (biological). After the State was established in 1948, Israeli geneticists and epidemiologists went on looking into questions focused on the issue of the biological unity underlying diversity, or alternatively, the biological diversity in spite of assumed unity of the Jews. I viewed the Israeli authored articles from a comparative perspective and thus my guiding questions revolved around issues similar to those discussed earlier.45 The following features stood out: 1) Except for a single article in 1959,46 the race category was never used between 1946 and 2003. The vast majority of the articles implicitly assumed a differentiation of the Israeli Jewish population according to country of origin or the country of origin of parents. While drawing distinctions along those lines, all who were European-born were considered as one group, while those born in the Eastern Middle East, in North Africa, in Africa more generally, and in the Arabian peninsula were divided into much more particulate groups.

39 Both Nelkin and Lindee (1995), and Keller (2002), argue that there has been a tendency in recent biological discourse to move away from the purely linear model of gene action, to a change of metaphorics, to networks of interactions. See also Kerr (2004). 40 As explicitly claimed in an article by Haga & Venter (2003). 41 It was widely publicised by the political Right (especially in Britain and Europe) in their defense of the existing order, and when expounding on their perceived dangers of immigration. 42 I shall not consider here the works of Israeli geneticists or physicians in general. On the Israeli geneticists see Kirsh (2003). 43 Of the rather large body of work on this, see Efron (1994); Falk (1998, 2006); Hart (2000). 44 Those from most of continental Europe and the British Isles (Ashkenazi), and those from around the Eastern Mediterranean, the Eastern Middle East, in some parts of Africa or in the Arabian peninsula (Sephardi). 45 I surveyed articles by Israelis in: Science, mostly from late 1980s on (few); American Journal of Human Genetics from the mid 1970s onwards; Genetic Epidemiology from 1986 onwards; Nature Genetics from 1995 onwards; the American Journal of Epidemiology from 1967 onwards; the New England Journal of Medicine from early 1980s (very few); the Lancet from late 1940s on (very few), and since the mid 1990s (more); the British Medical Journal from recent years only (very few). 46 This article was published in the May 1959 issue of the Lancet and dealt with the levels of blood lipids among ‘Jews from Yemen’ and ‘Jews from Europe’ (Brunner et al., 1959). Its authors, Brunner, Manelis and Loebel, were associated with a non-university hospital and they identified themselves by the places where they received their MD (Vienna, Geneva, and Bucharest). I would suggest that the peripherality of the article’s authors to the Israeli research system at the time might explain this extraordinary usage.

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2) When drawing comparisons between Jews and non-Jews in Israel all the Jews were regarded as a single group, while ‘Arabs’ (that is, Israeli Palestinians) were considered one entity and Bedouins and Druze were considered as two other separate entities. 3) Even in the medical and epidemiological journals there was an extraordinarily limited, and rare, discussion of ‘environment’ in its social-economic and cultural aspects. 4) No class distinctions were ever drawn; ‘class’ was hardly ever used as an explanatory or analytic category. 5) There was no difference between these articles and the general body of articles researched in terms of methods used in the relevant time periods. 6) The only difference found in terms of the types of questions asked was that a higher proportion of articles dealt with clusters of diseases usually considered more characteristic of specific groups of ‘the Jewish communities’, for example Tay-Sachs, Gaucher, and so on.47 7) A total absence of articles reflecting critically on the differentiations and distinctions mentioned above, their role in the research, and their possible scientific and/or cultural implications. The differentiations into various ‘groups’ or ‘units of research’ in these articles were not strictly ‘biological’. This became clear upon a closer examination of the criteria for distinguishing between groups within the Jewish population and between these and non-Jewish ones. I found a variety of distinctions whose underpinning was that of population genetics side by side with cultural-contextual and even religiondependent ones.48 These distinctions functioned in a more multi-layered mode than the category of race. On the one hand, Jewish population was perceived as consisting of one homogenous group, and accorded a substantive status when considered in relation to non-Jewish groups. On the other hand, when looked upon from the point of view of inter-Jewish comparisons, distinctions were perceived as those among heterogeneous groups along non-physiological lines. These distinctions were constituted as self-evident, and thus as ‘natural’. Inside the Jewish population at large these ‘internal’ distinctions were used in classificatory-descriptive, analytic and explanatory modes, in an analogous manner to the modes in which the category of race was used in the general body of articles. The almost total absence of the terms ‘class’ and ‘environment’ enhances the analogy. Recalling the frequent use of ‘race’ among Jewish authors and researchers before World War II, it seems that the avoidance of the term after the war indicates a consistency and perseverance worth questioning. I would suggest that the avoidance of the term ‘race’ for more than sixty years does not mean that the units of classification called ‘ethnic communities’ or ‘ethnic groups’ (in Hebrew edot) and so on were not conceptualised and used in an analogous manner to that of ‘race’ as it functioned in numerous American-authored articles. Rather, it indicates the existence of a powerful, cultural-emotional barrier concerning the use of ‘race’ in post-war Israeli society. This barrier prevented Israeli-Jewish

authors from reflecting on their use of ‘ethnic distinctions’, let alone on the possible analogy with and similarity to the use of ‘race’ as deployed by other authors in the selfsame journals. It would seem that Israeli-Jewish authors who used these differentiations and distinctions in their research felt they were exempt from reflecting on their plurality of meanings, their significance and their multiple roles. There is no ‘race’ in Israeli-authored works, no reflection on it, but a plurality of ‘quasi race’ uses, implicitly adopted.

8. Discussion of the critical-reflective positions Various critical positions on ‘race’ have recently been formulated, some shunning its use, others trying to find some room for a modified or ‘purified’ race concept. One should add that since around 2002 publications on the relationship of ‘race’, genetics, and medicine have to be counted in the hundreds. (A comparative cross-survey using Google and the journals’ search engines yielded close to 2,000 such articles). The following is a brief summary of the main critical positions between 1999 and 2003 that I found in the journals I surveyed.49 The first cluster of positions were those that while criticising what they termed the use or the reinscription of ‘race’ into research on the molecular level, would nonetheless see a host of reasons why it could not be completely purged from these scientific fields, and urged that it should be carefully delimited to specific uses. The common ground of the various positions was that ‘race’ served as a prominent category either in medical/public health or health policy research and practice, or in the long term accumulation of vital statistics that had been the foundation of such research. Those who held these positions suggested certain ways of setting up boundaries, making precise or reformulating either the meaning-in-use of ‘race’, the scope of its application, or the modes of its interpretation, including those found in evolutionary history research. They agreed that it could not be used causally. They pointed out the difference between measuring public health disparities through this category, using it as an indicator to discriminatory practices on the one hand, and on the other hand using it to classify and explain (reify ‘racial’) diseases, especially genetic diseases.50 The second cluster of positions called for completely banishing or purging ‘race’ from both genetics and biomedicine. Those who held these positions called upon the relevant scientific communities to find another, more sophisticated, classificatory mechanism that would capture the differences that could only barely correlate with the then existing ‘race’ categories and divisions.51 They called for the renewed use of interactive social and environmental categories for which ‘race’ served as a proxy and for rethinking the implications—scientific, social, and political—of its continued use. They claimed that the use of ‘race’ prevented researchers from distinguishing between what were proper and what were biased value systems in scientific practices. Many articles within this cluster related the use of ‘race’ within genetics to reductionism and/or determinism. They argued that any use of ‘race’ carried with it the penumbra of historically biologised ‘type thinking’ about humans.

47 For example, high frequency of BRCA1 mutations related to breast cancer in Ashkenazi Jews, certain Thalassemias (Alpha and Beta) and Familial Mediterranean Disease in Sephardic-Middle Eastern Jews. See also Goodman and Motulsky (1979); Motulsky (1995). In 1979, Karlin, Kennet and Bonne-Tamir claimed that it was reasonable to assume that ‘Jewish diseases’ were an artefact of intense data collecting among Jewish populations (Karlin et al., 1979). 48 Population genetics had, indeed, as argued by Gannett (2001), expunged the use of ‘race’ as a type, but this did not exclude ‘race’ at large from biological considerations. 49 In 2000 the United States Congress passed the Minority Health and Health Disparities Research and Education Act of 2000 (Public Law 106–525) which gave a mandate to the National Institutes of Health to support research on health disparities between groups designated by race/ethnicity. Geneticists too were mobilised into this endeavour. 50 Some examples for the first cluster would be an ambivalent article by Kaufman and Cooper in the American Journal of Epidemiology in 2001, and their answer to invited commentary appearing in same year (Kaufman & Cooper, 2001a, b); Sankar & Cho in Science (2002); Burchard et al. in the New England Journal of Medicine (2003); a reply by Nelson to a suggestion by Sankar to revise definitions on Medline, in Nature Genetics (Nelson, 2003). 51 They argued that no polymorphism that could define ‘race’ was ever found nor could be found.

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Articles within both clusters warned against a possible racist use of genetics both in forensics and in pharmaceutics.52 Critical articles in the years after 2002 and 2003 continued the debate, while extending and refining the arguments in both clusters to apply to both genomics/haplotype research and pharmacogenomics.53 The construction of the ‘race’ category in the various journals showed nuanced emphases, depending on the scientific context of the researchers, whether medical-epidemiological or genetic. The one consistent exception to the use of ‘race’ was Genetics.54 I would argue that the complete absence of the rhetoric of ‘race’ and of ‘ethnicity’ was due to a scientific (publishing) tradition that mostly did not do research on humans, and thus organised its groupings along different conceptual axes (see Section 6 on ‘Individuals and collectivities’). All authors assumed certain generalisations that have been widely agreed upon and accepted since the early 1970s on the use and need for ‘race’ in genetic, medical, and epidemiological research, namely that: a) There is greater diversity within groups than among groups. There has been agreement on this point since 1972 (see Lewontin, 1972, 1982, and Barbujani et al., 1997), but there is disagreement on the biological significance of this intragroup diversity.55 b) Genetically, statistically, and culturally it is difficult to delineate clear-cut dividing lines between ‘race groups’. There is almost unanimous agreement on this point. There have been discussions regarding gradients, clines, and the changing boundaries depending on the traits chosen. Even those who adhere to a so-called ‘geographical view’ of ‘races’ would assent that this division is not as smooth and coherent as it sounded. c) Only in rare ‘isolates’ in which marriage/mating have a parallel significance biologically and socially (for example the Amish researched by McKusick; see McKusick et al., 1964; Francomano et al., 2003) is there a correspondence between the DNA (and mutations) load and the socio-cultural distinction. (Thus, many would agree that the use of ‘races’, whether viewed as ‘biological entities’ or not, may be far too simplified and crude a division in comparison to sociocultural factors). Once the sequencing of a version of the human genome was accomplished, the question arose: ‘What did it clarify about being human?’ Possible answers had to confront, on the one hand, the

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accumulated and controversial disparity between the use of ‘race’ and genetic findings, and, on the other, a new geopolitical context.56 The range of positions of the practitioners in these fields had its parallel in the writings of sociologists, anthropologists, historians, and philosophers concerned with these fields. At times, the arsenal of arguments, the sophistication of historically laden analyses, and the reflective discussions of latent motivations and of implicit disciplinary and institutional interests have presented a rich and wide spectrum of views.57 However, underpinning all the reflectively critical positions there are the following three principal issues: a) Is there or is there not a correspondence, correlation or mere association between genetic-biochemical-genomic distinctions and any current version of racial classification? b) Given that in some societies (such as the United States) ‘race’ is a social and administrative category, should ‘race’ be adopted as a signifier of practices of stratification and hierarchisation relevant to genetic, medical, and epidemiological research, or on the contrary, should it be eliminated? c) Can any concept that has had a long social, political, and cultural history and a readily evident range of deployments, be neutrally used ‘in the sciences’, or be reformed in a way that would make it non-referable to its former modes of use?58 It should be clear that these issues can hardly be resolved by resorting to so-called facts or to supposedly straightforward simple values. It seems that scientists in these fields are caught in a predicament: even when they do not use ‘race’ as an explanatory (deterministic) or substantive category, they find it extremely difficult to extricate their discussion from this ‘variable’ when dealing with human differences. Within this context medicalisation and genetisation are perceived by some of the critics as legitimating discrimination and hierarchisation based on either implicit or explicit ‘racism’. 9. Conclusion My circumscribed task of looking at the uses of the category of race in a number of disciplinary journals had its obvious limitations, but it also afforded an in-depth long-term view at runof-the-mill work relating to ‘race’. I have argued that ‘race’ has been a protean hybrid at the interface of the social and the biological. My overview has shown that to a large extent it has never been banished from that ‘territory’. Thus classificatory categories could give an insight into the social character of scien-

52 Examples of the second cluster would be an editorial in Nature Genetics in 2001, indicating new ‘race-less’ directions (Editorial, 2001); invited commentary to Kaufman and Cooper by Jones in the American Journal of Epidemiology in 2001 (Jones, 2001); a more articulated position by these authors in a later article together with Ward in the NEJM in 2003 (Kaufman et al., 2003); and various discussions of individualised medicine and pharmacogenetics, such as Calafell writing in Nature Genetics in 2003 (Calafell, 2003). 53 Two critical articles from the American Psychologist in 2005 exemplify the multilayered ‘second-wave criticism’ (Ossorio & Duster, 2005; Shields et al., 2005). 54 Here, until the very beginning of 1990s the overwhelming majority of the articles, even when dealing with issues of human genetics, were either on possible inferences from work on drosophila, or on mutant/transgenic mice. From 1996 onwards there was a marked leap in the number of articles that dealt with issues of human genetics, though still primarily based on results with non-human organisms. Earlier, the increase had been from hardly any to around two to four annually, then to about ten. After the mid 1990s the number rose to over forty annually, about a third of which dealt with comparisons of human populations. They discussed differences among these in terms of various aspects of genetic diversity (including, from 1998 onwards, haplotypes) and reconstructed migratory–evolutionary history. In 1997 in an article describing population sampling from Asia/ Africa, it was defined as ‘race related’ (Hutchin & Cortopassi, 1997). In general, very few usages of it appeared at all, and when ‘race’ was used it was in relation to flora (for example maize) and fauna (for example drosophila). 55 This agreement has been somewhat undermined by recent interpretations. Hacking’s 2006 article expressed this by bringing in views that offer a refutation of Lewontin, such as Edwards (2003), and what he sees as a change of position from the claim that ‘race’ has no biological meaning (such as Editorial, 2001) to one that he reads to be a more nuanced position (such as Nature Genetics Editorial, 2004): See also Jorde & Wooding (2004) p. 28: ‘We review the results of genetic analyses that show that human genetic variation is geographically structured . . . clustering of individuals is correlated with geographic origin or ancestry. Clustering of individuals is also correlated with some traditional concepts of race, but the correlations are imperfect because genetic variation tends to be distributed in a continuous overlapping fashion among populations’. 56 The past decade has brought with it a sense of entrance into a new era of economic strains and social tensions between the ‘first’ and the ‘third’ world within the framework of globalisation, in addition to a concurrent intensification of social stresses within many ‘first world’ countries with large immigrant populations. 57 For well formulated representatives of the range of positions, see Duster’s corpus of works, Marks’ latest book (1995), and recent articles by Tempelton (1998, 2003), as well as by Shields et al., 2005). 58 Note that Yanow, whose book deals with the history and current use of American administrative race/ethnicity categories, and who did not discuss any biomedical implications and ramifications of these, said that in present day categories, which started as free/slave, then white/black, ‘The colour based origins story has been replaced with one told through geographic terms alone’ and calls for a radical purge, as any origin tales can be told ‘without recourse to the language of race or ethnicity’ (Yanow, 2003, p. 201).

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tific knowledge. At the core of this are the ways and modes through which the social fashions, forms, and produces the biological, which in turn informs the social; this is a continuous and simultaneous process of spiraling co-productive interaction.59 These processes were merely hinted at as if they existed ‘out there’, rather than as part and parcel of the authors, the journals, their disciplinary fields, their ongoing practices and institutions, all of them together forming the web of relations among the social in its widest sense, the genetic, the medical, and the epidemiological: a web in which ‘race’ has played a continuous role, constantly evolving and constantly being transformed. In addition, however, there is also the novel genetic mode of thinking, all the more so since the early to mid 1960s, with its various subsequent transformations, its proliferation into all the life sciences and all the disciplines dealing with humans, its entrenchment in institutions, interests, and social and economic practices. The fact that research in genetics, and consequently in medicine and in epidemiology, chooses to focus on ‘individualised differences’ that could be translated into group frameworks seems to indicate that there had been a prior assumption of ‘real classificatory groupings’. I would suggest that adopting the category of ‘race’ implied adopting the value systems and epistemological commitments within whose frameworks it had functioned as meaningful. And within this context there has been both continuity in and reconstruction of its roles within the genetic/medical discourse. Acknowledgements I have benefited from participation during the academic year 2004–2005 in the Van Leer Institute of Jerusalem research group on Race, Racialisation and Racism in Israel. I would like to thank Rafi Falk for his helpful comments on the early outline of my paper; Gar Allen for his concise and helpful critical comments on an earlier version of the paper; Diane Paul for a stimulating discussion and comments on an earlier draft; Soraya de Chadarevian, Joan Fujimura and Ilana Löwy for their encouragement and support in later stages; the two anonymous reviewers for their extremely helpful critical comments, and Sam Schweber for a careful and perceptive reading and comments on the article in all its stages. I am also deeply grateful to Everett Mendelsohn, whose assistance enabled me to use the rich resources of the Countway Medical Library and of the other Harvard libraries, without which this work could not have been carried out.

References AAAS Committee on Science in the Promotion of Human Welfare. (1963). Science and the race problem: A report of the AAAS Committee on Science in the Promotion of Human Welfare. Science, 142(3592), 558-561. Adams, M. M. (1986). The author replies. American Journal of Epidemiology, 124(3), 492–493. Ahdied, L., & Hahn, R. A. (1996). Use of the terms ‘race’, ‘ethnicity’, and ‘national origins’: A review of articles in the American Journal of Public Health, 1980– 1989. Ethnicity and Health, 1(1), 95–98. Allen, G. E (1999). Modern biological determinism: The ‘violence initiative’, the human genome and the new eugenics. In M. Fortun & E. Mendelsohn (Eds.), The practices of human genetics (pp. 1–23). Dordrecht & Boston: Kluwer Academic Publishers. Allen, G. E. (2001). The biological basis of crime: An historical and methodological study. Historical Studies in the Physical and Biological Sciences, 31(2), 183–222. Allen, G. E. (2002). The classical gene: Its nature and its legacy. In L. S. Parker & R. A. Ankeny (Eds.), Mutating concepts, evolving disciplines: Genetics, medicine and society (pp. 11–41). Dordrecht & Boston: Kluwer Academic Publishers. American Psychologist. (2005). 60A (January).

59

On co-production, see Jasanoff (2004).

Anderson, M. R., & Moscou, S. (1998). Race and ethnicity in research on infant mortality. Family Medicine, 30(3), 224–227. Ankeny, R. A. (2000). Model organisms as models: Understanding the ‘lingua franca’ of the human genome project. Philosophy of Science, 68D(Suppl.), 251–261. Ankeny, R. A (2002). Reduction reconceptualized. In L. S. Parker & R. A. Ankeny (Eds.), Mutating concepts, evolving disciplines: Genetics, medicine and society (pp. 127–142). Dordrecht & Boston: Kluwer Academic Publishers. Anthias, F., & Yuval-Davis, N., in association with Cain, H. (1992). Racialized boundaries: Race, nation, gender, colour and class and the anti-racist struggle. London: Routledge. Balibar, E., & Wallerstein, I. (1988). Race, nation, classe: Les identités ambigües. Paris: La Découverte. Barbujani, G., Magagni, A., Minch, E., & Cavalli-Sforza, L. L. (1997). An apportionment of human DNA diversity. Proceedings of the National Academy of Sciences, 94, 4516–4519. Barkan, E. (1992). The retreat of scientific racism. Cambridge: Cambridge University Press. Beck, U. (1992). Risk society: Towards a new modernity. London: Sage. Beckwith, J. (1997). The responsibilities of scientists in the genetic and race controversies. In W. Smith & W. Sapp (Eds.), Plain talk about the Human Genome Project: A Tuskegee University Conference on its promise and perils and matters of race (pp. 83–94). Tuskegee: Tuskegee University Press. Beurton, P. J. (2000). A unified view of the gene, or how to overcome reductionism. In P. J. Beurton, R. Falk, & H. J. Rheinberger (Eds.), The concept of the gene in development and evolution: Historical and epistemological perspectives (pp. 286–314). Cambridge: Cambridge University Press. Boyd, W. C. (1950). The use of blood groups in human classification. Science, 112, 187–196. Boyd, W. C. (1963). Genetics and the human race. Science, 140, 1057–1064. Boyd, W. C., & Mourant, A. E. (1954). Blood groups in racial classification. Science, 119, 767–777. Brunner, D., Manelis, G., & Loebl, K. (1959). Influence of age and race on lipid levels in Israel. Lancet, 237(7082), 1071–1073. Burchard, G. E., Ziv, E., Coyle, N., Gomez, S. L., Tang, H., Karter, A. J., Mountain, J. L., Pérez-Stable, E. J., Sheppard, D., & Risch, N. (2003). The importance of race and ethnic background in biomedical research and clinical practice. New England Journal of Medicine, 348, 1170–1175. Calafell, F. (2003). Classifying humans. Nature Genetics, 33, 435–436. Cavalli-Sforza, L. L. (1997). Race differences: Genetic evidence. In W. Smith & W. Sapp (Eds.), Plain talk about the Human Genome Project: A Tuskegee University Conference on its promise and perils and matters of race (pp. 51–58). Tuskegee: Tuskegee University Press. Cavalli-Sforza, L. L., Menozzi, P., & Piazza, A. (1993). Demic expansions and human evolution. Science, 259, 639–646. Chagnon, N. A., & Irons, W. (1979). Evolutionary biology and human social behavior: An anthropological perspective. North Scituate, MA: Duxbury Press. Cranor, C. (1994). Genetic causation. In idem (Ed.), Are genes us? The social consequences of the new genetics (pp. 125-141). New Brunswick, NJ: Rutgers University Press. Daedalus. (2005). Winter. Desforges, J. F. (1971). Editorial: Treatment of sickle crises. New England Journal of Medicine, 284(16), 913–914. Dobzhansky, T. (1951). Race and humanity. Science, 113, 264–266. Douglas, M., & Wildavsky, A. (1982). Risk and culture. Berkeley: University of California Press. Dupré, J. (2004). Understanding contemporary genomics. Perspecives on Science, 12, 320–338. Duster, T. (1984). The social frame for biological knowledge. In T. Duster & K. Garrett (Eds.), Cultural perspectives on biological knowledge (pp. 1–40). Norwood, NJ: Ablex Publishing. Duster, T. (2003). Buried alive: The concept of race in science. In A. H. Goodman, D. Heath, & S. M. Lindee (Eds.), Genetic nature/culture: Anthropology and science beyond the two-culture divide (pp. 258–277). Berkeley: University of California Press. Duster, T. (2006a). The molecular reinscription of race. Unanticipated issues in biotechnology and forensic science. Patterns of Prejudice, 40(4/5), 427–441. Duster, T. (2006b). Behavioural genetics and explanations of the link between crime, violence and race. In E. Parens, A. Chapman, & N. Press (Eds.), Wrestling with behavioral genetics (pp. 150–175). Baltimore: Johns Hopkins Press. Editorial. (1995). Crimes against genetics. Nature Genetics, 11(3), 223-224. Editorial. (2001). Genes, drugs and race. Nature Genetics, 29, 239-240. Editorial. (2004). The unexamined population. Nature Genetics, 36(11), 3. Edwards, A. W. F. (2003). Human genetic diversity: Lewontin’s fallacy. BioEssays, 25(8), 798–801. Efron, J. M. (1994). Defenders of the race. Jewish doctors and race science in fin-desiècle Europe. New Haven: Yale University Press. Ekberg, M. (2007). Second opinions: The old eugenics and the new genetics compared. Social History of Medicine, 20(3), 581–593. Falk, R. (1998). Zionism and the biology of the Jews. Science in Context, 11C–D, 587– 607. Falk, R. (2000). Final review: The gene—a concept in tension. In P. J. Beurton, R. Falk, & H. J. Rheinberger (Eds.), The concept of the gene in development and evolution:

S.B. Gissis / Stud. Hist. Phil. Biol. & Biomed. Sci. 39 (2008) 437–450 Historical and epistemological perspectives (pp. 317–348). Cambridge: Cambridge University Press. Falk, R. (2006). Ha Ziyonut vehabiologia shel hayehudim [Zionism and the biology of the Jews]. Tel Aviv: Resling. Francomano, C. A., McKusick, V. A., & Biesecker, L. G. (2003). Medical genetic studies in the Amish: Historical perspective. American Journal of Medical Genetics, 121c(1), 1–4. Gannett, L. (2001). Racism and the human genome diversity research: The ethical limits of ‘population thinking’. Philosophy of Science, 68C, 479–492. Gannett, L. (2004). The biological reification of race. British Journal for the Philosophy of Science, 55, 323–345. Gannett, L., & Griesemer, J. R. (2004). The ABO blood groups: Mapping the history and geography of genes in Homo sapiens. In H.-J. Rheinberger & J. P Gaudillière (Eds.), Classical genetic research and its legacy: The mapping cultures of 20th century genetics (pp. 57–87). London: Routledge. Gates, N. (Ed.). (1997). The concept of race in natural and social cience. New York: Garland. Gayon, J. (2003). Do biologists need the expression ‘human races’? UNESCO 19501951. In J. J. Rozenberg (Ed.), Bioethical and ethical issues surrounding the trials and code of Nuremberg: Nuremberg revisited (pp. 23-48). Symposium Series, 74. Lewiston: Edwin Mellen Press. Giddens, A. (2000). Runaway world: How globalization is reshaping our lives. New York: Routledge. Gifford, F. (2002). Understanding genetic causation and its implications for ethical issues concerning medical genetics. In L. S. Parker & R. A. Ankeny (Eds.), Mutating concepts, evolving disciplines: Genetics, medicine and society (pp. 109–126). Dordrecht & Boston: Kluwer Academic Publishers. Gilman, S. (Ed.). (2006). Race and contemporary medicine: Biological facts and fictions. Patterns of Prejudice, 40(4/5) (Special issue). Goodman, R. M., & Motulsky, A. (Eds.). (1979). Genetic diseases among Ashkenazi Jews. New York: Raven Press. Goodman, A. H., Heath, D., & Lindee, S. M. (Eds.). (2003). Genetic nature/culture: Anthropology and science beyond the two-culture divide. Berkeley: University of California Press. Graves, J. L. (2001). The emperor’s new clothes: Biological theories of race at the millennium. Brunswick, NJ: Rutgers University Press. Griesemer, J. R. (2000). Reproduction and the reduction of genetics. In P. J. Beurton, R. Falk, & H. J. Rheinberger (Eds.), The concept of the gene in development and evolution: Historical and epistemological perspectives (pp. 240–285). Cambridge: Cambridge University Press. Hacking, I. (2006). Genetics, biosocial groups and the future of identity. Daedalus, 135(4), 81–95. Haga, S. B., & Venter, J. C. (2003). FDA races in wrong direction. Science, 301(5632), 466. Hart, M. B. (2000). Social science and the politics of modern Jewish identity. Stanford: Stanford University Press. Hubbard, R. (1997). Exploding the gene myth: How genetic information is produced and manipulated by scientists, physicians, employers, insurance companies, educators and law enforcers. Boston: Beacon Press. Hutchin, T. P., & Cortopassi, G. A. (1997). Multiple origins of a mitochondrial mutation conferring deafness. Genetics, 145(3), 771–776. Jasanoff, S. (Ed.). (2004). States of knowledge. London: Routledge. Jasanoff, S. (2005). Designs on nature: Science and democracy in Europe and the United States. Princeton: Princeton University Press. Jones, C. P., LaVeist, T. A., & Lille-Blanton, M. (1991). ‘Race’ in epidemiologic literature: An examination of the American Journal of Epidemiology, 1921– 1990. American Journal of Epidemiology, 134(10), 1079–1084. Jones, C. P. (2001). Invited commentary: ‘Race’, racism and the practice of epidemiology. American Journal of Epidemiology, 154, 299–304. Jorde, L. B., Wooding, S. P. (2004). Genetic variation, classification and ‘race’. Nature Genetics, 36(11) (November supplement), S28–S33. Kaestle, F. A. (2003). The good, the bad, and the ugly: Promise and problems of ancient DNA for anthropology. In A. H. Goodman, D. Heath, & S. M. Lindee (Eds.), Genetic nature/culture: Anthropology and science beyond the two-culture divide (pp. 278–296). Berkeley: University of California Press. Karlin, S., Kennet, R., & Bonne-Tamir, B. (1979). Analysis of genetic data in Jewish populations. American Journal of Human Genetics, 31, 363–364. Kaufman, J. S., & Cooper, R. S. (2001a). Commentary: Considerations for use of racial/ ethnic classifications in etiologic research. American Journal of Epidemiology, 154, 291–298. Kaufman, J. S., & Cooper, R. S. (2001b). Kaufman and Cooper respond to ‘‘Race”, racism and the practice of epidemiology”. American Journal of Epidemiology, 154, 305–306. Kaufman, J. S., Cooper, R. S., & Ward, R. (2003). Race and genomics. New England Journal of Medicine, 348, 1166–1170. Kay, L. E. (2000). Who wrote the book of life? A history of the genetic code. Stanford: Stanford University Press. Keller, E. F. (1995). Refiguring life: Metaphors of twentieth century biology. NewYork: Columbia University Press. Keller, E. F. (2000). The century of the gene. Cambridge, MA: Harvard University Press. Keller, E. F. (2002). Making sense of life: Explaining biological development with models, metaphors and machines. Cambridge, MA: Harvard University Press. Kerr, A. (2004). Genetics and society: A sociology of disease. London: Routledge. King, P. (1997). The dilemma of difference. In W. Smith & W. Sapp (Eds.), Plain talk about the Human Genome Project: A Tuskegee University Conference on its

449

promise and perils and matters of race (pp. 75–81). Tuskegee: Tuskegee University Press. Kirsh, N. (2003). Population genetics in Israel in the 1950s. Isis, 94D, 631–655. Kitcher, P. (2003). In Mendel’s mirror. Oxford: Oxford University Press. Kittles, B. R., & Royal, C. (2003). The genetics of African Americans: Implications for disease gene mapping and identity. In A. H. Goodman, D. Heath, & S. M. Lindee (Eds.), Genetic nature/culture: Anthropology and science beyond the two-culture divide (pp. 219–233). Berkeley: University of California Press. Klineberg, O. (1951). Race and psychology. Paris: UNESCO. Kohn, M. (1996). The race gallery: The return of racial science. London: Vintage. Laumann, E. O., Gagnon, J. H., Michaels, S., Michaels, R. T., & Coleman, J. S. (1989). Lévi-Strauss, C. (1952). Race et histoire. Paris: UNESCO. Lewis, M. (1951). Race and culture. Paris: UNESCO. Lewontin, R. C. (1972). The apportionment of human diversity. Evolutionary Biology, 6, 381–398. Lewontin, R. C. (1982). Human diversity. New York: Scientific American Library. Lewontin, R. C., & Hartl, D. L. (1991). Population genetics in forensic DNA typing. Science, 254(5038), 1745–1750. Lindee, S. M. (2005). Moments of truth in genetic medicine. Baltimore: Johns Hopkins Press. Macbeth, H. (1997). What is an ethnic group? A biological perspective. In A. C. Parsons & E. Parsons (Eds.), Culture, kinship and genes: Towards cross cultural genetics (pp. 54–66). Houndmills: Macmillan Press. Marks, J. (1995). Human biodiversity: Genes, race, and history. New York: A. de Gruyter. McKusick, V. A., Egeland, J. A., Eldridge, R., & Krusen, D. E. (1964). Dwarfism in the Amish, I. The Ellis–Van Creveld syndrome. Bulletin of Johns Hopkins Hospital, 115, 303–336. Minow, M. (1990). Making all the difference. Inclusion, exclusion and American law. Ithaca: Cornell University Press. Montagu, A. (1951). Statement on race. An extended discussion in plain language of the UNESCO statement by experts on race problems. New York: Schuman. Morant, G. M. (1952). The significance of racial differences. Paris: UNESCO. Morris, J. N. (1979). Social inequalities undiminished. Lancet, 320(13 January), 87–90. Motulsky, A. G. (1973). Frequency of sickling disorders in US Blacks. New England Journal of Medicine, 288(1), 31–33. Motulsky, A. G. (1995). Jewish diseases and origins. Nature Genetics, 9, 99–101. Muller, H. J. (1949). First preface. American Journal of Human Genetics, 1, 1–18. Muller, H. J. (1951). Our load of mutations. American Journal of Human Genetics, 2B, 111–176. Muntaner, C., Nieto, F. J., & O’Campo, P. (1996). The bell curve: On race, social class, and epidemiologic research. American Journal of Epidemiology, 144, 531–536. Muntaner, C., Nieto, F. J., & O’Campo, P. (1997). Additional clarifications re: The bell curve. American Journal of Epidemiology, 146, 607–608. National Institutes of Health. (1980). Guidelines for Researchers, 9(6) (April). National Institutes of Health. (1982). Guidelines for Researchers, 11(4) (March). National Institutes of Health. (1987). Guidelines for Researchers, 18(40) (December). National Institutes of Health. (1989). Guidelines for Researchers, 18(23) (July). National Institutes of Health. (1995). Guidelines for Researchers, 24(15) (April). National Institutes of Health. (2001). Amendment: NIH policy and guidelines on the inclusion of women and minorities as subjects in clinical research. 9 October. Neel, J. V. (1974). On emphases in human genetics. Genetics, 78(1), 35–40. Neel, J. V., & Chagnon, N. A. (1968). The demography of two tribes of primitive relatively unacculturated American Indians. Proceedings of the National Academy of Sciences, 59(3), 680–689. Nelkin, D., & Lindee, S. M. (1995). Good genes and bad genes: DNA in popular culture. In M. Fortun & E. Mendelsohn (Eds.), The practices of human genetics (pp. 155–168). Dordrecht & Boston: Kluwer Academic Publishers. Nelson, S. J. (2003). Reply to ‘Medline definitions of race and ethnicity and their application to genetic research’. Nature Genetics, 34, 120. Ossorio, P., & Duster, T. (2005). Race and genetics: Controversies in biomedical, behavioral and forensic sciences. American Psychologist, 60A, 115–128. Parens, E., Chapman, A., & Press, N. (Eds.). (2006). Wrestling with behavioral genetics. Baltimore: Johns Hopkins Press. Proctor, R. N., Davidson, I., De Waal, F. B. M., et al. (2003). Three roots of human recency: Molecular anthropology, the refigured Acheuolean, and the UNESCO response to Auschwitz. Current Anthropology, 44B, 213–239. Provine, W. B. (1973). Geneticists and the biology of race crossing. Science, 182(4114), 790–796. Provine, W. B. (1986). Geneticists and race. American Zoologist, 26C, 857–888. Race, Ethnicity and Genetics Working Group (2005). The use of racial, ethnic and ancestral categories in human genetics research. American Journal of Human Genetics, 77, 519–532. Reardon, J. (2005). Race to the finish: Identity and governance in an age of genomics. Princeton: Princeton University Press. Rheinberger, H. J. (2000). Gene concepts: Fragments from the perspective of molecular biology. In P. J. Beurton, R. Falk, & H. J. Rheinberger (Eds.), The concept of the gene in development and evolution: Historical and epistemological perspectives (pp. 219–239). Cambridge: Cambridge University Press. Rose, S. P. R. (1975). Scientific racism and ideology. In F. J. Ebling (Ed.), Racial variation in man (pp. 191–210). London: The Institute of Biology. Sankar, P., & Cho, M. K. (2002). Enhanced: Towards a new vocabulary of human genetic variation. Science, 298, 1337–1338. Shapiro, H. L. (1953). Race mixture. Paris: UNESCO.

450

S.B. Gissis / Stud. Hist. Phil. Biol. & Biomed. Sci. 39 (2008) 437–450

Sharma, U. (1997). What is an ethnic group? The view from social anthropology. In A. C. Parsons & E. Parsons (Eds.), Culture, kinship and genes: Towards cross cultural genetics (pp. 67–79). Houndmills: Macmillan Press. Shields, A. E., Fortun, M., Hammonds, E. M., King, P. A., Lerman, C., Rapp, R., & Sulliva, P. F. (2005). The use of race variables in genetic studies of complex traits and the goal of reducing health disparities: A transdisciplinary perspective. American Psychologist, 60A, 77–103. Sismondo, S. (2004). Maps and mapping practices: A deflationary approach. In H. J. Rheinberger & J. P. Gaudillière (Eds.), From molecular genetics to genomics: The mapping cultures of the 20th century (pp. 203–210). London: Routledge. Small, S. (1993). Unravelling racialised relations in the USA and the United States of Europe. In J. Solomos & J. Wrench (Eds.), Racism and migration in Western Europe (pp. 233–249). Oxford: Berg. Smedley, A. (1999). Race in North America: Origin and evolution of a world view. Boulder: Westview Press. Smith, W., & Sapp, W. (Eds.). (1997). Plain talk about the Human Genome Project: A Tuskegee University Conference on its promise and perils and matters of race. Tuskegee: Tuskegee University Press. Solomos, J., & Wrench, J. (1993). Race and racism in contemporary Europe. In J. Solomos & J. Wrench (Eds.), Racism and migration in Western Europe (pp. 3–16). Oxford: Berg. State Office of Financial Management. (2001). Understanding census 2000: Race category changes & comparisons. Washington, D.C.: State Office of Financial Management. Research Brief, 12. Stepan, N. (1982). The idea of race in the natural sciences: Great Britain 1800–1960. New Haven: Macmillan Press. Strathern, M. (1992). Reproducing the future: Essays on anthropology, kinship and the new reproductive technologies. New York: Routledge. Teich, M. (1997). Mapping the human genome in the light of history. In M. Teich, R. Porter, & B. Gustafsson (Eds.), Nature and society in historical context (pp. 308–331). Cambridge: Cambridge University Press. Tempelton, A. R. (1998). Human races: A genetic and evolutionary perspective. American Anthropologist, 100, 632–650. Tempelton, A. R. (2003). Human races in the context of recent human evolution: A molecular genetic prospective. In A. H. Goodman, D. Heath, & S. M. Lindee (Eds.), Genetic nature/culture: Anthropology and science

beyond the two-culture divide (pp. 234–257). Berkeley: University of California Press. Tienda, M. (2005). Growing up ethnic in the UK and the USA. In M. Rutter & M. Tienda (Eds.), Ethnicity and causal mechanisms (pp. 21–59). Cambridge: Cambridge University Press. Trostle, J. S. (2005). Epidemiology and culture. Cambridge: Cambridge University Press. Turnbull, D. (2004). Genetic mapping: Approaches to the spatial topography of genetics. In H. J. Rheinberger & J. P. Gaudillière (Eds.), Classical genetic research and its legacy: The mapping cultures of 20th century genetics (pp. 208–220). London: Routledge. UNESCO. (1950). Statement on race. Paris: UNESCO. UNESCO. (1952). The race concept: Results of an inquiry. Paris: UNESCO. UNESCO. (1969). Four statements on race. Paris: UNESCO. UNESCO. (1978). Declaration on race and racial prejudice, adopted by the General Conference of UNESCO at its 20th session. Paris: UNESCO. Wade, P. (2002). Race, nature and culture: An anthropological perspective. London: Pluto. Wailoo, K. (2001). Dying in the city of the blues: Sickle cell anemia and the politics of race and health. Chapel Hill: University of North Carolina Press. Wailoo, K., & Pemberton, S. (2006). The troubled dream of genetic medicine. Baltimore: Johns Hopkins University Press. Wheeler, R. (2000). The complexion of race. Categories of difference in eighteenth century British culture. Philadelphia: University of Pennsylvania Press. Wrench, J., & Solomos, J. (1993). The politics and processes of racial discrimination in Britain. In J. Solomos & J. Wrench (Eds.), Racism and migration in Western Europe (pp. 157–176). Oxford: Berg. Wright, L. (1994). One drop of blood. New Yorker, 25 July, 46–55. Yanow, D. (2003). Constructing race and ethnicity in America: Category making in public policy and administration. Armonk, NY: M. E. Sharpe. Zilinskas, R. A. (1997). Global perspectives on the Human Genome Project. In W. Smith & W. Sapp (Eds.), Plain talk about the Human Genome Project: A Tuskegee University conference on its promise and perils and matters of race (pp. 59–74). Tuskegee: Tuskegee University Press.