PP- Exam 1 SG PDF.pdf

Study Guide Questions Exam #1 1) What is “normal” in terms of biological parameters? What are some examples of sources of variation on “normal.” Sources of variation on “normal” Genetics Age...

Study Guide Questions Exam #1 1) What is “normal” in terms of biological parameters? What are some examples of sources of variation on “normal.” Sources of variation on “normal” Genetics Age ○ HR for 3 y/o is tachycardic for an adult Gender (Sex) ○ Hormone level – testosterone, [estrogen, progesterone] ○ Testosterone = higher RBC count Situational ○ Living at sea level (lower RBC count) vs high altitude (more RBC count) Time ○ Hormone levels Testosterone levels highest in morning Female hormone levels diff based on ovulation cycle Laboratory conditions ○ Every lab has their own reference values based on their tests There is no single value for any biological parameter that is normal. There is a distribution of normal within a population. 2) How has “race” been used in medicine as a source of variation in biological parameters? Why is this problematic? Race: historically used as source of variation in normal values Problematic because the way race is defined does not tie it to something biological Race is self-identified with very broad categories (African American, non-Hispanic, Hispanic) Does not translate to what people think it does ○ BELIEF: People THINK race = ancestry-related genes → r/t variation in biological parameters & disease Ancestry-related genes correspond to only 0.1% of genes differences between ppl ○ Ancestry-related genes represent only minuscule part of genome ○ REALITY: race ≠ ancestry-related genes Race = social category Race is only used as a very poor substitute for ancestry-related genes Medicine ○ Repeatedly weaponized throughout history to justify & rationalize enslavement of black people ○ Still used to obfuscate incidents of racial injustice ○ Used race as sorting tool w/ profound impacts on diagnostics & treatments of disease Inaccurate, not true, and perpetuates idea that individuals in different racial categories are biologically different ○ When in fact, people from different racial categories are biologically the same ○ Reinforces racial stereotypes ○ Leads to bad medicine ○ Implicit bias ○ Use of harmful standards of care that have gone unexamined When we find differences in disease incidence and health outcomes, it is a difference in social determinants (from oppression) → it shows disparities and NOT differences in genetics 1