Race and medicine in light of the new mechanistic philosophy of science
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Race and medicine in light of the new mechanistic philosophy of science Kalewold Hailu Kalewold1 Received: 30 August 2019 / Accepted: 30 June 2020 © Springer Nature B.V. 2020
Abstract Racial disparities in health outcomes have recently become a flashpoint in the debate about the value of race as a biological concept. What role, if any, race has in the etiology of disease is a philosophically and scientifically contested topic. In this article, I expand on the insights of the new mechanistic philosophy of science to defend a mechanism discovery approach to investigating epidemiological racial disparities. The mechanism discovery approach has explanatory virtues lacking in the populational approach typically employed in the study of race and biomedicine. The explanatory constraints that form an integral part of the new mechanistic approach enable mechanism discovery to avoid the epistemic and normative shortcomings of the populational approach. The methodology of mechanism discovery can fruitfully be extended to the treatment and reversal of epidemiological racial disparities. Keywords Mechanism · Race · Epigenetics · Explanation · Disease · Epidemiology
Introduction Researching the sources of and potential solutions to epidemiological racial disparities, which are differences in rates of disease between self-described races, poses two challenges. On the one hand, critics of race-based studies argue that the continued incorporation of racial categories as proxies of genetic diversity reinforces the legacy of scientific racism. On the other hand, racial disparities in a number of biomedical outcomes, such as Alzheimer’s disease, chronic kidney disease, and low birth weights, suggest that race remains a significant factor for understanding and potentially reversing epidemiological disparities between different racial populations in the United States, and therefore “race-based studies” are an essential component of research into these disparities (Lorusso and Bacchini 2015). * Kalewold Hailu Kalewold [email protected] 1
Department of Philosophy, University of Maryland, College Park, 1125 Skinner, 4300 Chapel Lane, College Park, MD 20742, USA
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Nevertheless, both advocates and critics of the race-based studies take for granted their principal mode of reasoning and investigation, namely statistical reasoning and the tools of population genetics. Whether it is in biomedical research or social science, it is statistical reasoning, the kind employed in population genetics, that is used to build evidence for hypotheses relating to racial disparities. It is “statistical evidence of associations between variables” that is prized by the statistical reasoning approach (Matthews 2017, 1006). This paper argues that the populational/genetics approach, which remains the preeminent approach to investigating epidemiological racial disparities1 (ERDs), has a number of epistemic and normative shortcomings. I outline the three main varieties of explanations of ERDs,
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