Race changes the risk of various health problems, but many questions remain – Sept 2018

What Role Should Race Play in Medicine? Scientific American

Rather than a risk factor, it’s better conceptualized as a risk marker of vulnerability, bias, or systemic disadvantage

• in 1988 US hypertension guidelines added a BLACK designation – without giving any information about blackness.
  “. . . the U.K. inserted an addendum: Biracial patients do not differ from whites, Asian or Chinese patients, and therefore should be treated as non-blacks.”
• “The FRAX tool, an instrument used to predict the risk of osteoporotic fracture, utilizes various metrics based on different global populations. Among 72 national iterations, only the U.S. model is subdivided into four races: “Caucasian,” “Black,” “Hispanic,” and “Asian.” “
  “And if there are 11 standards (for osteoporotic fracture) for countries in Asia, why and how are these measures collapsed into a single instrument for “Asians” who live in the United States?”
• “In nephrology, measures of kidney function are automatically multiplied by a factor of 1.212 if the patient is “African-American.” ”
• “Other questions arise. Are all Europeans white? Are Arab people “Caucasian”? Are Africans the same as African-Americans? As “black”?”
• “A sampling of over 300 genetic studies published between 2001 and 2004 found that not one article explicitly defined its use of the term”
• “Racial categories in the U.S. census, for example, have changed every decade since 1790”
• “Research demonstrates that genetic differences are higher within racial groups than between racial groups —that two black patients sitting in the waiting room will have less genetic overlap with each other than with their white, Asian, or Hispanic neighbors.”

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Related items in VitaminDWiki include

6 Genes can restrict how much vitamin D gets to cells

• Genetics category listing has 343 items along with related searches
• Vitamin D Receptor category listing has 530 items along with related searches
  • Note: You can change the activation of your Vitamin D Receptor by supplementation and intense exercise

Skin Dark - but how dark?

• Skin - Dark category listing has 468 items along with related searches
• Overview Dark Skin and Vitamin D has details on many risk factors and shows 19 categories having many dark skin studies
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  • Note that African-Americans of all skin tones have low vitamin D
• Vitamin D paradox – Blacks need Vit D for health, but not as much D for strong bones – May 2018
• Increased health problems in blacks is similar to that of low vitamin D whites (John Singleton Stroke)
• Half of US high school students will have dark skins by 2025
• Blacks are more obese, have lower Vitamin D, and have more Cancer etc. than whites – Feb 2018
• Blacks die more often than whites of many diseases (they have less vitamin D) – 2012
• Crohn's disease in black children is worse in 6 ways – Dec 2015
• Breast cancer in blacks – 5X increased risk of triple negative if low vitamin D – Oct 2017

Many categories of people are at high risk of low D and thus poorer health

• High Risk category listing has 67 items along with related searches
  • Dark Skin, Seniors, Pregnant, Get little noon-day sun, Burkas, Obese, Far from Equator

Poor Response to Vitamin D supplementation is a function of genes, health, Obesity, as well as skin color/race

• Reasons for low response to vitamin D

Health is also a function of food, pollution, exercise, social customs, smoking, wealth, stress, etc. not just Vitamin D or race