The Concept of Race Is Not As Simple As It Seems

As the debate over racial classification continues in this issue of The New England Journal of Medicine and with the release of a drug for heart failure that has been described as “race specific,” it may be useful to step back from the fray and consider what a race really is. In one sense, a race is merely a term for grouping people with common physical characteristics. But in many ways, the concept of race is much more profound and consequential than that simple definition would suggest, because society uses the category of race to establish and justify systems of privilege, oppression and disenfranchisement.

When we talk about race, most Americans and almost all researchers have in mind a general categorical scheme that includes whites, blacks, Asians and Hispanics. But this scheme disguises significant heterogeneity within each of these major groups. In fact, most Americans have ancestry in more than one of these groups and are therefore multiracial. Moreover, in the United States and in other countries, individuals are frequently assigned to more than one of the five official racial categories because of the practice of intermarriage.

A more important point is that most human variation — 85% or so — exists within, rather than between, races. This means that two random Koreans are likely to be genetically different from one another, but that the same is true for any pair of Italians or Kurds or Cherokees. It also makes it impossible to construct a biologically grounded distinction between, for example, the Caucasian and Mongoloid races of Europe, Africa, and Asia or the Negroid and Australo-Melanesia races of East Asia, Australia and the Americas.

In addition, the very act of assigning someone to a particular racial category introduces bias into any study that deals with racial differences in health or in other outcomes. When individuals are asked to identify their race or ethnicity, they are often motivated by a desire to please the surveyor and may be inclined to select the option that most closely approximates the way they think others will perceive them. The result is that studies using these data are often flawed and misleading.

Clearly, then, there is no scientific basis for the category of race. In its place, anthropologists have long advocated the use of a more sophisticated approach to understanding human diversity: that of origins. In surveys, instead of asking whether respondents are “Asian,” for example, we should ask about their country of origin, and allow them to mark as many options as they wish. This will reduce nonresponse and allow the study of a wide range of subgroups. It will also make it possible to combine the questions on race and Hispanic origin into one on nationality or ancestry, which will facilitate the collection of more accurate statistics. These kinds of changes will not erase racial differences, but they will help to reduce the influence of those that stem from structural racism, the systematic exploitation of certain racial groups by society as a whole.