Testicular Cancer Among White Males

Being a white male of age 22 puts me at the most risk for testicular cancer. Testicular cancer is most prevalent among white males in my age group, especially compared with other races, specifically blacks. Here are a few graphs demonstrating this (these reflect the average percentage of life lost in the Greater Bay Area):

Average Percentage of Lifespan Lost Among White Males

 

Average Percentage of Lifespan Lost Amongt Black Males

(Source: http://www.cpic.org/site/c.skI0L6MKJpE/b.6148445/)

Even between these graphs you can see the disparity is very apparent. In fact, testicular cancer doesn’t even show up for black males in terms of lifespan lost. Keep note that these graphs don’t show the amount of each population that are diagnosed with testicular cancer, but simply the average percentage of lifespan lost due to various cancers. But it’s still noticeable that it means white males are much more susceptible to losing their lives due to testicular cancer, making it much more dangerous among my age and race group.

I believe there is such disparity because white males are among the more wealthy in the United States. They are also typically the ones that hold white-collar jobs, not usually manual-labor. And it has been shown that those that hold white-collar jobs are more likely to develop testicular cancer than those that have blue-collar jobs. It is also likely that, at least in the United States, blue-collar jobs are more often held by people of other races, meaning that they are less susceptible to testicular cancer. It shows that there is something within our culture leading to this particular health disparity, not necessarily genetic factors in my opinion. (Source: http://www.health.ny.gov/statistics/cancer/registry/abouts/testis.htm)

To me, race, genetics, and health can all be intertwined. In the first lecture we were shown a video about malaria and how genetics factor in. I believe this is a very good example of how these three elements are related. It shows that, due to years of dealing with the disease, people in the area had begun to build immunities to it. This has then been passed on through genetics. So, this race of people has built up an immunity over time because they have breed with each other and passed on the gene that allows for this. As a consequence, an outsider who has no immunities due to genetics is going to be very likely to contract the disease. This leads to health disparity because they are likely of a different race (or culture) and should the trend continue, races who are NOT native to the area are more likely to contract malaria due to similar circumstances.

Diabetes among Native Hawaiians

(Self-reported Diabetes in Hawaii: 1988-1993 http://www.aloha.net/~mattman/diabetes.html)

Native Hawaiians have the one of the highest rate of diabetes than any other culture or race.  Hawaiians are five times more likely to develop diabetes between ages 19 to 35 than any other culture on the planet.   Eleven percent of Native Hawaiians develop type two diabetes between these ages compared to only two percent seen elsewhere in the world.[1]  At one time in American history Hawaii was viewed as one of the healthiest states in America but today Native Hawaiians have a lower life expectancy and higher mortality rates for heart disease, cancer, and diabetes than any other culture in America.[2]

Many studies have been conducted by scientists trying to determine what it is that makes Native Hawaiians more susceptible to diabetes.  Of course, many Americans thought genetics played a part in the ill health of the Hawaiian people but none of the research could prove it.  Anthropologists on the other hand have located several problems that may have led the Hawaiian people to poor health.  Anthropologists have found that removing the Hawaiian people from their culture is one of the biggest problems Hawaiians face deteriorating health.  Part of the culture involves the importance of land and this aspect of their culture has been taken away from them.  Juliet McMullin describes the causes of Native Hawaiians health in her book “The Healthy Ancestor.”  McMullin states “The introduction of capitalist modes of production resulted in the subsequent alienation of the Native Hawaiians from their land and their methods of subsistence, and the subjugation of their knowledge.”[3]

By removing the land from the Hawaiian people they lost a large part of their culture.  They were no longer able to grow the foods that were native to the islands once the land was taken from them.  Land is also a large part of their religious and cultural identity.  Once these things are removed chronic anxiety can ensue which increases many potential health problems.

As was discussed in class this week race was originally believed to be the factor behind these health problems.  Thankfully, more and more scientists are beginning to show that there are no such thing as “race” diseases and only specialized genetic adaptations have been found in people living in specific parts of the world.  An example of this would include people who live in Western Africa and South America who have developed the sickle-cell gene.  This adaptation occurs when humans live in areas of the world with a high prevalence of malaria.  Although genetics are involved with this trait race does not.  Although western scientists and doctors have developed eugenics programs to eliminate the bad genes of a society we can see the only thing wrong was society itself.  Culture and cultural practices, discrimination, socioeconomic status has more to do with health within a population than anything that can be found in genetics.


[1]APIAHF, “Native Hawaiians,” Asian and Pacific Islander American Health Forum, last revised August 2003,  accessed July 12, 2012, http://www.hawaii.edu/hivandaids/Native_Hawaiians_Health_Brief.pdf.

[2]Juliet McMullin, “The Healthy Ancestor,” Left Coast Press Inc, Walnut Creek, California. 2010. Print. P. 16.

[3] McMullin. P. 162.

White American-Cardiovascular Disease

 

A=Cardiovascular Disease

Source

http://www.heart.org/idc/groups/heart-public/@wcm/@sop/@smd/documents/downloadable/ucm_319575.pdf

 

 

Cardiovascular disease is so prevalent in white Americans today because there are so many overweight people.  Obesity is the leading problem in white Americans that leads to cardiovascular disease and with all the fast food and things around today it seems like it may never get better.  People who are overweight see that they have a problem but cannot break out of their habits they have to get into a program or schedule that will help them steer clear of heart disease.  Another problem is that many kids don’t get out and play enough because of all the video games now available.  They sit and play these games and eat junk food which eventually leads to adult obesity, and later to heart disease.  This can be averted if parents get involved in what their kids are doing and either get them involved in sports or get them to go outside at least once a day for the recommended amount of time.  This can slowly help get out country away from being called the most obese country.

Source

http://circ.ahajournals.org/content/125/1/e2.full.pdf+html

 

These three terms are rather closely related within healthcare.  Unlike what some people may have thought though, what race you are is not encoded within your genes.  After the human genome project was complete this was found, but there are many health problems that affect some races more than others.  This may be due to the area that that race lives, for example more African Americans have sickle cell disease due to living in African areas that are home to many mosquitoes, some of which are carrying the disease malaria.  Over the years African Americans had begun to evolve a certain mutation in their genetic makeup that allowed them to resist this disease.  Having only one copy of this mutation allowed them to live normal lives and resist the deadly disease, but if someone ended up with 2 copies of the mutation, then they would still be resistant to malaria, but would show symptoms for it due complications with their red blood cells.

Cervical Cancer among Hispanic Women

I personally have the privilege of identifying with many races: Hispanic, black, white and even American Indian, but for simplicity’s sake I will focus on the Hispanic race. As is shown by the graph I’ve selected, incidence rates of cervical cancer in the United States are notably higher among marginalized minority groups such as black and Hispanic women. Cervical cancer is one that is rather easy to manage when caught in its early stages, I believe that mainly social factors explain why its rates are highest among Hispanic women. Also from the CDC website, I was able to find that the incidence rates of HPV are much higher among Hispanic and black women than any other group. Certain strains of HPV are precursors to cervical cancer so I do not believe that this correlation is a coincidence. Similar to the Pima Indians discussed in lecture, I do not believe that these statistics can be attributed to genetics alone. On the whole, Hispanics are considered a socially marginalized minority group and as such rates of unprotected sex are higher among them which is more likely to lead to HPV contraction and therefore increased risk of cervical cancer. Aside from this, I also believe that treatment seeking behaviors are such that Hispanic women are less likely to have regularly scheduled doctor visits than white women in the United States due to economic factors such as lack of health insurance or even social factors such personal shame or embarrassment.

Based upon what we learned this week, Race is a completely social construct and therefore can have no significant bearing upon genetic-related treatments and diseases. For example, within the Hispanic group alone, there are individuals of many skin colors ranging from what would be considered “white” to what would be considered “black”. Therefore, I feel that the relationship between race and health illustrates the way in which social determinants can negatively or positively affect ones health. Since there is no way to genetically determine “race” I believe that most genetic predispositions to certain health conditions are free from association with racial classification.

 

Cervical cancer Incidence rates by Race and Ethnicity, U.S., 1999-2008

graph source: http://www.cdc.gov/cancer/cervical/statistics/race.htm

HPV info source: http://www.cdc.gov/cancer/hpv/statistics/race.htm

 

White Women and Breast Cancer

I decided to look into the occurrence of breast cancer in white women. I have had many relatives with breast cancer, and felt this might be appropriate to look into. According to the American Cancer Society, white women have the highest incidence of breast cancer overall, while Asian American and Pacific Islander women have the lowest.

Studies from the American Cancer Society show that immigrants to the United States have the same rate of breast cancer incidence of the women back in their home country. However, it was also pointed out that after several generations their risk of developing breast cancer rises to that of American women. I also found it interesting that although white women have higher rates of breast cancer, African American women are more likely to die of the cancer than white women. According to the studies looking into this phenomenon, it is most likely because African American women often have aggressive tumors that are associated with poorer prognosis.

The survival rates of women with breast cancer vary quite drastically between ethnic groups. This is most likely explained by the difference in the breast cancer screening practices in these different cultures, stage at diagnosis, the biology of the tumor and also the treatment. It could also be due to the cost of health insurance and or the lack of awareness about screening tests and access to screening facilities.

Based on the materials we covered in class this week, it is easy to see that while genetics and “race” may play some role in health outcomes, factors that come from the world around us and our social lives are extremely influential in determining overall health of an individual. As seen in the Unnatural Causes videos, the environment one lives in is a huge determinant in health. It determines the job one can sustain and the amount of money the individual makes and also the stress one experiences. Ones income and location can affect the type and quality of food that one consumes, which is a hugely influential in ones health.

 

 

American Cancer Society. Breast Cancer Facts & Figures 2011-2012. Atlanta: American Cancer Society, Inc.http://www.cancer.org/acs/groups/content/@epidemiologysurveilance/documents/document/acspc-030975.pdf

World Cancer Reserach Fund/American Institute for Cancer Research. Food, nutrition, physical activity, and the prevention of cancer: a global perspective. Washington, DC: AICR; 2007.

 

National Health Interview Survey Public Use Data File 2010, National Center

White Americans – Breast Cancer

source: http://ww5.komen.org/breastcancer/statistics.html

The health disparity I chose to talk about is breast cancer. When I was looking on the internet it was the most talked about disparity among white american women so I figured it would be a good choice. As with other cancers, breast cancer is when cells divide and grow without normal control, and 50-75% of all cases will start in the ducts. It is the most common cancer of women in all ethnic groups, but it is still the most prevalent in white women. I found it interesting that the website also provided the mortality rates for breast cancer and Michigan had a rate of 24 deaths per 100,000 women. I think it is prevalent among white women because of genetics, since you are more likely to get it if you have a close relative who has had it. I also learned from one of the websites that hormones play a role in the development of breast cancer so this could also be a reason.                  sources: http://www.cancer.org/Cancer/BreastCancer/DetailedGuide/breast-cancer-what-causes ; http://ww5.komen.org/understandingbreastcancerguide.html

Health can be related to many more things than just race and genetics. Things such as environmental factors also play a big role is determining the health outcome of a person. Another thing to point out is that the term race, cannot be defined very well and many people have different meanings for this. This makes it hard to categorize people, because some people identify with more than one group. Another point is that if you do decide to group people by race, this doesn’t mean that there genetics are the same and that they will respond the same way to certain treatments. Some populations are more prevalent in a certain disease, populations differ in genetic variants. It is also good to point out that no one disease is exclusive to one group. This means that we cannot just assume the health of a person based on what group they associate themselves with.

White Women and Respiratory Disease

*After deciding on two different health disparities before respiratory disease I came across an article that changed my mind.  It showed the graphs seen above and as you can see, respiratory disease is much more prevalent in white women than any other social race.  Respiratory disease in itself can be any number of different diseases ranging from emphysema to asthma to COPD.  However, I would like to focus mainly on one disease that would fall under the large umbrella that is respiratory disease. 

Alpha-1 antitrypsin deficiency is a serious disease that can cause the lungs to be left vulnerable to attack by an enzyme called neutrophil elastase. Neutrophil elastase is produced by white blood cells when an infection or other irritants are introduced to the lungs.  This enzyme will digest damaged tissue in the lungs and is needed in small amounts.  Alpha-1 antitrypsin is used to protect the lungs from unnecessary attack from neutrophil elastase.2 

This deficiency is an autosomal recessive disorder.  In other words, the patient with the disease must have inherited the recessive trait from both their mother and father.  Also, the recessive trait is carried more in whites than in persons of other social races causing the increased prevalence in whites.

*Race, genetics, and health are greatly interlocked and affect each other.  Genetics, between races are not substantial enough to divide the world into different races.  Race, however, is more of a social term.  With that said, the main differences in genetics between races are that of skin color, hair color, etc.  Skin color was determined thousands of years ago due to the location in which humans lived in reference to the equator.  At the equator the UV and UVD rays are stronger causing darker skin pigmentation.  This helps to block out the harmful UV rays of the sun and only needs to allow a small amount of UVD rays for the production of Vitamin D in skin.  However, the further from the equator the lighter the skin color would be.  This was due to the fact that UVD rays are strong enough for Vitamin D production in skin only a small portion of the year.  Also, the UV rays are less intense allowing lighter skin colors. 

Health in different races is dependent on many more things than just race and genetics.  The stresses imposed on different racial groups by the majority causes health issues; especially when this stress is constant.  Also, the environment in which persons live can affect health.  When the environment does not allow for healthy food, or adequate income for life, health can deteriorate for any person of any race. This can all be seen in the Unnatural Causes video “Place Matters” and is discussed in this week’s Lecture 1.

 Citations

 1.  National Heart Lung and Blood Institute People Science Health

        2011 Fact Book. National Heart Lung and Blood Institute.  

        http://www.nhlbi.nih.gov/about/factbook/chapter4.htm#4_5, accessed July 12, 2012

 

2.  Learn Genetics Genetic Science Learning Center

         Genetic Science Learning Center, “Alpha-1 Antitrypsin Deficiency,”     

         Learn.Genetics, 31 December 1969,      

         http://learn.genetics.utah.edu/content/disorders/whataregd/a1ad/, accessed July 12,

         2012

Familial Mediterranean Fever (W2 Reflection)

Whenever I’m presented with a series of confineing boxes to check off race, I’ll smudge some graphite into the “other” box if I’m lucky enough to have that option. Sometimes they’re generous enough to give you a blank space to jot down your identity. That’s when I like to write in “human” and that just makes my day. Being from the largest ethnic group in the world without an internationally recognized nation-state makes me slightly apathetic to race and nationalities (Kurds). The fact that there are greater genetic differences within Africans than between Africans and Eurasians only reinforces my belief that race is somewhat overrated (Genetics). The U.S. Census and some other forms like to inform me that I am White via parentheses that include “any of the original peoples of Europe, the Middle East, or North Africa”. It’s interesting that prior to 1944 Middle Easterners and North Africans were ineligible to obtain citizenship because they were not considered White at that time (Lopez). In my opinion those designations of race were much more political than health-minded; they were designed to determine citizenship rights not health outcomes. That is why I refuse to use my census ascribed race to address my chosen health issue. Let’s put all that history and personal commentary aside while I address a disease much more common among Middle Eastern/Mediterranean Americans than those of other lineages; Familial Mediterranean Fever.

Familial Mediterranean Fever is an inherited condition characterized by episodic fever, rash, and painful inflammation of the abdomen, chest and joints (Counsyl). Approximately 1 in 16 Middle Easterners carry the Mediterranean Fever gene [MEFV] (Counsyl). Mutations in the MEFV gene are mostly responsible for the condition. The MEFV gene produces a protein called pyrin which inhibits chemotactic factors that are produced in response to inflammatory stimuli. Those with the MEFV gene mutated
lack that ability and experience uninhibited activity and episodes of inflammation with fever.
Aside from the biological origin i.e. the random genetic mutation that caused the diseased, I think that cultural factors are mostly responsible for its spread and concentration. To survive ethnic and religious persecution, many Mediterranean families converted to other religions or intermarried members of other ethnic groups, thus carrying the MEFV gene with them (Medscape). It is not uncommen in these cultures to marry a blood relative such as a second or third cousin (Counsyl). That practice increases the likelihood of the trait being passed on and/or expressing itself. (Textmed)(Textmed)

Race, Genetics, and Health

Certain genetic mutations are more common in certain populations. Genetics are one of the several factors including environment and behavior that determine disease manifestation. The prevalence of diabetes among the Pima indians residing in the United States can help explain the relationship between those factors. The ancestors of the Pima lived in an environment where food was not consistently available. These ancestors developed a genotype that is better at processing sugar and storing storing fat (Week 2: Lecture 2). That mutation was passed on through their generations, remains in their population until today and results in high rates of obesity which leads to type II Diabetes. It isn’t that simple though because Pima populations in Mexico which have a nearly identical thrifty genotype do not experience such levels of diabeties. That is because their diet and physical behaviors reduce their risk for developing obesity and diabetes. Many people attempt to study the effects of genetics by examining disease prevalence by race. This is not reliable because race is overrated (Roberts). The phenotype that we use to determine race is a nearly unidentifiably small and insignificant part of our genotype (Roberts). It is important to study genetic drift and heredity lineages but using race as a proxy is unreliable.

Sources

Kurds

The Kurds- A Nation without a State

http://www.angelfire.com/az/rescon/mgckurds.html

Genetics

Larger Genetic Differences Within Africans Than Between Africans and Eurasians Genetics, Vol. 161, 269-274, May 2002 http://www.genetics.org/content/161/1/269.full

Lopez

How the U.S. Courts Established the White Race: White By Law

New York University Press, 1996

http://www.modelminority.com/joomla/index.php?option=com_content&view=article&id=284:how-the-us-courts-established-the-white-race-&catid=42:law&Itemid=56

Counsyl
Familial Mediterranean Fever
https://www.counsyl.com/diseases/familial-mediterranean-fever/

Medscape
Familial Medierranean Fever

http://emedicine.medscape.com/article/330284-overview#a0199

Textmed
http://www.textmed.com/disease/familial-mediterranean-fever.htm

Week 2: Lecture 2
http://anthropology.msu.edu/anp204-us12/schedule/week-2-lecture-2-2/

Roberts

Dorothy Roberts: Race and the New Biocitizen – Tarrytown 2010

https://www.youtube.com/watch?v=d7GIU6XF3Dw

 

Cystic Fibrosis and White Americans

1. 

This is a picture showing how with cystic fibrosis mucus blocks the airways. source: http://pathologyproject.wordpress.com/2011/02/04/cystic-fibrosis/

  This graph shows how the genetic prevalence of the gene is more common in caucasians. Source: http://www.ntdlabs.com/molecular-testing/

2. Cystic Fibrosis is a genetic disease caused by a mutated gene that causes the body to produce a thick sticky mucous. It then builds up in the airways of the lungs, and in the pancreas. It leads to life threatening lung infections and serious digestion problems. . It is possible to carry the gene for cystic fibrosis but have to symptoms. In order to get the disease you must inherit the gene from both parents. I chose this disease because it is the most common, deadly, inherited disease in White Americans. Most children are diagnosed by age 2 but less severe forms may not appear till the age of 18. It is more prevalent among White Americans because as a carrier with one mutation and one normal gene its protects the person against diarrheal diseases like cholera and typhoid . Since these disease used to be deadly to people in Western Europe in might have stayed among the caucasians to help against those diarrheal diseases. Also I think that because it is genetic disease and needs to be passed through both parents, while either parent probably does not know that they have the gene because they don’t have symptoms so I think that this keeps its prevalence among this group. Social determinants can also play a factor like there may be more cystic fibrosis among an mostly populated White American area. It also may be the case that inter-racial couples are not coming together and have children as much as a caucasian couple.

http://www.news-medical.net/health/Cystic-Fibrosis-(CF).aspx

Sources: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001167/

3. Race, genetics and health are all very intertwined into each other. It is interesting because you cant tell what race a person is by just looking at genetics but you can see a prevalence of genetic diseases in certain races. Health issues can be based on the economy and environment so if people of the same race are in the same area as certain diseases or things like contaminated water, they are more likely to come up with that illness.  In the lecture 2 it said that science proved that their is no such things as biologically discrete races but that it is still thought of in this way. Like for instance the medicine BiDil that is said it is more helpful in African Americans that is currently an argument because how do you define races and the only way for a doctor to define race is what race they tell you they are. It was interesting to that the lecture said that racial stresses maybe leading to heart conditions. So health, genetics and race are all in some way related but what is interesting is what race is defined as. I would say it is the culture you live, if their is more poverty that race or area of people may not be able to afford treatment for illnesses or disease.

 

 

 

 

 

Hypertension in African Americans

In the African American community,
there are various diseases that are more prevalent than in other
cultures. One of which is Hypertension also known as high blood
pressure. Hypertension can cause heart disease, kidney failure,
stroke, and congestive heart failure. According to the Center for
disease Control and Prevention, African Americans are more likely to
attain Hypertension than other races. There are various factors that
causes African Americans predisposed to the condition some of which
are  obesity/overweight, unhealthy eating ( high sodium intake), low
adherence to treatment, and missing appointments. (Martins, D.,
Norris, K., 2004) I do agree that these are some of the main reasons
why Hypertension is so common. When living at home with my extended
family this past year, I noticed just how much they fried food and
how little physical activities they performed. Food that would
normally be healthy are soaked in salt and cooked twice in bacon fat
left over from breakfast. I think there are some genetic factors that
cause African Americans to not absorb the medications as well but the
reason is still unknown

.

In the lecture material this week, we
learn there are other factors that contribute to the well being of a
person and or community. This is shown  in the Pima Indians and Type
II diabetes. Pima Indians have a genetic predisposition to store more
fat for longer periods of time to accommodate for famines. I believe
this to be a similar trait in African Americans that came about first
in Africa where those who were of larger size are seen as the
healthiest and second when slavery when they were only fed once a
day. Their bodies had to learn to adapt to the changing circumstances
of their new found lives. The high sodium diets are part of our
cultural ecology. In some African communities, boys were not yet men
until they urinate blood. While we know this to be a disease, they
call it a rite of passage. In the African American community, a girl
can not truly cook until she can make a mean fried chicken, smothered
pork chops, and candied yams. Everyone I know that is African
American has grown up knowing to have at least one fried meal a week.
It was the quickest form of cooking for large groups of people and
with every adult working from sunrise to sunset, waiting a long time
for a meal did not cut it. Food was also the center for most family
functions and is associated with some of the happier times in our
past so the tradition is passed down from one person to another. They
say that some ways to decrease hypertension is to reduce stress. Most
African Americans deal with various situations that elevate stress on
a regular basis in their work environment, financial challenges, and
inequalities. This is a display of the political ecology that affects
the health of the African American community.

 

While some of this information is not
proven, the effects of these issues and factors have been shown to
greatly change one’s health in regards to hypertension. If a person
can change their diet, exercise, and  reduce the stress in their
lives, their challenges with hypertension can decrease.

Graphs

http://www.cdc.gov/bloodpressure/facts.htm

http://www.sciencedirect.com/science/article/pii/S002571250570568X

Information

 

Martins, David, and Keith Norris. “Hypertension Treatment in African
Americans: Physiology Is Less Important than Sociology.” 
Cleveland
Clinic Journal of Medicine
 71.9
(2004): 735-43. 
Www.ccjm.org.
Web.