John Ruffin, former head of the National Institute of Minority Health and Health Disparities wrote:
"The 19th-century scientist and pathologist Rudolph Virchow gave voice to many of our present-day concerns about disparities and went a long way toward defining the task before us. A socially minded man, he believed that science should speak the language of the common people and that medicine should serve the public's health. He wrote, 'If medicine is to fulfill her greatest task, then she must enter the political and social life…'"
Do you agree and why? Is it permissible for scientists to become advocates in the areas of their research? What steps can one take to balance advocacy with the objectivity that is considered the ideal in scientific inquiry?
Yes, I agree with this statement. I think one of the main responsibilities of physicians and scientists as the experts in their field is to become advocates in their areas of research and to promote social justice and improvement of public health. This would provide politicians and general public with reliable knowledge than can help guide the policies in the right direction away from prejudice and misinformation. There is a valid concern that advocacy can affect the objectivity of the scientific inquiries. This can happen because physicians and scientists may implicitly favor getting the results that are promoted and advertised by their advocacy work. Therefore, it’s imperative for the physicians and scientists to be cognizant about the potential biasing effect of their advocacy work on their research and always declare their potential conflicts of interest when they present their scientific results. Advocacy work through non-profit professional medical organizations that promote health in specific areas, such as the American of Society of Nephrology and the National Kidney Foundation in the field of nephrology, can help physicians and scientists in that specific field to present a unified view for improving the public health while minimizing the potential detrimental effect of advocacy work on any individual physician or scientist’s work.
Please describe an of controversy for health disparities research that you learned about in this course, or alternatively an area of research that should be prioritized in health disparities. Include why you find this area interesting or controversial.
My research is in the field of kidney disease and one of the most interesting controversial issues that I learned about in this course was the role of race vs. social disparities in development of kidney disease in the African Americans. Before this course, my assumption was that race plays a major role in development of kidney disease in African American and this effect can be explained by higher prevalence of mutations in APOL1 gene in this population. A genetic variation of APOL1 gene is protective against trypanosoma brucei infection (sleeping sickness) and that may explain its higher prevalence in African Americans; however, this variation can increase the chance of developing kidney disease. After taking this course I learnt that race is a social construct, rather than definitive genetic differences. I also learnt that contribution of APOL1 gene mutations to the higher prevalence of kidney disease in African Americans cannot fully explain the higher prevalence of kidney disease in this populations and even after controlling for the more obvious elements of social injustice such as the level of income and education, there are still some elements of social injustice such as implicit or systemic racism in the health care system and society that are not easily measurable but contribute to the higher prevalence of kidney disease in this population.