Race, widely used as a variable across biomedical research and medicine, is an appropriate proxy for racism — but not for anything biological. Proposals to use genetic ancestry instead of race are at risk of perpetuating the same problems.
Dozens of algorithms widely used in clinical care contain an adjustment factor for a patient’s race. When estimating kidney function, for example, different results are returned depending on whether the patient’s race is entered as “Black” or “non-Black,” though at least for kidney function the use of race is being challenged.
But using genetic ancestry risks perpetuating the same problems as relying on race, as several colleagues and I argue in a Policy Forum essay in Science magazine. We argue that genetic ancestry can be part of the solution to understanding our different risks to developing disease and response to therapies, but only if a suitably complex conceptualization of it is adopted.
The danger in turning to genetic ancestry stems from the dominant way ancestry is currently used within genetics, as continental categories such as African ancestry, European ancestry, and the like. These categories are easy to conflate with racial categories. European ancestry, for example, is conflated with “white” race. This confuses a sociopolitical concept with a biological one.
