Diabetes and RACE: A historical perspective

American Journal of Public Health

Volumn 101, Issue 1, 2011, Pages 24-33

  Tuchman, Arleen Marcia ^a  

^a VANDERBILT UNIVERSITY   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; EPIDEMIOLOGY; ETHNOLOGY; HISTORY; HUMAN; JEW; NON INSULIN DEPENDENT DIABETES MELLITUS; RACE; SOCIAL PSYCHOLOGY; STATISTICS; UNITED STATES;

CONTINENTAL POPULATION GROUPS; DIABETES MELLITUS, TYPE 2; EPIDEMIOLOGY; HISTORY, 20TH CENTURY; HUMANS; JEWS; STEREOTYPING; UNITED STATES;

EID: 78650871141     PISSN: 00900036     EISSN: 15410048     Source Type: Journal    
DOI: 10.2105/AJPH.2010.202564     Document Type: Review

References (142)

1. W. H. Thomas, "Medical Treatment of Diabetes," Albany Medical Annals 25, no. 4 (1904): 358.
2. This article was abstracted in the Journal of the American Medical Association 42 (May 28, 1904): 1451.
3. O. B. Pancoast, "Diabetes in the Negro," Johns Hopkins Hospital Bulletin 9 (1898): 40-41.
4. National Institute of Diabetes and Digestive and Kidney Diseases, "National Diabetes Statistics, 2007," available at http://diabetes.niddk.nih.gov/dm/pubs/statistics/#10 (accessed May 25, 2010).
5. See also the poster "Diabetes Favors Minorities," available at http://wwwihm.nlm.nih.gov/cgi-bin/gw-44-3/chameleon (accessed May 25, 2010).
6. G. Stocking, "The Turn-of-the-Century Concept of Race," Modernism/Modernity 1 (1994): 4-16
7. Matthew Frye Jacobson, Whiteness of a Different Color: European Immigrants and the Alchemy of Race (Cambridge, MA: Harvard University Press, 1998)
8. Karen Brodkin, How the Jews Became White Folks and What That Says About Race in America (New Brunswick, NJ: Rutgers University Press, 1988)
9. John M. Efron, Defenders of the Race: Jewish Doctors and Race Science in Fin-de-Siècle Europe (New Haven, CT: Yale University Press, 1994)
10. Sander Gilman, The Jew's Body (New York: Routledge, 1991).
11. E. Barkin, The Retreat of Scientific Racism: Changing Concepts of Race in Britain and the United States Between the World Wars (Cambridge: Cambridge University Press, 1992)
12. Richard H. King, Race, Culture, and the Intellectuals, 1940-1970 (Washington, DC: Woodrow Wilson Center Press, 2004)
13. Mitchell B. Hart, Social Science and the Politics of Modern Jewish Identity (Stanford, CA: Stanford University Press, 2000).
14. See, for example, E. G. Burchard, E. Ziv, N. Coyle, et al., "The Importance of Race and Ethnic Background in Biomedical Research and Clinical Practice," New England Journal of Medicine 348, no. 12 (2003): 1170-1175.
15. For a particularly cogent description of the arguments for and against research on genetics and health disparities, see Michael J. Fine, Said A. Ibrahim, and Stephen B. Thomas, "Editorial. The Role of Race and Genetics in Health Disparities Research," American Journal of Public Health 95, no. 12 (2005): 2125-2128.
16. See also Andrew John Karter, "Race and Ethnicity: Vital Constructs for Diabetes Research [commentary]," Diabetes Care 26, no. 7 (2003): 2189-2193.
17. M. Gregg Bloche, "Race-Based Therapeutics," New England Journal of Medicine 351, no. 20 (2004): 2035-2037
18. Stephen Epstein, Inclusion: The Politics of Difference in Medical Research (Chicago: University of Chicago Press, 2007)
19. David R. Williams, "Race and Health: Basic Questions, Emerging Directions," Annals of Epidemiology 5 (1997): 322-333.
20. Physicians did not yet distinguish between type 1 and type 2, but they recognized that the disease progressed differently in the young, where the telltale symptoms of polydipsia, polyuria, and glycosuria developed quickly and with great severity. Their concern about the rapid increase in diabetes was, however, restricted to the more chronic form that was much more common among the middle-aged and elderly.
21. See, for example, J. G. Wilson, "Increase in the Death Rate From Diabetes Mellitus - A Possible Explanation," Medical Record 82 (1912): 6662-6663
22. Elliott P. Joslin, "The Prevention of Diabetes Mellitus," The Journal of the American Medical Association 76 (1921): 79-84
23. "War on Diabetes," Time (April 21, 1923): 21, available at http://www.time.com/time/magazine/article/0,9171,845911,00.html (accessed May 25, 2010).
24. W. Sternberg, Die Judenkrankenheit, die Zuckerkrankheit, eine Folge der rituellen Küche und orthodoxen Lebensweise der Juden? (Mainz: Joh. Wirth'sche Hofbuchdruckerei, 1903), 10.
25. See also John M. Efron, Medicine and the German Jews: A History (New Haven, CT: Yale University Press 2001) 133.
26. Albert A. Epstein, "Diabetes Among Jews; Its Cause and Prevention," Modern Medicine 1 (1919): 269-275, 270.
27. W. Osler, The Principles and Practice of Medicine, 1st ed. (New York: D. Appleton & Company, 1892), 275.
28. Heinrich Stern, "The Mortality From Diabetes Mellitus in the City of New York (Manhattan and the Bronx) in 1899. Classified According to the Month, Sex, and Age; Also an Expose as to Nationality, Duration of Residence in the United States, Occupation, Direct Causes of Death, and Accompanying Diseases," Medical Record 58 (1900): 766-774, 766.
29. Wilson, "Increase in the Death Rate From Diabetes."
30. Increase in the Death Rate From Diabetes, Ibid, 663.
31. Osler, Principles and Practice of Medicine, 275.
32. Wilson, "Increase in the Death Rate From Diabetes," 663
33. Heinrich Stern, "The Mortality From Diabetes Mellitus in the City of New York (Manhattan and the Bronx) in 1899. Classified According to the Month, Sex, and Age; Also an Expose as to Nationality, Duration of Residence in the United States, Occupation, Direct Causes of Death, and Accompanying Diseases," Medical Record 58 (1900): 766-774, 767.
34. R. Saundby, "Diabetes Mellitus," in A System of Medicine, ed. Thomas Clifford Albutt (London: Macmillan, 1897), 167-212
35. cited in Sander L. Gilman, "Fat as Disability: The Case of the Jews," Literature and Medicine 23 (2004): 46-60, 51.
36. Elliott P. Joslin, "The Diabetic Problem of Today," Journal of the American Medical Association 83 (1924); 727-729, 727.
37. I. Howe, World of Our Fathers (New York: Harcourt Brace Jovanovich, 1976).
38. Osler, Principles and Practice of Medicine, 295.
39. See also H. C. Riggs, "On the Treatment of Diabetes Mellitus," Journal of the American Medical Association 18 (1892): 674-677, 675.
40. Barkin, Retreat of Scientific Racism, 2.
41. E. L. Goldstein, The Price of Whiteness: Jews, Race, and American Identity (Princeton, NJ: Princeton University Press, 2006), 1.
42. Jacobson, Whiteness of a Different Color.
43. 61st Congress, 3rd Session, document no. 662, Reports of the Immigration Commission, Dictionary of Races or Peoples (Washington, DC: Government Printing Office, 1911), 1-5.
44. Stocking, "The Turn-of-the-Century Concept of Race"; Jacobson, Whiteness of a Different Color, 78
45. Brodkin, How the Jews Became White Folks; Barkin, Retreat of Scientific Racism, 2, 19.
46. Jacobson, Whiteness of a Different Color.
47. Dictionary of Race or Peoples, 74.
48. 61st Congress, 3rd Session, document no. 764, Statements and Recommendations Submitted by Societies and Organizations Interested in Immigration (Washington, DC: Government Printing Office, 1911), 48.
49. E. L. Goldstein, "Contesting the Categories: Jews and Government Racial Classification in the United States," Jewish History 19 (2005): 79-107.
50. For an outstanding discussion of the political nature of current racial categories, see Stephen Epstein, Inclusion: The Politics of Difference in Medical Research (Chicago: University of Chicago Press, 2007), 148 ff.
51. Quotations are from Mary Clark Barnes and Lemuel Call Barnes, The New America: A Study in Immigration (New York: Fleming H. Revell Co, 1913)
52. Burton J. Hendrick, The Jews in America (Garden City, NY: Doubleday, Page & Company, 1923)
53. and Lothrop Stoddard, Racial Realities in Europe (New York, 1924)
54. all cited in Robert Singerman, "The Jew as Racial Alien: The Genetic Component of American Anti-Semitism," in Anti-Semitism in American History, ed. David A. Gerber (Urbana: University of Illinois Press, 1986), 103-129, 110, 117.
55. See also Jacobson, Whiteness of a Different Color, 103, 180
56. Gilman, The Jew's Body, 174.
57. Goldstein, The Price of Whiteness. 102-108.
58. The Price of Whiteness, Ibid, 170-177.
59. The Price of Whiteness, Ibid, 172.
60. On the notion of Jews as racial aliens, see Singerman, "The Jew as Racial Alien.
61. H. Emerson, "Sweetness Is Death," The Survey 53 (1924): 23-25, 24.
62. For biographical information on Emerson, see Charles Bolduan, "Haven Emerson - The Public Health Statesman," American Journal of Public Health and the Nation's Health 40, no. 1 (1950): 1-4.
63. Emerson served a term as president of the American Public Health Association in 1934; see "APHA Past Presidents," available at http://www.apha.org/about/aphapastpresidents.html (accessed May 25, 2010).
64. This image of the Jew had a long history. See Gilman, "Fat as Disability.
65. J. G. Wilson, "A Study in Jewish Psychopathology," Popular Science Monthly 82 (1913): 264-271, 265.
66. Wilson was criticized for this at the time. See Hyman Morrison, "A Statistical Study of the Mortality From Diabetes Mellitus in Boston From 1895 to 1913, With Special Reference to Its Occurrence Among Jews," Boston Medical and Surgical Journal 175 (1916): 54-57, 55.
67. Wilson, "Increase in the Death Rate From Diabetes," 663.
68. Gilman, The Jew's Body
69. Efron, Medicine and the German Jews
70. Efron, Defenders of the Race.
71. On the Jewish medical community's general acceptance of Jewish diseases, see Mitchell B. Hart, "Racial Science, Social Science, and the Politics of Jewish Assimilation," Isis 90 (1999): 268-297
72. Efron, Medicine and the German Jews
73. Efron, Defenders of the Race.
74. J. Jacobs and M. Fishberg, "Diabetes Mellitus," Jewish Encyclopedia, available at http://www.jewishencyclopedia.com/view.jsp?artid= 321&letter=D&search=diabetes%20mellitus (accessed May 25, 2010).
75. Morrison, "Statistical Study of the Mortality From Diabetes Mellitus," 54.
76. Epstein, "Diabetes Among Jews.
77. Diabetes Among Jews, Ibid, 274.
78. On Lamarckian notions of race in the early 20th century, see Stocking, "The Turn-of-the-Century Concept of Race.
79. G. Graham, The Pathology and Treatment of Diabetes Mellitus (London: Henry Frowde and Hodder & Stoughton, 1923), 34-35, 82.
80. S. Solis-Cohen, "Society Proceedings. Adiposity and Other Etiologic Factors in Diabetes Mellitus," Journal of the American Medical Association 84 (1925): 1775-1776, 1776.
81. Jacobs and Fishberg, "Diabetes Mellitus.
82. C. E. Rosenberg, "George M. Beard and American Nervousness," in No Other Gods: On Science and American Social Thought (Baltimore: Johns Hopkins University Press, 1997), 98-108
83. Barbara Sicherman, "The Uses of a Diagnosis: Doctors, Patients, and Neurasthenia," Journal of the History of Medicine and Allied Sciences 32, no. 1 (1977): 33-54.
84. Carl H. von Noorden, "Diabetes Mellitus," in Twentieth Century Practice: An International Encyclopedia of Modern Medical Science, ed. Thomas H. Stedman, 21 vol. (New York: William Wood and Company, 1895-1903), vol. 2: Nutritive Disorders (1895), 64
85. Emil Kleen, On Diabetes Mellitus and Glycosuria (Philadelphia: P. Blakiston's Son & Co, 1900), 15.
86. See also Morrison, "A Statistical Study of the Mortality From Diabetes Mellitus," 56.
87. Kleen, On Diabetes Mellitus and Glycosuria, 17.
88. Barkin, Retreat of Scientific Racism
89. King, Race, Culture, and the Intellectuals
90. Hart, Social Science and the Politics of Modern Jewish Identity.
91. Jacobson, Whiteness of a Different Color
92. Nicholas Lemann, The Promised Land: The Great Black Migration and How It Changed America (New York: Vintage Books, 1992)
93. James R. Grossman, Land of Hope: Chicago, Black Southerners, and the Great Migration (Chicago: University of Chicago Press, 1989).
94. Brodkin, How the Jews Became White Folks.
95. K. Wailoo and S. Pemberton, The Troubled Dream of Genetic Medicine: Ethnicity and Innovation in Tay-Sachs, Cystic Fibrosis, and Sickle Cell Disease (Baltimore: The Johns Hopkins University Press, 2006).
96. The Troubled Dream of Genetic Medicine: Ethnicity and Innovation in Tay-Sachs, Cystic Fibrosis, and Sickle Cell Disease, Ibid, chap. 1.
97. R. J. Lifton, The Nazi Doctors: Medical Killing and the Psychology of Genocide (New York: Basic Books, 1986)
98. Robert Proctor, Racial Hygiene: Medicine Under the Nazis (Cambridge, MA: Harvard University Press, 1988)
99. Paul Weindling, Health, Race, and German Politics Between National Unification and Nazism, 1870-1945 (Cambridge: Cambridge University Press, 1989)
100. Wailoo and Pemberton, Troubled Dream of Genetic Medicine, 7.
101. Christopher McLoughlin, Lester M. Petrie, and Richard H. Fetz, "Diabetes Detection in Georgia," Journal of the Medical Association of Georgia 40 (1951): 285-286, 286.
102. Data from the National Vital Statistics System, "Series 20. Number 10: Diabetes Mellitus Mortality in the United States, 1950-1967" (July 1971), 6, available at http://www.cdc.gov/nchs/data/series/sr 20/sr20 010.pdf (accessed February 11, 2008).
103. I. I. Lemann, "Diabetic Gangrene in the South," Journal of the American Medical Association 89, no. 9 (1927): 659-662, 660.
104. Eugene J. Leopold, "Diabetes in the Negro Race," Annals of Internal Medicine 5 (1931): 285-293, 292.
105. See also Harold Bowcock, "The Diabetic Negro," Diabetes 1, no. 4 (1933): 109-110, 118.
106. Leopold, "Diabetes in the Negro Race"
107. Bowcock, "The Diabetic Negro"
108. John Herman Lewis, The Biology of the Negro (Chicago: Chicago University Press, 1942)
109. Louis I. Dublin, "The Problem of Negro Health as Revealed by Vital Statistics," Journal of Negro Education 6, no. 3 (1937): 268-275, 274.
110. M. Gover, "Trend of Mortality Among Southern Negroes Since 1920," Journal of Negro Education 6 (1937): 276-288.
111. Indeed, in the 1930s and 1940s, the Journal of the National Medical Association, the National Negro Health News, and the Journal of Negro Medical Education published relatively few articles on diabetes.
112. J. H. Jones, Bad Blood: The Tuskegee Syphilis Experiment, new and expanded edition (New York: Free Press, 1993)
113. Tuskegee's Truths: Rethinking the Tuskegee Syphilis Study, ed. Susan M. Reverby (Chapel Hill: University of North Carolina Press, 2000)
114. Susan M. Reverby, Examining Tuskegee: The Infamous Syphilis Study and Its Legacy (Chapel Hill: University of North Carolina, 2009).
115. Steward R. Roberts, "Nervous and Mental Influences in Angina Pectoris," The American Heart Journal 7 (1931): 21-35, 23.
116. I. I. Lemann, "Diabetes Mellitus in the Negro Race," Southern Medical Journal 14, no. 7 (1921): 522-525, 524.
117. L. Dublin, "The Problems of Negro Health as Revealed by Vital Statistics.
118. Lewis, Biology of the Negro, 283.
119. Hugh Wilkerson, "Problems of an Aging Population: Public Health Aspects of Diabetes," American Journal of Public Health 37 (1947): 177-188, 180.
120. For the original study, see Hugh Wilkerson and Leo P. Krall, "Diabetes in a New England Town," Journal of the American Medical Association 135 (1947): 209-216.
121. Diabetics Unknown [motion picture] (1962), sponsored by the Public Affairs Committee, Inc. and the Conference of State and Territorial Directors of Public Health Education. Copy viewed at the National Library of Medicine (NLM Unique ID 8800470A).
122. See, for example, "Is Race 'Real?' a Web forum organized by the Social Science Research Council," available at http://raceandgenomics.ssrc. org (accessed May 25, 2010).
123. See also Williams, "Race and Health,"
124. and Wailoo and Pemberton, The Troubled Dream of Genetic Medicine.
125. J. Marks, "The Realities of Races," in "Is Race 'Real?'
126. N. Krieger, "If 'Race' Is the Answer, What Is the Question? On 'Race,' Racism and Health: A Social Epidemiologist's Perspective," in "Is Race 'Real?' "
127. Karter, "Race and Ethnicity"
128. Vivian Ota Wang and Stanley Sue, "In the Eye of the Storm: Race and Genomics in Research and Practice," American Psychologist 60 (2005): 37-45.
129. V. Navarro, "Race or Class Versus Race and Class: Mortality Differentials in the United States," Lancet 36 (1990): 1238-1240
130. Nancy Krieger, "Stormy Weather: Race, Gene Expression, and the Science of Health Disparities," American Journal of Public Health 95 (2005): 2155-2160.
131. For the National Institute of Diabetes and Digestive and Kidney Diseases, see "National Diabetes Statistics, 2007."
132. For rates in Appalachia, see Centers for Disease Control and Prevention (CDC), "County Level Estimates of Diagnosed Diabetes," available at http://apps.nccd.cdc.gov/DDT-STRS2/NationalDiabetesPrevalenceEstimates.aspx (accessed July 7, 2010). This new Web site, released by the CDC in 2008, provides data about diabetes rates by region. According to this site, Logan County in West Virginia has the highest percentage of diagnosed diabetes - 14.2% of the adult population - in the country. On Logan County
133. see Dan Hurley, Diabetes Rising: How a Rare Disease Became a Modern Pandemic, and What to Do About It (New York: Kaplan Publishing, 2010)
134. On other regions in Appalachia, see Meghan Holohan, "The Diabetes Dilemma," at the Diabetes Library at Ohio University, available at http://diabetes.boomja.com/index.php?ITEM=81574;and "
135. Diabetes in the Big Sandy Area Development District, 2005," available at http://chfs.ky.gov/NR/rdonlyres/D7D77EF6-FF86-4071-B566- BB7E1B694D54/0/BigSandy1.pdf (both accessed May 25, 2010).
136. For an excellent historical analysis of the way government data have created as much as recorded racial categorizations, see Melissa Nobles, "History Counts: A Comparative Analysis of Racial/ Color Categorization in US and Brazilian Censuses," American Journal of Public Health 90, no. 11 (2000): 1738-1745.
137. For a recent study that found that racial differences in the prevalence of diabetes disappeared when populations of similar socioeconomic status were compared, see L. B. Signorello, D.|G. Schlundt, S. S. Cohen, et al., "Comparing Diabetes Prevalence Between African Americans and Whites of Similar Socioeconomic Status," American Journal of Public Health 97, no. 12 (2007): 2260-2267.
138. See also Claudia Chaufan, "Poverty Versus Genes: The Social Context of Type 2 Diabetes," Diabetes Voice 49 (2004): 35-37.
139. For an example of an early 20th-century epidemiological study that linked class and disease but simultaneously rendered gender and race invisible, see Harry M. Marks, "Epidemiologists Explain Pellagra: Gender, Race, and Political Economy in the Work of Edgar Sydenstricker," Journal of the History of Medicine and Allied Sciences 58, no. 1 (2003): 34-55.
140. Krieger, "If 'Race' Is the Answer"
141. Williams, "Race and Health"
142. Audrey Smedley and Brian D. Smedley, "Race as Biology Is Fiction, Racism as Social Problem Is Real: Anthropological and Historical Perspectives on the Social Construction of Race," American Psychologist 60 (2005): 216-226.