Conflating race and ancestry: Tracing decision points about population descriptors over the precision medicine research life course.

Responding to calls for human genomics to shift away from the use of race, genomic investigators are coalescing around the possibility of using genetic ancestry. This shift has renewed questions about the use of social and genetic concepts of difference in precision medicine research (PMR). Drawing from qualitative data on five PMR projects, we illustrate negotiations within and between research teams as genomic investigators deliberate on the relevance of race and genetic ancestry for different analyses and contexts. We highlight how concepts of both social and genetic difference are embedded within and travel through research practices, and identify multiple points across the research life course at which conceptual slippage and conflation between race and genetic ancestry occur. We argue that moving beyond race will require PMR investigators to confront the entrenched ways in which race is built into research practices and biomedical infrastructures.

Identification in Interaction: Racial Mirroring between Interviewers and Respondents.

Previous research has established that people shift their identities situationally and may come to subconsciously mirror one another. We explore this phenomenon among survey interviewers in the 2004-2018 General Social Survey by drawing on repeated measures of racial identification collected after each interview. We find not only that interviewers self-identify differently over time but also that their response changes cannot be fully explained by several measurement-error related expectations, either random or systematic. Rather, interviewers are significantly more likely to identify their race in ways that align with respondents' reports. The potential for affiliative identification, even if subconscious, has a range of implications for understanding race-of-interviewer effects, the social construction of homophily, and for how we consider causality in studies of race and racial inequality more broadly.

Conflicting signals: Exploring the socioeconomic implications of gender discordant names.

We investigate the educational and employment consequences of having a gender discordant name - one that is also given to people of a different gender. People with discordant names may be more likely to experience stigma due to the conflicting signal between their gender and the perceptions of femininity or masculinity associated with their names. Our primary measure of discordance is based on the percentage of men and women with each first name, using a large administrative dataset from Brazil. We find that both men and women with gender discordant names attain significantly less education. Gender discordant names are also negatively and significantly associated with earnings though, after controlling for educational attainment, only people with the most discordant names have significantly lower earnings. These results are corroborated when using crowd-sourced gender perceptions of names in our dataset, which suggests that stereotypes and the judgments of others are a probable mechanism for the observed disparities.

Targeting Representation: Interpreting Calls for Diversity in Precision Medicine Research.

Scientists have identified a "diversity gap" in genetic samples and health data, which have been drawn predominantly from individuals of European ancestry, as posing an existential threat to the promise of precision medicine. Inadequate inclusion as articulated by scientists, policymakers, and ethicists has prompted large-scale initiatives aimed at recruiting populations historically underrepresented in biomedical research. Despite explicit calls to increase diversity, the meaning of diversity - which dimensions matter for what outcomes and why - remain strikingly imprecise. Drawing on our document review and qualitative data from observations and interviews of funders and research teams involved in five precision medicine research (PMR) projects, we note that calls for increasing diversity often focus on "representation" as the goal of recruitment. The language of representation is used flexibly to refer to two objectives: achieving sufficient genetic variation across populations and including historically disenfranchised groups in research. We argue that these dual understandings of representation are more than rhetorical slippage, but rather allow for the contemporary collection of samples and data from marginalized populations to stand in as correcting historical exclusion of social groups towards addressing health inequity. We trace the unresolved historical debates over how and to what extent researchers should procure diversity in PMR and how they contributed to ongoing uncertainty about what axes of diversity matter and why. We argue that ambiguity in the meaning of representation at the outset of a study contributes to a lack of clear conceptualization of diversity downstream throughout subsequent phases of the study.

Strategies of inclusion: The tradeoffs of pursuing "baked in" diversity through place-based recruitment.

US funding agencies have begun to institutionalize expectations that biomedical studies achieve defined thresholds for diversity among research participants, including in precision medicine research (PMR). In this paper, we examine how practices of recruitment have unfolded in the wake of these diversity mandates. We find that a very common approach to seeking diverse participants leverages understandings of spatial, geographic, and site diversity as proxies and access points for participant diversity. That is, PMR investigators recruit from a diverse sampling of geographic areas, neighborhoods, sites, and institutional settings as both opportunistic but also meaningful ways to "bake in" participant diversity. In this way, logics of geographic and institutional diversity shift the question from who to recruit, to where. However, despite seeing geographic and site diversity as social and scientific 'goods' in the abstract and as key to getting diverse participants, PMR teams told us that working with diverse sites was often difficult in practice due to constraints in funding, time, and personnel, and inadequate research infrastructures and capacity. Thus, the ways in which these geographic and institutional diversity strategies were implemented resulted ultimately in limiting the meaningful inclusion of populations and organizations that had not previously participated in biomedical research and reproduced the inclusion of institutions that are already represented. These prevailing assumptions about and practices of "baked-in" diversity in fact exacerbate and produce other forms of inequity, in research capacity and research representation. These findings underscore how structural inequities in research resources must be addressed for diversity to be achieved in both research sites and research participants.

Consistent Divisions or Methodological Decisions? Assessing the U.S. Racial Hierarchy Across Outcomes.

Scholars have offered a range of perspectives on the twenty-first century racial landscape with little consensus about either the current state of the U.S. racial hierarchy or its future trajectory. We offer a more comprehensive assessment, using data from the National Longitudinal Study of Adolescent to Adult Health (Add Health) to study racial stratification across a number of socioeconomic outcomes. We pay particular attention to the robustness of results across different categorization schemes that account for self-identification and interviewer classification, as well as racial fluidity. Although we observe that White and Asian Americans generally have the best socioeconomic outcomes, on average, while Black Americans and American Indians have the worst, we also find meaningful differences in patterns of stratification both across outcomes and depending on how race is operationalized. These differences in stratification are reflected in the estimated number of strata as well as the rank order of racial categories. Our results suggest that ongoing debates about the nature of the U.S. racial hierarchy can be partly explained by methodological decisions about which outcomes to study and how best to measure race. Supplementary Information: The online version contains supplementary material available at 10.1007/s12552-021-09351-2.

Beyond inclusion: Enacting team equity in precision medicine research.

PURPOSE: To identify meanings of and challenges to enacting equitable diversification of genomics research, and specifically precision medicine research (PMR), teams. METHODS: We conducted in-depth interviews with 102 individuals involved in three U.S.-based precision medicine research consortia and conducted over 400 observation hours of their working group meetings, consortium-wide meetings, and conference presentations. We also reviewed published reports on genomic workforce diversity (WFD), particularly those relevant to the PMR community. RESULTS: Our study finds that many PMR teams encounter challenges as they strive to achieve equitable diversification on scientific teams. Interviewees articulated that underrepresented team members were often hired to increase the study's capacity to recruit diverse research participants, but are limited to on-the-ground staff positions with little influence over study design. We find existing hierarchies and power structures in the academic research ecosystem compound challenges for equitable diversification. CONCLUSION: Our results suggest that meaningful diversification of PMR teams will only be possible when team equity is prioritized as a core value in academic research communities.

Gender, Generation, and Multiracial Identification in the United States.

Multiracial self-identification is frequently portrayed as a disproportionately female tendency, but previous research has not probed the conditions under which this relationship might occur. Using the 2015 Pew Survey of Multiracial Adults, we offer a more comprehensive analysis that considers gender differences at two distinct stages: reporting multiple races in one's ancestry and selecting multiple races to describe oneself. We also examine self-identification patterns by the generational locus of multiracial ancestry. We find that females are more likely to be aware of multiracial ancestry overall, but only first-generation females are more likely than their male counterparts to self-identify as multiracial. Finally, we explore the role of racial ancestry combination, finding that multiracial awareness and self-identification are likely gendered differently for different segments of the mixed-race population. This offers a more nuanced picture of how gender interacts with other social processes to shape racial identification in the United States.

Measuring Race and Ancestry in the Age of Genetic Testing.

Will the rise of genetic ancestry tests (GATs) change how Americans respond to questions about race and ancestry on censuses and surveys? To provide an answer, we draw on a unique study of more than 100,000 U.S. adults that inquired about respondents' race, ancestry, and genealogical knowledge. We find that people in our sample who have taken a GAT, compared with those who have not, are more likely to self-identify as multiracial and are particularly likely to select three or more races. This difference in multiple-race reporting stems from three factors: (1) people who identify as multiracial are more likely to take GATs; (2) GAT takers are more likely to report multiple regions of ancestral origin; and (3) GAT takers more frequently translate reported ancestral diversity into multiracial self-identification. Our results imply that Americans will select three or more races at higher rates in future demographic data collection, with marked increases in multiple-race reporting among middle-aged adults. We also present experimental evidence that asking questions about ancestry before racial identification moderates some of these GAT-linked reporting differences. Demographers should consider how the meaning of U.S. race data may be changing as more Americans are exposed to information from GATs.

Consumer (dis-)interest in Genetic Ancestry Testing: The roles of race, immigration, and ancestral certainty.

Genetic ancestry testing (GAT) is marketed as a way to make up for missing knowledge about one's ancestry. Previous research questions the GAT industry's ability to fulfill this promise in terms of the validity and reliability of test results. We instead explore the demand side of GAT, evaluating who is most and least likely to express interest in GAT. Using data from an original, nationwide survey of over 100,000 American adults, we find that GAT interest is related to both self-identified race and immigrant generation, with Asian Americans and first-generation immigrants expressing the least interest. Our quantitative and qualitative evidence suggests interest is further shaped by a pre-existing sense of ancestral certainty, leading some individuals to decline GAT, even if it were free. How interest and ancestral certainty are patterned has implications for who is included in - and thus for the conclusions that can be drawn from - genetic ancestry databases.

Placing Racial Classification in Context.

This article extends previous research on place-based patterns of racial categorization by linking it to sociological theory that posits subnational variation in cultural schemas and applying regression techniques that allow for spatial variation in model estimates. We use data from a U.S. restricted-use geocoded longitudinal survey to predict racial classification as a function of both individual and county characteristics. We first estimate national average associations, then turn to spatial-regime models and geographically weighted regression to explore how these relationships vary across the country. We find that individual characteristics matter most for classification as "Black," while contextual characteristics are important predictors of classification as "White" or "Other," but some predictors also vary across space, as expected. These results affirm the importance of place in defining racial boundaries and suggest that U.S. racial schemas operate at different spatial scales, with some being national in scope while others are more locally situated.

Gender and Health: Beyond Binary Categorical Measurement.

This study leverages multiple measures of gender from a US national online survey (N = 1,508) to better assess how gender is related to self-rated health. In contrast to research linking feminine behaviors with good health and masculine behaviors with poor health, we find that masculinity is associated with better self-rated health for cisgender men, whereas femininity is associated with better self-rated health for cisgender women. The patterns are similar whether we consider self-identification or how people feel others perceive their gender, though reflected appraisals are most strongly associated with health for cisgender women. We also find that people who report they are seen as gender nonconforming report worse health, but only when this perception does not match their gender identification. Our results demonstrate that multiple measures of gender allow researchers to disentangle how health is not only shaped by gender enactments but also shapes perceptions of gender and gender difference.

Race, Ethnicity and Ancestry in Unrelated Transplant Matching for the National Marrow Donor Program: A Comparison of Multiple Forms of Self-Identification with Genetics.

We conducted a nationwide study comparing self-identification to genetic ancestry classifications in a large cohort (n = 1752) from the National Marrow Donor Program. We sought to determine how various measures of self-identification intersect with genetic ancestry, with the aim of improving matching algorithms for unrelated bone marrow transplant. Multiple dimensions of self-identification, including race/ethnicity and geographic ancestry were compared to classifications based on ancestry informative markers (AIMs), and the human leukocyte antigen (HLA) genes, which are required for transplant matching. Nearly 20% of responses were inconsistent between reporting race/ethnicity versus geographic ancestry. Despite strong concordance between AIMs and HLA, no measure of self-identification shows complete correspondence with genetic ancestry. In certain cases geographic ancestry reporting matches genetic ancestry not reflected in race/ethnicity identification, but in other cases geographic ancestries show little correspondence to genetic measures, with important differences by gender. However, when respondents assign ancestry to grandparents, we observe sub-groups of individuals with well- defined genetic ancestries, including important differences in HLA frequencies, with implications for transplant matching. While we advocate for tailored questioning to improve accuracy of ancestry ascertainment, collection of donor grandparents' information will improve the chances of finding matches for many patients, particularly for mixed-ancestry individuals.

Disentangling the Effects of Racial Self-identification and Classification by Others: The Case of Arrest.

Scholars of race have stressed the importance of thinking about race as a multidimensional construct, yet research on racial inequality does not routinely take this multidimensionality into account. We draw on data from the U.S. National Longitudinal Study of Adolescent Health to disentangle the effects of self-identifying as black and being classified by others as black on subsequently being arrested. Results reveal that the odds of arrest are nearly three times higher for people who were classified by others as black, even if they did not identify themselves as black. By contrast, we find no effect of self-identifying as black among people who were not seen by others as black. These results suggest that racial perceptions play an important role in racial disparities in arrest rates and provide a useful analytical approach for disentangling the effects of race on other outcomes.

A "mulatto escape hatch" in the United States? Examining evidence of racial and social mobility during the Jim Crow era.

Racial distinctions in the United States have long been characterized as uniquely rigid and governed by strict rules of descent, particularly along the black-white boundary. This is often contrasted with countries, such as Brazil, that recognize "mixed" or intermediate racial categories and allow for more fluidity or ambiguity in racial classification. Recently released longitudinal data from the IPUMS Linked Representative Samples, and the brief inclusion of a "mulatto" category in the U.S. Census, allow us to subject this generally accepted wisdom to empirical test for the 1870-1920 period. We find substantial fluidity in black-mulatto classification between censuses-including notable "downward" racial mobility. Using person fixed-effects models, we also find evidence that among Southern men, the likelihood of being classified as mulatto was related to intercensal changes in occupational status. These findings have implications for studies of race and inequality in the United States, cross-national research on racial classification schemes in the Americas, and for how demographers collect and interpret racial data.

When white people report racial discrimination: The role of region, religion, and politics.

Scholarly interest in the correlates and consequences of perceived discrimination has grown exponentially in recent years, yet, despite increased legal and media attention to claims of "anti-white bias," empirical studies predicting reports of racial discrimination by white Americans remain limited. Using data from the 2006 Portraits of American Life Study, we find that evangelical Protestantism increases the odds that whites will report experiencing racial discrimination, even after controlling for racial context and an array of social and psychological characteristics. However, this effect is limited to the South. Outside the South, political affiliation trumps religion, yielding distinct regional profiles of discrimination reporters. These findings suggest that institutions may function as regional "carriers" for whites inclined to report racial discrimination.

Looking the part: social status cues shape race perception.

It is commonly believed that race is perceived through another's facial features, such as skin color. In the present research, we demonstrate that cues to social status that often surround a face systematically change the perception of its race. Participants categorized the race of faces that varied along White-Black morph continua and that were presented with high-status or low-status attire. Low-status attire increased the likelihood of categorization as Black, whereas high-status attire increased the likelihood of categorization as White; and this influence grew stronger as race became more ambiguous (Experiment 1). When faces with high-status attire were categorized as Black or faces with low-status attire were categorized as White, participants' hand movements nevertheless revealed a simultaneous attraction to select the other race-category response (stereotypically tied to the status cue) before arriving at a final categorization. Further, this attraction effect grew as race became more ambiguous (Experiment 2). Computational simulations then demonstrated that these effects may be accounted for by a neurally plausible person categorization system, in which contextual cues come to trigger stereotypes that in turn influence race perception. Together, the findings show how stereotypes interact with physical cues to shape person categorization, and suggest that social and contextual factors guide the perception of race.

Cause of death affects racial classification on death certificates.

Recent research suggests racial classification is responsive to social stereotypes, but how this affects racial classification in national vital statistics is unknown. This study examines whether cause of death influences racial classification on death certificates. We analyze the racial classifications from a nationally representative sample of death certificates and subsequent interviews with the decedents' next of kin and find notable discrepancies between the two racial classifications by cause of death. Cirrhosis decedents are more likely to be recorded as American Indian on their death certificates, and homicide victims are more likely to be recorded as Black; these results remain net of controls for followback survey racial classification, indicating that the relationship we reveal is not simply a restatement of the fact that these causes of death are more prevalent among certain groups. Our findings suggest that seemingly non-racial characteristics, such as cause of death, affect how people are racially perceived by others and thus shape U.S. official statistics.