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Chapter 109: Race, Ethnicity, and Cardiovascular Disease

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Which of the following statements concerning race and ethnicity is false?

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A. Race and ethnicity are precise proxies for genetic or other biological phenomena

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B. Race and ethnicity are often confounded by socioeconomic status (SES)

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C. Race and ethnicity are social, political, historical, and cultural constructs

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D. Data on race and ethnicity can be invaluable in clinical and public health practice

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E. The collection of data on race and ethnicity are crucial in the quest to advance health equity

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The answer is A. (Hurst’s The Heart, 14th Edition, Chap. 109) Race and ethnicity are social, political, historical, and cultural constructs (option C).1,2 As such, they are flawed as biological concepts and inappropriate or, at best, imprecise when used as proxy for genetic or other biological phenomena (option A).1-5 Consistent with this premise, racial and ethnic differences observed in the incidence, prevalence, morbidity, and mortality of cardiovascular diseases (CVD) should not be construed as necessarily resulting from genetic or other biological differences. Race and ethnicity are often confounded by socioeconomic status (SES) (option B). Thus, observed racial and ethnic differences that are not appropriately adjusted for SES and related factors could lead to erroneous conclusions with potentially adverse clinical and public health implications. Despite these challenges, data on race and ethnicity, when properly collected, analyzed, and interpreted, can be invaluable in clinical and public health practice (option D).6-8 In particular, the appropriate collection and use of data on race and ethnicity are crucial in the quest to eliminate racial and ethnic disparities in cardiovascular health and to advance health equity (option E).9,10

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A 21-year-old African American man presents to your clinic for a routine physical examination. Which of the following statements is false?

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A. “Race” as an identifier lacks a clear definition

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B. Culture, language, religion, and ethnicity are often strong indicators of ancestry

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C. Race and ethnicity introduce provider bias about an patient’s ability or willingness to accept care and may adversely affect disease management

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D. Race and ethnicity are associated with differences in disease prevalence, expression, and outcome

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E. All of the above

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The answer is B. (Hurst’s The Heart, 14th Edition, Chap. 109) Historically, the biological concept of race has been associated with hierarchical ranking, biological determinism, eugenics, and justification for genocide, colonialism, slavery, and other social inequities.11 It should not be ...

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