Is there still too much extrapolation from data on middle-aged white men?

Article Abstract:

Medical research studies have traditionally used middle-aged white men as subjects when testing new drugs and procedures; the advantage in this approach is that this group is biologically homogenous. Many scientists believe that the inclusion of women, persons of various ethnic backgrounds, and the elderly will complicate their studies and obscure the interpretation of the results. Even in research with rats, females are often excluded. However, over the past decade it has become clear that sex, race and age may greatly influence an individual's risk for disease and response to drugs; physicians are left wondering whether a treatment effective in the middle-aged white male is appropriate for other patients as well. Examples of drugs that have only been tested on men are the cholesterol-lowering medications and aspirin taken daily to prevent heart attacks; these treatments have never been studied in women, even though heart disease is the number one killer of both men and women. Activist groups representing the elderly, women, and minorities are challenging the National Institutes of Health (NIH) about their policies for selecting studies to be funded, claiming that the NIH condones discrimination in research study designs. As more and more women become researchers, the fact that the menstrual cycle and the possibility of pregnancy can confound research results may be more regularly taken into account. It is also possible that minorities have been ignored because so few researchers are nonwhite; one problem with enrolling minorities is that, taken in general as low-income groups, they may have difficulty participating in studies if they lack transportation and child care arrangements. According to one expert, because the elderly are often the first to take new drugs and may be particularly vulnerable to their side effects, they should be studied much more closely. (Consumer Summary produced by Reliance Medical Information, Inc.)

Middle aged men, Old age, White men, Pharmacokinetics

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Examples abound of gaps in medical knowledge because of groups excluded from scientific study

Article Abstract:

The vast majority of clinical research studies have been done on white male subjects, leaving large gaps in the knowledge of how drugs and other treatments affect women and minorities. While a small number of studies have included these groups, even fewer studies have intentionally evaluated racial or sex differences. Some scientists are proposing a special multi-ethnic research center to evaluate such issues. To date, most ethnic differences have been discovered by chance, for instance when many patients had an unexplained reaction to a drug. Asians have been found to metabolize beta-blockers faster and psychotropic drugs slower than white patients. Blacks, who are already 17 times more likely to develop kidney failure than whites, have a greater risk of lithium toxicity, which can damage the kidneys. Black women have an increased risk for delivering low birth weight infants, which may result from high inner-city stress causing chronic vasoconstriction that limits blood flow to the fetus. In women, the menstrual cycle appears to alter responses to medications for depression, epilepsy, and asthma. The disease receiving the most attention currently in regard to gender differences is heart disease. The beneficial effects seen in men from low-fat diets, daily aspirin to prevent heart attacks, and cholesterol-lowering drugs may not occur in women; instead these interventions could even be harmful. There are no data available to guide doctors and their female patients on the risks and benefits of these treatments. (Consumer Summary produced by Reliance Medical Information, Inc.)

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Attacks on homosexual persons may be increasing, but many 'bashings' still aren't reported to police

Article Abstract:

Gay-bashing, or assaults against gays, increased 15% in 1991, but many gays are afraid to report such incidents because they fear abuse at the hands of police. They may also fear that doctors will treat them badly, and they may not want to reveal their sexual orientation. Gay-bashing does not evoke the kind of moral outrage that other hate crimes do, partly because of societal and individual attitudes. Several states and municipalities have included sexual orientation in laws dealing with hate crimes, and a similar bill is pending in Congress. The Federal Bureau of Investigation (FBI) in 1990 began collecting data on hate crimes against gays and lesbians. Many of the perpetrators are young males who may beat up gays to reinforce their identity as 'real men.' The best response to verbal insults may be to move away from the attacker, while memorizing a complete physical description, which can be reported to the police.

Social aspects, Gays, Crimes against, Violence

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