"Race" in the epidemiologic literature: an examination of the American Journal of Epidemiology, 1921-1990.

The routine presentation of epidemiologic data by "race" has been challenged as impeding identification of modifiable risk factors and fostering an unsubstantiated belief in the biologic distinctness of the "races." This study examines the past and current uses of "race" in US epidemiologic research. The authors reviewed every paper published in the 1921, 1930, 1940, 1950, and 1960 volumes of the American Journal of Hygiene and in the 1965, 1970, 1975, 1980, 1985, and 1990 volumes of the American Journal of Epidemiology. Of the total of 1,200 papers published during the sample years, 558 reports of original epidemiologic research conducted in the United States were identified. The proportion of these papers containing a reference to "race" rose steadily from 1975. However, the proportion of papers reporting inclusion of "nonwhite" populations did not show a parallel increase. Exclusion of "nonwhite" subjects and description of predominantly "white" study populations increased instead. Recommendations for future epidemiologic practice include the following: 1) greater inclusion of "nonwhite" populations in epidemiologic research and 2) vigorous investigation of the root causes of observed "race"-associated differences.