Lung function, race and ethnicity: a conundrum.

I n this issue BRAUN et al. [1] make a plea for an international workshop to review aspects of race and ethnicity in relation to lung function. This is a timely initiative, as many people struggle in epidemiological and genetic studies, and in clinical practice, with the interpretation of test results in an increasingly multi-ethnic society [2]. Our notions of race derive from Blumenbach, who defined ‘‘Four varieties of mankind, one species’’ (adding a fifth variety in 1781) [3]. Definitions of ‘‘race’’ and ‘‘ethnic’’ are confusing and often used interchangeably. This ambiguity is reflected in the frequent use of race/ethnicity, a transitional concept adopted for use while phasing out ‘‘race’’ from the USA census [4]. At this stage the USA census recognises two ethnicities: ‘‘Hispanic or Latino’’, and ‘‘not Hispanic or Latino’’, and five races; Hispanic/Latino individuals have a mixed European, African and native American ancestry [5]. American citizens were allowed to selfidentify with more than one race in 2000: 2.4% self-identified as multiracial. In sharp contrast, France passed a law in 1978 barring the government from collecting all racial and ethnic data (the Act prohibits collecting ‘‘any information that shows, directly or indirectly, racial or ethnic origins, political, philosophical or religious opinions, trade union membership, moral principles, or information that relates to health or sexual life’’ without either the written consent of the individual or an advance recommendation of the National Commission for Information Technology and Civil Liberties, which must first be approved by the Conseil d’État) [6]. The collection of data on race and ethnicity by governments serves administrative and statistical purposes; the classifications should not be interpreted as being scientific or anthropological in nature. However, this caveat is not heeded, and the classifications are widely used in everyday life, science and medicine, where race/ethnicity is used as a proxy for other phenomena.