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Benign ethnic neutropenia, common in people of African ancestry, is a harmless low neutrophil count. This condition highlights how medical systems may misinterpret normal ethnic variations as disease, contributing to systemic racism.

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Area of Science:

  • Hematology
  • Genetics
  • Medical Anthropology

Background:

  • Benign ethnic neutropenia (BEN) is characterized by an absolute neutrophil count (ANC) below 1500 cells/μL without increased infection risk.
  • This phenotype is prevalent in individuals of African ancestry, with reference ranges in African countries confirming its commonality and harmlessness.
  • The Duffy null [Fy(a-b-)] phenotype, protective against malaria, is the genetic driver of lower ANC levels in populations of sub-Saharan African descent.

Purpose of the Study:

  • To examine the implications of labeling benign ethnic neutropenia as a medical condition.
  • To investigate how standard hematological practices may perpetuate systemic racism by pathologizing normal ethnic variations.
  • To advocate for the rectification of practices that contribute to racial bias in medicine.

Main Methods:

  • Review of existing literature on benign ethnic neutropenia and its genetic underpinnings.
  • Analysis of racial disparities in the interpretation of hematological reference ranges.
  • Critical examination of the historical and societal context of medical definitions and classifications.

Main Results:

  • The Duffy null phenotype, common in individuals of African ancestry, explains the lower ANC levels observed in benign ethnic neutropenia.
  • Standard medical reference ranges, often based on European populations, can lead to the misclassification of normal ethnic variations as pathological.
  • The designation of BEN as a "condition" by the predominantly White American medical system implicitly labels non-White phenotypes as abnormal.

Conclusions:

  • Benign ethnic neutropenia is a clinically insignificant ethnic variation, not a disease state.
  • The medical system's framing of BEN contributes to systemic racism by pathologizing normal human variation.
  • Urgent re-evaluation of hematological practices is necessary to address and eliminate racial bias in medicine.