San Francisco Chronicle
Racial initiative ignites medical worries
Researchers fear Prop. 54 will hinder collection of data
Ulysses Torassa, Chronicle Health Writer
Monday, August 11, 2003

Researchers are sounding alarms over the potential health effects of Proposition 54 -- the initiative to ban state government from collecting racial or ethnic data -- fearing it will jeopardize efforts to pinpoint cancer hot spots, keep tabs on disease outbreaks and fashion effective health messages.
Although the measure contains an exemption for "medical research subjects and patients," dozens of prominent health officials and organizations have now lined up against it, saying the wording doesn't protect wide swaths of data now used to track important health issues.
The initiative also comes at a time when researchers are focusing more attention on the marked differences in disease rates and treatments found among various ethnic groups -- a field that would be hamstrung should the measure pass, they say.
"Prop. 54 is bad medicine for all Californians," said Dr. Michael Sexton, chairman of the board of the California Medical Association, at a rally last week at San Francisco City Hall to help kick off the campaign against the measure.
Prop. 54 will appear on the Oct. 7 ballot alongside the gubernatorial recall, and a recent Field poll found about half of California voters say they support it. The initiative is being spearheaded by University of California Regent Ward Connerly, who also led the successful 1996 effort to pass Proposition 209, which prohibits racial preferences in public employment, contracting and education.
Initiative backers say that opponents are using scare tactics and that they have no intention of interfering with legitimate health research -- including epidemiological studies and health surveys.
"We believe the exemption is broad enough to include everything, and if there is a particular area that comes up later, and they can show a compelling need, we will accompany them to the Legislature to get an override," of the measure, said Diane Schachterle, Prop. 54 coordinator for the American Civil Rights Coalition, which put the initiative on the ballot.
Schachterle said the measure was intended to abolish racial classifications -- a legacy of slavery and Jim Crow laws -- and promote equality among all Californians. Already, she said, large numbers of people don't consider themselves one race or another, and many now refuse to check boxes that identify their ethnicity.
But researchers say the wording of the exemption is far too narrow. They view the term "medical research subject" in its public health context, in which it refers to volunteers in medical experiments, not individuals responding to surveys or filling out forms. There is even concern that the exemption will not cover birth and death records, making it nearly impossible to track trends in life expectancies and disease rates for various groups.
The application of the initiative to vital statistics is not yet clear. But other sources of data are more clearly affected, such as population estimates calculated by the California Department of Finance. State breast cancer researchers have relied on that data to accurately gauge the racial composition of various geographical regions.
Since breast cancer rates vary widely by race (Caucasian women are the most likely to get it; Hispanics and Asians, the least), the statistics must take into account the racial makeup of an area to make sure the comparisons of one region to another are fair.
"If we lose our ability to have state-produced population estimates, that could really impact our ability to do high-quality surveillance in the state," said Tina Clarke, a breast cancer researcher at the Northern California Cancer Center. "It's alarming. We're very concerned about it."
Concern is also high at the San Francisco Department of Public Health, where officials have identified several areas where the initiative could hurt them, including addressing the health needs of the city's diverse populations and being competitive for grants, which often require racial or ethnic data to help support a request for funding.