IS RACIAL research in medicine racist? Publications about comparative racial research number in the thousands. A review of the English-language medical literature reveals that there is a predilection for making comparisons between black and white patients, particularly with diseases associated with promiscuity, underachievement, and antisocial behavior. Reports on studies of sexually acquired diseases,1-6 suboptimal intellectual performance,7-9 drug abuse,10,11 violence,12-14 and sexual assault15-17 are common. Other topics of racial comparison are differences in incidence of renal and cardiovas-cular18-21 diseases and presumed racial differences in anatomy,22,23 physiology,24-26 and psychology.27See also pp 259 and 268.When race is used as a variable in research, there is a tendency to assume that the results obtained are a manifestation of the biology of racial differences; race as a variable implies that a genetic reason may explain differences in incidence, severity, or outcome ofmedical conditions. Research¬ ers, without saying so, lead readers to assume that certain racial groups have a special predisposition, risk, or suscep¬ tibility to the illnesses studied. Since this presupposition is seldom warranted, this kind of comparison may be taken to represent a subtle form of racism. But in any case, although there are ethical problems with the search for genetic reasons to explain certain types of diseases, the scientific pitfalls that stand in the way of ethnic research are formidable since racial status is highly correlated with social, economic, and political factors. We will explore the practical problems and examine the consequences of using race as a category in medical re¬ search. Practical Problems With Racial ClassificationRacism.-Scientists do not operate in a vacuum; they are members of a larger society and operate within a social, political, and cultural framework. Racism-a doctrine, atti¬ tude, or activity that promotes feelings of antagonism based on racial differences-has influenced for centuries the na¬ ture, structure, and function of societies. It is a term that applies especially to activities that encourage feelings of ra¬ cial superiority, inferiority, or purity. It also applies to doc¬ trines that further the concept that the behavior, social achievements, and intellectual capacity of humans are ge¬ netically determined by race. It is unlikely that scientists From the

Effective policy development of human service delivery to American Indians depends on an understanding of cultural characteristics and extended family networks

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The problematic behaviors of teenagers and the subsequent negative consequences are extensive and well documented: unwanted pregnancy, substance abuse, violent behavior, depression, and social and psychological consequences of unemployment. In this article, the authors review an approach that uses a cooperative learning, empirically based intervention that employs peers as teachers. This intervention of choice is Teams-Games-Tournaments (TGT), a paradigm backed by five decades of empirical support. The application of TGT in preventive health programs incorporates elements in common with other prevention programs that are based on a public health orientation and constitute the essential components of health education, that is, skills training and practice in applying skills. The TGT intervention supports the idea that children and adolescents from various socioeconomic classes, between the ages of 8 and 18 and in classrooms or groups ranging in size from 4 to 17 members, can work together for one another. TGT has been applied successfully in such diverse areas as adolescent development, sexuality education, psychoactive substance abuse education, anger control, coping with depression and suicide, nutrition, comprehensive employment preparation, and family intervention. This article reviews the extensive research on TGT using examples of successful projects in substance abuse, violence, and nutrition. Issues are raised that relate to the implementation of preventive health strategies for adolescents, including cognitive aspects, social and family networks, and intervention components.

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