Massage & Bodywork

MARCH | APRIL 2023

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L i s te n to T h e A B M P Po d c a s t a t a b m p.co m /p o d c a s t s o r w h e reve r yo u a cce s s yo u r favo r i te p o d c a s t s 71 Fitzpatrick Skin Tone Scale. Type I Type IV Type II Type V Type III Type VI 1 Race vs. Ethnicity The term race is often used to describe groups of people who are divided by inherited physical characteristics, like skin tone, eye color, hair texture, and so on. However, race can also be described as a purely social or political construct: a convenient way to identify who is "in" and who is "out" of a particular group—especially when establishing hierarchies of power. When we look at our genetic blueprints, we find more variation within self-identified racial groups than between them (according to the National Human Genome Research Institute), so the term race as a way to make genetic distinctions becomes a bit meaningless. I personally promote the idea that while we have rich diversity in physical (as well as mental, cultural, and other ways of self- expression) differences, ultimately there is only one race: the human race. So how do we describe our obvious differences in skin colors, which is necessary when discussing skin cancer? Ethnicity is a term that refers to groups who are identified by shared and inherited cultural practices and traditions, often linked to geographic regions. Some people suggest ethnicity is a better term than race to categorize humans, because it has less political baggage. Race and ethnicity are not synonymous, and neither one captures the concept of skin tone—which is a relevant identifier, at least in the context of skin cancer. I personally choose ethnicity to refer to distinctions between groups, because race has a long tradition of being used as a way to subjugate certain people, and I want to avoid falling into that linguistic trap. scale in 1975. His purpose was to clarify who, regardless of race or ethnicity, was most at risk for skin damage related to UV radiation (Image 1). Fitzpatrick found that people with Types I and II skin are most likely to sustain damage from UV radiation, regardless of their ethnic or racial heritage. This is useful, because it takes race identification or assignment (and all its accompanying cultural judgments) out of the equation (see "Race vs. Ethnicity"). Unfortunately, over time the use of the Fitzpatrick Skin Tone Scale has been distorted to oversimplify connections between skin color and ethnicity, so it has lost some of its effectiveness as an analytical or predictive tool. Physiologically, the main difference between people with dark skin and those with light skin is how much melanin they produce. How does this difference come about? Do people with dark skin have more melanocytes, or bigger melanocytes, or do their melanocytes just produce more melanin? Surprisingly, the answer to that question isn't always clear. Regardless of how many, or how big, or how active our melanocytes are, two truths have emerged from studies of skin cancer risk for people with skin of color: • People with dark skin get skin cancer less often than people with light skin. • People with dark skin are more likely to be diagnosed at an advanced stage, and more likely to die from skin cancer, compared to people with light skin.

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