Spirometry in Mixed-Race Civil War Veterans

The use of race in pulmonary function interpretation is controversial.Plantation-based studies in proslavery publications first suggested racial differences in lung function.Because of its size, Benjamin Gould's study was a landmark (1).Gould was tasked to lead a large anthropometric survey of over 1.2 million Union soldiers.Gould's work was published in 1869 by the U.S. Sanitary Commission, a body whose still-famous members included Frederick Law Olmsted, architect of Central Park, and Louisa May Alcott, author of Little Women (1).An influential 1966 publication cited Gould's work as evidence that observed differences in lung function between Black and White individuals reflect innate features of those races ( 2).Yet, Gould's findings have been criticized for failing to account for socioeconomic status or to adequately adjust for height (3).Gould commented that the "similarity of values for full blacks and mulattoes . . .warrants their consolidation into a single class" (1).This statement highlights a largely neglected but critical group: Americans of mixed race.Political structures starting with the Jim Crow era dichotomized racial designations into White or Black social groups.Although there is no lung function reference equation for mixed-race individuals, studies of genetic ancestry and lung function suggest that their mean vital capacity (VC) should exceed that of African American individuals, who have greater African ancestry (4).The Global Lung Initiative's other race equation, often used for mixed-race individuals, also yields predicted values higher than those in its reference equation for African American individuals (5).Using Gould's work as one time point, comparison with later studies can assess for change in racial VC differences.If genetics is a primary determinant of racial VC differences, we would expect the relationship between race and lung function to be consistent over time.Alternatively, if environmental conditions are more influential, then we would expect that associations with VC evolve alongside social definitions of race.We present an interrogation of the Gould data that aims to distinguish these two possibilities.We hypothesize that because even minimal African ancestry assured low social status in the 19 th -century United States, a formal analysis of Gould's data will support his assertion of overlapping VC for mixed-race and African American veterans. Methods

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