Mapping "Race"

Mapping "Race": Critical Approaches to Health Disparities Research

Laura E. Gómez
Nancy López
Copyright Date: 2013
Published by: Rutgers University Press
Pages: 246
https://www.jstor.org/stable/j.ctt5hhwjx
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  • Book Info
    Mapping "Race"
    Book Description:

    Researchers commonly ask subjects to self-identify their race from a menu of preestablished options. Yet if race is a multidimensional, multilevel social construction, this has profound methodological implications for the sciences and social sciences. Race must inform how we design large-scale data collection and how scientists utilize race in the context of specific research questions. This landmark collection argues for the recognition of those implications for research and suggests ways in which they may be integrated into future scientific endeavors. It concludes on a prescriptive note, providing an arsenal of multidisciplinary, conceptual, and methodological tools for studying race specifically within the context of health inequalities.Contributors:John A. Garcia, Arline T. Geronimus, Laura E. Gómez, Joseph L. Graves Jr., Janet E. Helms, Derek Kenji Iwamoto, Jonathan Kahn, Jay S. Kaufman, Mai M. Kindaichi, Simon J. Craddock Lee, Nancy López, Ethan H. Mereish, Matthew Miller, Gabriel R. Sanchez, Aliya Saperstein, R. Burciaga Valdez, Vicki D. Ybarra

    eISBN: 978-0-8135-6138-7
    Subjects: Health Sciences, Sociology

Table of Contents

  1. Front Matter
    (pp. i-iv)
  2. Table of Contents
    (pp. v-vi)
  3. List of Figures and Tables
    (pp. vii-viii)
  4. Foreword
    (pp. ix-xii)
    R. Burciaga Valdez

    In 2008, the National Institutes of Health hosted over five thousand scholars at its first Science of Eliminating Health Disparities Summit. The subsequent annual summits were designed to encourage integration of science, practice, and policy to build a healthier society. As the opening plenary keynote speaker for the first one, I was asked to address “Health Disparities and the Intersection of Science and Policy.” I deliberately anchored my talk in an explanation of health disparities as a reflection of social stratification and inequitable resource allocations along “racial” and “ethnic” lines. But what do we mean by “racial” and “ethnic” lines?...

  5. Preface
    (pp. xiii-xviii)
    Laura Gómez and Nancy López
  6. Chapter 1 Introduction: Taking the Social Construction of Race Seriously in Health Disparities Research
    (pp. 1-22)
    Laura E. Gómez

    Typing the word “disparities” into the search engine of the American Diabetes Association web site generates nearly 1,700 hits that relate to racial and/or ethnic gaps in diabetes rates and care (http://www.diabetes.org, accessed July 5, 2012). Similarly, an agency of the U.S. Health and Human Services Department proclaims that the risk of diabetes is “much greater for minority populations than the white population” (“Diabetes Disparities among Racial and Ethnic Minorities Fact Sheet” 2012). These warnings reflect multiple biomedical studies that have identified differential rates of diabetes among Whites (6.2 percent), American Indians (9 percent), Mexican Americans (10.6 percent), and African...

  7. Part I Charting the Problem
    • [Part I Introduction]
      (pp. 23-24)

      This section ofMapping “Race”charts the scope of the problem identified in chapter 1: not adequately conceptualizing “race” as socially constructed leads to weaknesses in terms of both how we assess and attempt to redress health disparities linked to race. This section features four chapters written by scholars who approach the topic from vantage points in diverse positions across the humanities, biological, medical, and social sciences.

      Legal scholar and historian Jonathan Kahn begins our dialogue by asserting that where one locates the source of health disparities is crucial because it determines whether the observed racial disparity is identified as...

    • Chapter 2 The Politics of Framing Health Disparities: Markets and Justice
      (pp. 25-38)
      Jonathan Kahn

      The increase of using race as a biological construct in biomedical research and practice raises concerns over the dangers of reifying race in a manner that leads to new forms of discrimination. The most prominent example of racialized medicine is BiDil, the first drug ever approved by the FDA with a race-specific indication on its label—for use in “Black” patients. BiDil, however, is part of a much larger dynamic in which the purported “reality of race” as genetic is used to obscure the social reality of racism (Kahn 2008; Kahn 2012). To the extent that this dynamic succeeds in...

    • Chapter 3 Looking at the World through “Race”-Colored Glasses: The Fallacy of Ascertainment Bias in Biomedical Research and Practice
      (pp. 39-52)
      Joseph L. Graves Jr.

      The mortality pattern difference between African Americans and Euro-Americans in the twentieth century was staggering. Figure 3.1 shows the ratios of age-specific mortality from all sources for these two populations from 1963, 1980, 1996, and 2004. African American infant mortality was between two to two and a half times higher than that of European Americans, and the agespecific mortality of African Americans was always in excess of that of European Americans except at the oldest ages (greater than eighty-five years). The data from 2004 show significant reduction of the differential in age-specific mortality occurring between twenty-five and fifty-five years old....

    • Chapter 4 Ethical Dilemmas in Statistical Practice: The Problem of Race in Biomedicine
      (pp. 53-66)
      Jay S. Kaufman

      Most discussions of ethics in statistical practice revolve around declaring conflicts of interest due to funding sources and engaging in honest descriptions of data and procedures (American Statistical Association 1983, 1999; International Statistical Institute 1985; Jowell 1981). This is all well and good, but such a narrow focus on greed and fabrication ignores some of the more interesting and intractable ethical problems necessarily involved in inference and prediction, especially when social groups are transformed into statistical categories. Racial comparisons therefore provide an interesting case study of some of these problems, as they are frequently the targets of statistical analysis in...

    • Chapter 5 A Holistic Alternative to Current Survey Research Approaches to Race
      (pp. 67-84)
      John A. Garcia

      Social scientists have examined and used measures of race for much of the period marking the advent of empirical social science. The world’s largest social science data archive, the Inter-University Consortium for Political and Social Research, maintains an archive of more than 70,000 data sets of research in the social sciences. Hosting sixteen specialized collections of data in education, aging, criminal justice, substance abuse, terrorism, and other fields, more than 19,000 of its data sets include at least one variable labeled as race. An initial review of these studies indicates two major patterns. First, virtually all of the data sets...

  8. Part II Navigating Diverse Empirical Settings
    • [Part II Introduction]
      (pp. 85-86)

      The opening chapter ofMapping “Race”argued that the conventional approach to studying race-based health disparities has been characterized by the failure to rigorously define and operationalize “race.” The core problem is twofold. First, research that does not expressly conceptualize race often ends up reifying race as a fixed characteristic that is implicitly rooted in biology. At the same time, such research also can have significant policy hazards by distracting health care providers and policy makers from taking steps to address the genuine causes of disparities, which often are rooted in racialized patterns of socioeconomic and structural inequality that create...

    • Chapter 6 Organizational Practice and Social Constraints: Problems of Racial Identity Data Collection in Cancer Care and Research
      (pp. 87-103)
      Simon J. Craddock Lee

      This chapter focuses on the pragmatics of how race and ethnic identity data are collected in the course of clinical care, drawing from my own interactions with the staff and procedural mechanisms of a university medical center and county safety-net hospital. This chapter differs from others in this volume because I set aside topics such as the legitimacy of the race construct, its social construction, race as a biological fallacy, and the reification of race.¹ I want to bracket those uncertainties. I also do not directly engage with the methodological challenges of how “race” or “ethnicity” may be engaged in...

    • Chapter 7 Lessons from Political Science: Health Status and Improving How We Study Race
      (pp. 104-116)
      Gabriel R. Sanchez and Vickie D. Ybarra

      Over the past twenty-plus years, hundreds of studies have verified the persistence of pervasive racial/ethnic inequities in access to health care, health outcomes, and health status in the United States (for a sampling, see AHRQ 2009; Berenson et al. 1996; Collins et al. 1999; Gornick 2000; James et al. 2007; McGuire and Miranda 2008; Satcher et al. 2005; Smedley et al. 2003; Waidmann and Rajan 2000). In fact, a recent edition of the premier academic journal for the study of race in the social sciences, theDu Bois Review, specifically focused on racial inequalities in health. The articles in this...

    • Chapter 8 Advancing Asian American Mental Health Research by Enhancing Racial Identity Measures
      (pp. 117-130)
      Derek Kenji Iwamoto, Mai M. Kindaichi and Matthew Miller

      Asian Americans are often racialized by society through the minimization of Asian ethnic group variations and the exaggeration of similarities across these ethnic groups (Liu and Iwamoto 2006). As a result, diverse people with a particular phenotype are categorized racially as “Asian” regardless of various ethnic differences (Iwamoto and Liu 2010). Terminology for race, ethnicity, ethnic identity, and culture are often conflated or used interchangeably to lump people of various Asian ethnicities and cultural groups into one homogenous group: the racial category “Asian American” is comprised of at least thirty different ethnic groups and potentially many more cultural groups (U.S....

  9. Part III Surveying Solutions
    • [Part III Introduction]
      (pp. 131-132)

      In this final section ofMapping “Race,”we survey conceptual and methodological solutions to the problems we have identified in the prior eight chapters. These three chapters are written by scholars in sociology, psychology, and public health who present diverse ways of closing the gap between conceptualizing race as a socially constructed, multidimensional, dynamic phenomenon and implementing that vision by way of careful research design in the health disparities context.

      In chapter 9, sociologist Aliya Saperstein argues that we must engage both the strategies of maximizing existing survey data sets and creating better ones in order to fully operationalize race...

    • Chapter 9 Representing the Multidimensionality of Race in Survey Research
      (pp. 133-145)
      Aliya Saperstein

      When designing and conducting research, taking the claim that race is socially constructed seriously is easier said than done. Some methods, such as historical/archival research or in-depth interviewing and ethnography, are better suited to reveal the specific moments, mechanisms, and processes through which racialized categories and boundaries shape life chances and come to have meaning in people’s lives. However, that does not—and should not—let those of us who employ demographic methods or quantitative survey research off the hook. The critique of standard practices in survey research and official data collection is twofold: first, most practitioners continue to use...

    • Chapter 10 How Racial-Group Comparisons Create Misinformation in Depression Research: Using Racial Identity Theory to Conceptualize Health Disparities
      (pp. 146-162)
      Janet E. Helms and Ethan H. Mereish

      A multitude of studies in various physical and mental health domains attests to disparities in health outcomes of African Americans, Latina/Latino Americans, Asian/Pacific Island Americans, Native or Indigenous Americans (ALANAs), and immigrant groups of Color relative to their White American counterparts (U.S. Department of Health and Human Services 2001).¹ According to the World Health Organization (WHO 2001), depression is the leading cause of disability in the general population; it damages the quality of life of sufferers, and failure to treat depression places an economic burden on the depressed person as well the communities in which the person lives. Moreover, depression...

    • Chapter 11 Jedi Public Health: Leveraging Contingencies of Social Identity to Grasp and Eliminate Racial Health Inequality
      (pp. 163-178)
      Arline T. Geronimus

      Eliminating racial health inequality remains seemingly impervious to efforts and intentions. Of significance in addressing this dilemma is the concept of race and how this concept is and can be linked to health. Historically, public health has conceptualized race either as static, essentialist characteristics (genetic, behavioral, cultural, or social attributes and predispositions) or as entrenched conditions (poverty and social disadvantages related to the legacies of slavery and systematized racial segregation). However, increasingly, public health researchers are approaching race dynamically. Some are looking at how ongoing and new social processes maintain race as a lived experience with health impacts, and how...

    • Chapter 12 Contextualizing Lived Race-Gender and the Racialized-Gendered Social Determinants of Health
      (pp. 179-212)
      Nancy López

      When I take my two daughters and other family members to the local hospitals in Albuquerque, New Mexico, I am sometimes asked to fill out forms regarding “race,” ethnicity, and language at the registration desk.¹ As I fill out these forms, I make note of the large bright posters lining some of the registration cubicles, which feature smiling patients from a variety of backgrounds. Several captions attempt to reassure patients by explaining why it is important to collect race, ethnicity, and language data in the hospital setting: “We ask because we care. By asking your race, ethnicity, and language, we...

  10. Notes on Contributors
    (pp. 213-216)
  11. Index
    (pp. 217-226)
  12. Back Matter
    (pp. 227-228)