HLTC05H3 Lecture Notes - Medicalization, Racialization, Syndemic
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Coloring the white plague: a syndemic approach to immigrant
tuberculosis in Canada
Sylvia Reitmanova & Diana L. Gustafson
−This article challenges the contemporary epidemiological models of infectious
diseases that tend to racialize and medicalize the risk of infections in socio-
economically disadvantage populations and obscure the role of social conditions
in sustaining the unequal distribution of diseases in these populations
−This theoretical article examines the racialization and medicalization of TB in the
−It uses a syndemic approach to immigrant TB
−A syndemic approach unravels social and biological connections which shape the
distribution of infections over space and time and is useful in deracializing and
de-medicalizing these epidemiologic models.
−Analyzed socio-cultural, political, historic factors to examine social factors which,
refracted through medical science, were central to the development of TB
control in Canada at the beginning of twentieth century.
−expose the ideological assumptions about race, immigration, and social status
which underpin current policies designed to control TB within the immigrant
−argue that TB control policies which divert the attention from structural health
determinants perpetuate health and social inequities of racialized populations in
−Medical screening and surveillance is an ineffective control policy because the
proportion of TB cases attributed to immigrants increased from 18 to 66%
between 1970 and 2007.
−More effective TB control policies require shifting the focus from the individual
disease carriers toward social inequities which underlie the problem of
immigrant TB in Canada.
−In addition, de-racialization and de-medicalization of the contemporary
epidemiological models of infectious diseases entail an in-depth exploration of
how the categories of ethnicity, culture, and immigration status are played out in
everyday health-related experiences of racialized groups.