HLTC05H3 Lecture Notes - Medicalization, Racialization, Syndemic

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31 Jan 2013
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Coloring the white plague: a syndemic approach to immigrant
tuberculosis in Canada
Sylvia Reitmanova & Diana L. Gustafson
Objective
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
immigrant population.
Design
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.
Results
expose the ideological assumptions about race, immigration, and social status
which underpin current policies designed to control TB within the immigrant
population.
argue that TB control policies which divert the attention from structural health
determinants perpetuate health and social inequities of racialized populations in
Canada.
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.
Conclusion
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.
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