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HLTC05H3 Chapter Notes -Social Epidemiology, Leg Before Wicket, Straw Man

Health Studies
Course Code
R Song

of 3
HLTC05 Tuesday October 1, 2012
First, the magnitude of racialinequalities in health demands attention. In the UnitedStates, where
debate over race is most intense, the risk of morbidity and mortality from every leading cause is
patterned along racial lines
We can see “race” dividing health: more AA dieing prematurely than white counterparts
Race is a cultural construct but we see clear differences in health status therefore we need to look at
how race can become biological.
Epidemiologic evidence regarding racial inequalities in health and show that these inequalities are
commonly interpreted as evidence of fundamental, genetic differences between ‘‘races.’
In North America, a central tenet of the racial worldview isthat humans are naturally divided into a few
biological subdivisions. These subdivisions, or races, are thought tobe discrete, exclusive, permanent,
and relatively homogenous
Science ie) anthropology have played a eey role in building construct of race
where epidemiological data has reflected and reinforced scientific thinking about race for more than
CVD showed most significan differences btw black and white, death rate almost 30% haigher
In 1995, the blackwhitegap in life expectancy was the same as it was 40 yearsearlier6.9 years. Only
recently has the gap narrowed to its historic low of just over 5 years
Comparisons of black-white are limited in at least 3 ways
Four models emphasize environmental factors, including 1) socioeconomic status, 2)health behaviors, 3)
psychosocial stress, and 4) social structure and cultural context. The fifth model assumes that genetic
factors contribute substantially to racial inequalities in health.
Liturate in science doesn’t define race, perpettues notion that its genetic
Race/ethinicity is used equal to gene pool
This finding does not warrant the conclusion that racial inequalities are genetic in origin; genetic
hypotheses require genetic data
The defense of race relies on two related lines of evidence: 1) studies of worldwide genetic variation
show that individuals from the same continent reliably cluster together
2) in the United States,‘‘self-identified race/ethnicity’’ is a useful proxy for genetic differentiation
between groups that vary in continental ancestry
Evidence that humans can be divided into five clusters does not mean they are naturally divided, as the
classical definition of race would suggest.
Straw-man view that ‘‘racial and ethnic categories are purely social and devoid of genetic content’
Evidence of genetic clustering, then, does not contradict the claim that most human genetic
variationoccurs within rather than between traditional racial categories.
In racially stratified societies like the United States, continental ancestry is likely to be confounded with
many environmental factors; consequently, reported associations between genetic ancestry and disease
may be mediated through unmeasured environmental mechanisms.
We are not just saying race is not biology. There are, in fact, well-defined differences between racially
defined groups for a range of biological outcomescardiovascular disease, diabetes, renal failure,
cancer, stroke, and birth outcomes
Krieger’s ecosocial theory for social epidemiology uses the concept of EMODIEDMENT; a concept
referring to how we literally incorporate, biologically, the material and social world in which we live,
from conception to death. Our biology can not be undersood with the absent of social living ways
Researchers in several societies have linked selfreported experiences of discrimination to elevated blood
Pressure HD, mental health, BMI, LBW etc
Racial residential segregation is a fundamental cause of racial inequalities in health, because it a)
constrains opportunities for success on traditional markers of individual SES such as education,
occupational status, or income, and b)creates pathogenic social contexts that influence the distribution
of disease
A recent study of birth outcomes before and after September 11, 2001, provides a dramatic example.
Lauderdale (2006) examined birth certificate data for allCalifornia births during the 6 months after
September 2001, compared to the same period 1 year earlier. They found that women with Arabic
namesand only women with Arabic namesexperienced a 34% increased in the of having a low birth
weight infant after 9/11
Pathways through which social disadvantage may be transmitted from one generation to the next
. The toxic effects of exposure to racism in one’s own lifetime include a higher risk of hypertension,
diabetes, stroke, and other conditions .These conditions, in turn, affect the health of the next
generation, because they alter the quality of the fetal and early postnatal environment. The immediate
consequence of this intergenerational effect is a higher risk of adverse birth outcomes
. In particular, amajor thrust of current research in cultural anthropology is to understand how global
political–economic structures shape the local context of people’s lives and become
embodied in individual sickness and suffering
Our response to this challenge must deal withtwo senses in which race becomes biology: Systemic
racism becomes embodied in the biology of racialized groupsand individuals, and embodied inequalities
reinforce a racialized understanding of human biology