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HLTC05H3 Chapter Notes -Human Genetic Variation, Hypertensive Kidney Disease, Infant Mortality

Health Studies
Course Code
Rhan- Ju Song

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HLTC05 - Week 4 – Gravlee 2009
How Race Becomes Biology: Embodiment of Social Inequality
Racial inequalities in health allow:
1) reiteration of why race concept is inconsistent with patterns of global human genetic diversity
2) refocus attention on the environmental influences on human biology through lifespan
3) revise the claim that race is a cultural construct, allows us to expand research on the sociocultural
reality of race and racism
Does race actually exist - and why should this question even be debated about?
1) magnitude of racial inequalities in health demands attention
2) important opportunity to advance scientific and public understanding of race, racism and human
3) the association between race and health exposes the inadequacy of the conventional critique of race
in anthropology and other social sciences - social sciences often dismiss race as a cultural construct and
not a biological reality, yet why are there such clear differences among racial groups? This question
needs to be addressed -- we need to move beyond "race as bad biology" and to explain how "race
becomes biology"
-- 2 ways in which race becomes biology
1) sociocultural reality of race and racism has biological consequences for racially defined
2) epidemiological evidence of racial inequalities in health reinforces public understanding of
race as biology, this shared understanding shapes the questions researchers ask and the ways
they interpret their data-- reinforcing a racial view of biology
What is the epidemiological evidence for racial inequalities in health?
substantial racial inequalities in morbidity/mortality across multiple biological systems, harshest
for African Americans
age-adjusted death rate for Af.Am was 30% higher than whiteAm
age-adjusted death rates for diabetes, septicemia, kidney disease and hypertension, hypertensive
renal disease - 2 X higher for Af.Am
CVD is LARGEST black-white mortality difference (30.4%)
inequalities exist in infant mortality and life expectancy, infant mortality declined by 26% for
US as a whole but the gap between black and white Americans remained the same
infant mortality among Af.Am was 2.4 X the rate of other groups
Limitations to crude Black-White comparisons:
1) conceal variation in morbidity and mortality profiles WITHIN racial categories
2) neglect changing racial demography of the US where Af.Ams are NO longer largest minority
3) imply that race is an important cause of health inequalities, rather than focusing on causal
factors that shape racial inequalities in health
(4) models emphasize environmental factors to explain racial health inequalities:
1) socioeconomic status
2) health behaviors
3) psychosocial stress
4) social structure and cultural context
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