HLTC05. Wk 4. Gravlee.odt

4 Pages
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Department
Health Studies
Course Code
HLTC05H3
Professor
Rhan- Ju Song

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Description
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 variation 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 groups 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 forAf.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 whiteAmericans remained the same • infant mortality amongAf.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 whereAf.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 • Racial-genetic determinism persists because of the uncritical use of race in biomedical sciences and public health, without identifying the definition of race -- this masks the cause of racial inequalities in healthAND favors the assumption that racial differences are genetic in origin Why does research NOT refute the claim that race is INADEQUATE to describe global human genetic diversity? 1) studies of worldwide genetic variation show that individuals from the same continent reliably cluster together o evidence that humans CAN be divided into 5 clusters does not mean theyARE naturally divided as the classical definition of race would suggest o the # of clusters reported have been inconsistent o conventional race classification accounts for 5-10% of human genetic variation = most human genetic variation occurs WITHIN rather than between traditional racial categories o studies confirm that human genetic variation is CLINAL (a continuous variation in form between members of a species having a wide variable geographi cal orecological range), THUS: genetic distance is strongly associated with geographic distance between populations 2) US "self-identified race/ethnicity" is a useful proxy for genetic differentiation between groups that vary in continental ancestry o the claim that continental ancestry may explain racial differences in diseases is problematic:
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