Ethnicity, Race, and Health in Multicultural Societies: Foundations for Better Epidemiology, Public Health, and Health Care

“Race has played a major role in the way societies work and intereact and the cocept has been abused in the past to justify inequalities.” -Raj S. Bhopal (Page 10)

Author: Raj S. Bhopal

This reading is an introduction to a text that focuses on improving health using race and ethnicity in multidisciplinary epidemiological settings. I found it relevant to this course because it directly addresses a key element of the discussion of HIV/AIDS among black women: race. But the author approaches race and also ethnicity from the perspective of an epidemiologist and discusses how taking into account race and ethnicity in research may help or hinder advances in medical research and policy.

This introduction is especially useful because it discusses the concepts of race and ethnicity theoretically, socially and scientifically. It also addresses how human understandings of the two terms have evolved over time. On a more practical level, Bhopal discusses how race and ethinicity may be used as variables in research. This made me wonder how gender and race could be used as variables in HIV/AIDS research.

But at the end of the day, the reasons why HIV/AIDS seems to be affecting black women disportionately to other women and groups are more social than biological. Bhopal’s work speaks to this idea simply because he discusses the power of race and ethnicity in forming prejudices and biases. He also addresses the history of using race based theories to explain the inferiority of some races compared to others and while he sees the benefits of using both race and ethnicity in research he does so with caution all while acknowledging the negative that may come out of it. He writes, “since interest in, and the influence of, research on ethnicity and race is increasing it is important that the conceptual basis of the work is sound,” (9). He seems to be saying that people are going to use the two concepts as variables whether we like it or not, so the next essential step is to clearly define and understand the terms. For that reason Bhopal spends a lot of time explaining and discussing the differences between the two terms.

He goes on to talk about their influence. He writes, “Directly or indirectly, race and ethnicity have a major impact on populations’ health patterns,” (7). The indirect impacts (social results of being from a particular racial group) are what I am most interested in in my research and how ackowldeing them in AIDS related research may help in addressing the spread of HIV among black women. If this type of research would be beneficial or capable of… helping black women deal with the challenge of HIV/AIDS.

Bhopal acknowledges that race is social rather than biological construction but still asserts that is a useful tool for analysis. He devotes an entire section in the reading to discussing the social harm that has been and can be caused by the two concepts. He also makes a good case for the idea of environment as a causal factor in disease, specifically the social conditions of a given group.

I don’t disagree with Bohopal’s assertions, in fact I agree with a lot what he has to say about race and ethinicty. Mainly because he is relying on the facts of social and scientific history in his discussion of race and ethnicity and how the terms have been used and may be used in the future. This is by far the most practical reading I have yet to study because it addresses how these concepts and their use may impact research and then eventually policy.

The policy part is also what I’m interested in. Specifically Bhopal outlines how research using ethnicity or race as variables may influence the development of health services and individual clinical care. Research that looked at treating HIV/AIDS or caring for patients with the virus with a focus on race, so black people, or ethnicity, so a specific cultural group like carribeans, would be beneficial in developing policy and standards of care that could be more considerate of the culutural backdrop of a patient’s experiences and their specific needs.

A large majority of clinical care is focused on the general population, perhaps to the detriment of patients in minority groups. A more targeted approach to care could make a huge difference and research that encourages finding that out I think at least is important.

This is a reading from which real and positive results could be developed from. It is important work for that reason.