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Multi-ethnicity and Health Care: Racial/Ethnicity Categorizations and Health Care
Racial/Ethnicity Categorizations and Health Care: Census Changes and Categorizing Distinctions
Several significant health care groups have spoken up in regard to categorizing race and ethnicity. One, the American Medical Association (AMA), endorsed the multiple racial/ethnic checklist for the 2000 Census, suggesting that clinical and epidemiological research would benefit from more detail about racial and ethnic backgrounds of research participants and the population in general. The AMA felt that examining genetic and cultural contributions to health and illness could better be achieved with more specific information about the racial and ethnic identities of research subjects and communities.
Another organization is the IOM (Institute of Medicine). The IOM published a report, commissioned by the United States Congress, examining the effectiveness of National Institute of Health (NIH) cancer research programs in addressing the needs of the medically underserved and ethnic minorities. Among the various IOM recommendations was one suggesting that NIH cancer surveillance and other population-based research should shift emphasis to studying ethnic groups rather than race. The recommendation was based on the fact that racial categorizations used in this country are "not discernible on the basis of genetic information".
The IOM further argued that categorization by ethnic group rather than race would encourage health care research to focus on "an appreciation of the range of cultural and behavioral attitudes, beliefs, lifestyle patterns, and other factors" that may affect health and, in particular, cancer risk.
While there is distinct merit to this argument, the importance and usefulness of race as a variable in health and public health research and practice should not be overlooked. Racial categorizations have been a useful tool leading researchers to demonstrate long-standing health disparities. Thomas makes several cogent arguments for the use of race as a variable in health research. He argues that failing to examine race as a variable in health research will make it difficult to examine racism and social inequality in health care and public health practice. Similarly, because race is a factor in social inequality, eliminating race as a variable in research will affect its application in public health interventions including community mobilization and policy initiatives.
Thomas states: As a social category, race remains the most potent force for mobilizing the American people against injustice. By taking away the ability to link health status and race, we remove one of the most powerful tools used by disenfranchised people to fight for social justice, not only in medical care and public health, but also in our development as one nation.
Various organizations and groups opposed the Census changes, some voicing just the concern that Thomas has raised.
reprinted from Medscape
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