The Meaning of Race in Health Care and Research - Part 1
The Meaning of Race in Health Care and Research - Part 1
Questions about the relevance of genetics to health disparities, and evidence that racial and ethnic health disparities are strongly associated with social factors are impacting the understanding of health care needs and research. This first of two articles (see the next issue of the journal for the second) examines the history of understanding race and its impact on assumptions and biases in healthcare. The concept of race as we know it is relatively modern. Yet, in the United States, race has strongly influenced the development of social systems and relations. The legacy of early ideas about race, and centuries of unequal treatment based on those ideas, plague us as a nation even today. Increasing evidence suggests that this is true in the arena of health care. In fact, mounting evidence indicates that the race of patients can significantly influence the treatment they get. Nurses need to develop a sophisticated understanding of issues and concerns relevant to race and health care, including the history of race, current literature on race and health care, as well as stereotypes and biases regarding race.
An 8-year old boy, appearing to be of European ancestry, presented with acute abdominal pain and anemia. He was scheduled for surgery, which was subsequently cancelled when a routine blood smear led to identification of previously undiagnosed sickle cell anemia. The child was of South Asian, northern European, and Mediterranean ancestry (Witzig, 1996).
Incidence, prevalence, and mortality rates of common illnesses are calculated and reported based on the standard racial and ethnic categories used in the U.S. Census. This practice inevitably leads to associations between race and risk. In addition, certain conditions have been extensively reported in the media as associated with particular racial groups: sickle cell anemia among African Americans is one example. However, as the above case history demonstrates, relying on conventional wisdom regarding race and risk - such as sickle cell being a "black" disease - can be dangerous to patients and can blind healthcare providers to alternative explanations for health problems.
This article and one in the subsequent issue of this journal together explore the complexities and controversies surrounding the issue of race in healthcare practice and research. This article offers a brief overview of the history of the modern concept of race which is important for understanding our current views of race. The topic of racial/ethnic health disparities will be introduced based on a review of recent literature. The second article will explore some current debates about the meaning of race in health outcomes, and whether the concept of race is actually useful in health care. Some emerging areas of research will be briefly discussed, and the article will conclude with implications for pediatric nursing.
Questions about the relevance of genetics to health disparities, and evidence that racial and ethnic health disparities are strongly associated with social factors are impacting the understanding of health care needs and research. This first of two articles (see the next issue of the journal for the second) examines the history of understanding race and its impact on assumptions and biases in healthcare. The concept of race as we know it is relatively modern. Yet, in the United States, race has strongly influenced the development of social systems and relations. The legacy of early ideas about race, and centuries of unequal treatment based on those ideas, plague us as a nation even today. Increasing evidence suggests that this is true in the arena of health care. In fact, mounting evidence indicates that the race of patients can significantly influence the treatment they get. Nurses need to develop a sophisticated understanding of issues and concerns relevant to race and health care, including the history of race, current literature on race and health care, as well as stereotypes and biases regarding race.
An 8-year old boy, appearing to be of European ancestry, presented with acute abdominal pain and anemia. He was scheduled for surgery, which was subsequently cancelled when a routine blood smear led to identification of previously undiagnosed sickle cell anemia. The child was of South Asian, northern European, and Mediterranean ancestry (Witzig, 1996).
Incidence, prevalence, and mortality rates of common illnesses are calculated and reported based on the standard racial and ethnic categories used in the U.S. Census. This practice inevitably leads to associations between race and risk. In addition, certain conditions have been extensively reported in the media as associated with particular racial groups: sickle cell anemia among African Americans is one example. However, as the above case history demonstrates, relying on conventional wisdom regarding race and risk - such as sickle cell being a "black" disease - can be dangerous to patients and can blind healthcare providers to alternative explanations for health problems.
This article and one in the subsequent issue of this journal together explore the complexities and controversies surrounding the issue of race in healthcare practice and research. This article offers a brief overview of the history of the modern concept of race which is important for understanding our current views of race. The topic of racial/ethnic health disparities will be introduced based on a review of recent literature. The second article will explore some current debates about the meaning of race in health outcomes, and whether the concept of race is actually useful in health care. Some emerging areas of research will be briefly discussed, and the article will conclude with implications for pediatric nursing.
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