Is Racism a Fundamental Cause of Inequalities in Health?
Racially and ethnically stigmatized people experience higher than average rates of illness, impairment, and death in their societies in the United States and globally. Biological and genetic explanations of race, and of differences in health among racial groups, dominated in the 19th and early 20th century and still persist among many today. However, human genetic variation does not naturally map onto the subgroups that correspond to our racial categories, and most genetic variation is found among individuals and not among population groups. However, although racial categories are not good indicators of biological variation within the human population, considerable research documents the salience of race as a social category and that existing racial categorization has considerable social consequences. Making sense of racial health disparities requires careful consideration of multiple issues captured by racial categories. Race reflects simultaneously unmeasured confounding of biological factors linked to ancestral history, geographic origins, and environmental exposures. These environmental factors include the current psychological, social, physical, and chemical environment; the exposures over the life course and across generations; and the biological adaptation to these environmental exposures, including gene expression (Williams et al., 2010). For example, some researchers have historically sought to explain the large Black White differences in hypertension in the United States in terms of genetics. In contrast, an international comparative study of hypertension among West Africans in Africa and persons of West African descent in other contexts found a stepwise increase in hypertension as a person moved from rural to urban Africa, to the Caribbean, and then to the United States, with persons of African descent in the United States having hypertension levels that were twice as high as that of Blacks in Africa. It is instructive to note that Whites in the United States have higher rates of hypertension than do Blacks in Africa, and other comparative data reveal that the prevalence of hypertension among African Americans in the United States is higher than those in some predominantly White populations in Europe, such as Sweden and Italy, but is lower than those in other European countries, such as Germany and Finland.These data highlight the potential of social, cultural, and environmental factors to predict variation in hypertension risk. SES is a complex and multidimensional concept comprising a range of factors encompassing economic resources, power, and prestige that can influence health at different times in the life course, at different
levels (e.g., individual, household, neighborhood), and via different pathways. SES are strongly patterned by race. Asians, a group heavily made up of immigrants, have a high SES profile. Levels of college graduation are almost twice as high for Whi...
