"Race" and ethnicity

A major problem with the way people nowadays talk about health disparities -- and many other areas of inequality -- is confusion about the biological and social meanings of race and ethnicity. The U.S. is still a racist society, by which I mean that people believe in the reality of "race" both as a biological phenomenon and an organizing principle for social advocacy -- whether they are white supremacists or, unfortunately in too many cases, Black academics.

Ethnicity refers to group identity within a larger society, often connected with cultural differences and sometimes reinforced by socially accepted beliefs about the significance of certain physical traits. Such prejudices about physical differences underlie the construction of social “races.” The scientific consensus does not doubt that certain variant genes differed in frequency in different places in ancient times. However, it rejects the socially constructed concepts of race that pervade society. African Americans are a very real ethnic group, but very few African Americans are of exclusively African ancestry, and many people who are not ethnically African American have a higher proportion of African ancestry than many African Americans. Pakistanis, Chinese, and Filipinos are all aggregated into a putative “Asian” race, but this is as nonsensical biologically as it is socially. Examples are endless.

It must also be said that the notion that humanity was once divided into five reproductively isolated, independently evolving groups is obviously false. Native Americans came from Asia in evolutionarily very recent times. Africans, Europeans, and Southwest Asians were never reproductively isolated, rather their genes and populations flowed and intermingled along gradients. The genes of Africans flowed into Europe throughout history, and vice versa. (Remember Antony and Cleopatra, Othello and Desdemona, or Solomon and the Queen of Sheba?) The construction of five races from gene frequencies, physical traits, or anything else, is largely arbitrary. Pick a different set of characteristics as dispositive, and you get a different set of races.

The differences in health status that correlate with ethnicity – or “race,” if one bases analysis on racial categories – have much to do with social phenomena and little to do with genes. These include socio-economic status and access to opportunities, prejudice and discrimination, differing physical environments, cultural differences in diet and other behaviors that affect health, and many other factors including some as yet unknown. Whatever the importance of sickle cell anemia, Black people in the United States do not have shorter life expectancies than white people because of their genes.

Ethnicity, culture, group identity -- these are socially constructed but are real social phenomena. Race, as a biological concept, is also socially constructed but entirely false. Never forget this.