Office of Management and Budget Racial/Ethnic Categories in Mortality Research: A Framework for Including the Voices of Racialized Communities.

Since its founding, the US government has sorted people into racial/ethnic categories for the purpose of allowing or disallowing their access to social services and protections. The current Office of Management and Budget racial/ethnic categories originated in a dominant racial narrative that assumed a binary biological difference between Whites and non-Whites, with a hard-edged separation between them. There is debate about their continued use in researching group differences in mortality profiles and health outcomes: should we use them with modifications, cease using them entirely, or develop a new epistemology of human similarities and differences? This essay offers a research framework for including in these debates the daily lived experiences of the 110 million racialized non-White Americans whose lived experiences are the legacy of historically limited access to society's services and protections. The experience of Latinos in California is used to illustrate the major elements of this framework that may have an effect on mortality and health outcomes: a subaltern fuzzy-edged multivalent racial narrative, agency, voice, and community and cultural resilience.

Racially Ambiguous Babies and Racial Narratives in the United States: A Growing Contradiction for Health Disparities Research.

Researchers attempting to identify and track health disparities and inequities generally use five racial or ethnic (R/E) categories-four racial groups (white, black, Asian/Pacific Islander, and American Indian) and one ethnic group (Hispanic)-to analyze and predict variations in health outcomes in the overall U.S. population. These categories are used as if they were permanent, naturally occurring, internally homogeneous, and discrete. However, the United States is becoming increasingly racially ambiguous because of (1) the growth of the Latino population, nearly half of whom do not identify with one of the four racial groups; and (2) the growing population of racially ambiguous babies, whose mothers and fathers are of different R/E groups. In California, an average annual 52.6% of the babies born between 2011 and 2015 were racially ambiguous (i.e., their parents were from different R/E groups or at least one parent was something other than a single race).We describe the social-legal construction of hard-edged, binary racial categories in the United States from 1790 to the present (and the subsequent racial structuring of U.S. society along those categories). Researchers should shift the conceptualization of race from that of an innate, individual trait to that of a narrative, and should consider the impact that racial narratives can have on the life courses of individuals categorized as nonwhite. In light of the increasing racial ambiguity in the United States, the Latino fuzzy-edged, multivalent racial narrative that embraces racial mixing may be one alternative to the United States' hard-edged, binary one.

California And The Changing American Narrative On Diversity, Race, And Health.

The historical narrative on diversity, race, and health would predict that California's population change from 22 percent racial/ethnic minority in 1970 to 62 percent in 2016 would lead to a massive health crisis with high mortality rates, low life expectancy, and high infant mortality rates-particularly given the state's high rates of negative social determinants of health: poverty, high school incompletion, and uninsurance. We present data that suggest an alternative narrative: In spite of these negative factors, California has very low rates of mortality and infant mortality and long life expectancy. This alternative implies that racial diversity may offer opportunities for good health outcomes and that community agency may be a positive determinant. Using national-level mortality data on racial/ethnic groups, we suggest that new theoretical models and methods be developed to assist the US in achieving high-level wellness as it too becomes "majority minority."