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1.
Acad Med ; 94(8): 1099-1102, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-30973362

RESUMO

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.


Assuntos
Etnicidade/estatística & dados numéricos , Disparidades nos Níveis de Saúde , Disparidades em Assistência à Saúde/etnologia , Medicina Narrativa/métodos , Crescimento Demográfico , Grupos Raciais/estatística & dados numéricos , Feminino , Hispânico ou Latino/estatística & dados numéricos , Humanos , Lactente , Recém-Nascido , Masculino , Estados Unidos
2.
Health Aff (Millwood) ; 37(9): 1394-1399, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-30179544

RESUMO

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."


Assuntos
Diversidade Cultural , Etnicidade/estatística & dados numéricos , Disparidades nos Níveis de Saúde , Narração , Grupos Raciais/estatística & dados numéricos , California , Humanos , Lactente , Mortalidade Infantil/tendências , Expectativa de Vida/tendências , Mortalidade/tendências , Pobreza , Determinantes Sociais da Saúde
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