Recent research shows that the inappropriate use of race and ethnicity in healthcare leads to poor patient outcomes. Contemporaneous work shows that accounting for inequalities caused by discrimination often requires the use of race and ethnicity as variables that are mediated in their effects by discrimination along those dimensions of identity and/or classification. This suggests that the appropriateness of using racial and ethnic group descriptors depends on context. This paper explores some contexts in which the use of racial and ethnic group descriptors may be appropriate, and the limitations thereof. I begin my argument by interrogating whether it is best to use self-reported identities or externally assigned classifications for healthcare purposes. I argue that the use of these group descriptors should depend on their contribution to healthcare purposes. I end by arguing for the need to account for racial and ethnic intra-group heterogeneity in clinical care and public health policy.
This paper deals with the use of race and ethnicity as population descriptors in health and the limitations of their use as variables in clinical and public health settings. The concepts of race and ethnicity have a controversial history in the health sciences. Under the typological thinking predominant in the modern period, races were thought to be biologically specific population groups and ethnicities were thought of as subraces or a collection of so-called tribes of even smaller nested sets of biological groups. This was a common motif in European ethnographic studies found in research and encyclopaedias produced in the 19th and early 20th century. Notable depictions of this typological view of races and ethnicities are the 1852 global map of ethnic divisions by Berghaus (Winlow 2020: 310-11), Martin’s 1903 illustrations of global ethnic types (M’charek 2020: 371), and Meyer’s 1885-1892 ethnographic map of
˜
Click here to download full article