begun to change this criterion. Interestingly, the gap between White and Black educational attainment is narrowing, whereas that between Hispanics and Whites is widening. This is undoubtedly because of the large proportion of Hispanics who are not yet fully conversant with the English language.
Family Feuds Oppenheimer rightly sees “race/ethnicity” as a transitional accommodation.2 Researchers face a daunting challenge in the years ahead. Longitudinal data and comparative analyses will perforce be made difficult, and
linking findings from related data sets will be nigh impossible. Perhaps the experiment of self-identification in the 2000 census will be instructive. Early returns are not hopeful. David P. Willis, MPH
2.
3.
Requests for reprints should be sent to David P. Willis, MPH, Mailman School of Public Health, Columbia University, 722 W 168th St, 9th Fl, New York, NY 10027 (e-mail:
[email protected]). This editorial was accepted January 9, 2001.
4.
References
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1. Jones S. The Archeology of Ethnicity: Con-
5.
structing Identities in the Past and Present. New York, NY: Routledge; 1997. Oppenheimer GM. Paradigm lost: race, ethnicity, and the search for a new population taxonomy. Am J Public Health. 2001;91: 1049–1055. Seymour-Smith C. Macmillan Dictionary of Anthropology. London, England: Macmillan; 1986. Cohen A. Custom and Politics in Urban Africa. London, England: Routledge & Kegan Paul; 1969. Gluckman M. Colonialism in Africa: The Economics of Colonialism. Palo Alto, Calif: Hoover Institution Press; 1975. Roosens EE. Creating Ethnicity: The Process of Ethnogenesis. London, England: Sage Publications; 1989.
Paradigm Lost: Race, Ethnicity, and the Search for a New Population Taxonomy A B S T R A C T The Institute of Medicine (IOM) recently recommended that the National Institutes of Health (NIH) reevaluate its employment of “race,” a concept lacking scientific or anthropological justification, in cancer surveillance and other population research. The IOM advised the NIH to use a different population classification, that of “ethnic group,” instead of “race.” A relatively new term, according to the IOM, “ethnic group” would turn research attention away from biological determinism and toward a focus on culture and behavior. This article examines the historically central role of racial categorization and its relationship to racism in the United States and questions whether dropping “race” from population taxonomies is either possible or, at least in the short run, preferable. In addition, a historical examination of “ethnicity” and “ethnic group” finds that these concepts, as used in the United States, derive in part from race and immigration and are not neutral terms; instead, they carry their own burden of political, social, and ideological meaning. (Am J Public Health. 2001;91:1049–1055)
Gerald M. Oppenheimer, PhD, MPH The construction of new classifications [for human populations] never occurs as a sudden or arbitrary redefinition of some social entity. . . . Their acceptance marks the end of a historical process in which social problems and political positions mature or ripen before crystallizing into a durable statistical fact. Patrick Simon1 In 1999, the Institute of Medicine (IOM) published a volume that placed it squarely in the fray over how to catalogue the members of an increasingly diverse US population.2–14 Charged by Congress with assessing how well the cancer research programs at the National Institutes of Health (NIH) address the needs of ethnic minorities and the medically underserved, the IOM delivered a report, The Unequal Burden of Cancer, in which it offered 22 recommendations. One of them, highlighted by The New York Times in its story of the report,15 was to place (italics added) an emphasis on ethnic groups rather than on race in the NIH’s cancer surveillance and other population research. This implies a conceptual shift away from the emphasis on fundamental biological differences among “racial” groups to an appreciation of the range of cultural and behavioral attitudes, beliefs, lifestyle patterns, diet, environmental living conditions, and other factors that may affect cancer risk.16(p83)
Any recommendation to the NIH to revamp its population taxonomy of race and July 2001, Vol. 91, No. 7
ethnicity is ultimately directed at the US Office of Management and Budget (OMB), whose Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity17 (like Statistical Policy Directive No. 15, which it superseded) stipulates the minimum racial and ethnic classes to be used by any federal agency. Since October 1997, the OMB has recognized 2 categories of ethnicity (Hispanic or Latino vs neither) and 5 categories of race (Asian, American Indian or Alaska Native, Native Hawaiian or Other Pacific Islander, Black or African American, and White). The OMB concedes that these, its own race and ethnic categories, are neither anthropologically nor scientifically based. In addition, the OMB holds that its categories “represent a social-political construct designed for collecting data on the race and ethnicity of broad population groups in this country,” al-
The author is with the Department of Health and Nutrition Sciences, Brooklyn College, The City University of New York, and the Division of Sociomedical Sciences of the Joseph L. Mailman School of Public Health, Columbia University, New York, NY. Requests for reprints should be sent to Gerald M. Oppenheimer, PhD, MPH, Department of Health and Nutrition Sciences, Brooklyn College (CUNY), 2900 Bedford Ave, Brooklyn, NY 11210 (e-mail:
[email protected]). This commentary was accepted August 14, 2000.
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though it does not define “social-political construct”—a term fraught with possibilities.17,18 The IOM contends that these categories continue to be used, despite their severe limitations, in critical data-gathering efforts—national household surveys and the decennial census, for example—and that they are generally incorporated into federally supported scientific research projects in which race is accepted as a scientific category of analysis. The IOM argues that in all instances race is a social and cultural construct. (The IOM goes on to call race a “construct of human variability based on perceived differences in biology, physical appearance, and behavior.”)16(p38) The traditional conception of race, it finds, rests on the false premise that natural distinctions grounded in significant biological and behavioral differences can be drawn between groups.16,19–21 None of the “racial” groups on the OMB’s list are “discernible on the basis of genetic information.”16(p82) At the same time, the institute faults the empiric value of the OMB’s racial categories, which, unlike ethnicity, inadequately describe or reflect the diversity of the US population. The Unequal Burden of Cancer urges that ethnicity, now applied to Hispanics alone, become the universal basis for subdividing our population. Unlike race, ethnicity, a “recent term,”16(p35) has rarely been considered a scientific concept. Unlike race, ethnicity encapsulates those cultural, behavioral, and environmental factors that, among other outcomes, increase the risk of disease. According to the IOM: Ethnicity . . . involves how one sees oneself and how one is “seen by others as part of a group on the basis of presumed ancestry and sharing a common destiny. . . .” Common threads that may tie one to an ethnic group include skin color, religion, language, customs, ancestry, and occupational or regional features. In addition, persons belonging to the same ethnic group share a unique history different from that of other ethnic groups. Usually a combination of these features identifies an ethnic group. For example, physical appearance alone does not consistently identify one as belonging to a particular ethnic group.16(p35,38)
Finally, the IOM contends, rather mechanically, that a switch from race to ethnic group should prove relatively easy, since “the aggregations which are called ‘races’ ” plus the current Hispanic category constitute 5 “macro-ethnic groups.”16(p84) The latter could be subdivided as required by scientific research. For example, the Asian macro-ethnic group might include Chinese, Japanese, Indian, Southeastern Asian, and others. Ultimately, the use of such macro-ethnic groups, the IOM argues, should allow for conceptual change without much modification of current data collection. 1050
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Nonetheless, the IOM (and with it, the OMB) has taken a significant public position by declaring race to be a socially constructed category, not a naturally occurring set of biological distinctions. Yet the IOM recognizes too that cancer incidence and mortality rates differ substantially across “racial” subgroups, with some minorities, as well as the poor, suffering unequally heavy burdens of cancer. To investigate those differences and to develop strategies of prevention and intervention, the IOM advocates the use of ethnic group as a population taxonomy, thereby stressing “an appreciation of the range of cultural and behavioral attitudes, beliefs, lifestyle patterns, diet, environmental living conditions, and other factors that may affect cancer risk.”16(p4) In this article, I question whether race—an ideologically powerful category during most of US history and one central to how most Americans think—can so easily be expunged and whether something significant may not be lost by excising race as an analytic category. I also question whether “ethnic group” is a neutral term, without its own negative denotations. By looking at how race and ethnicity have been historically constructed and used in the United States, I hope to underscore the complex nature of any shift from “race” to “ethnicity.”
Race and Ethnicity in America: Historical Perspectives In confronting the issue of race, the IOM, like other critics, faces a formidable cultural challenge. Racism is certainly not a recent phenomenon in this country. The introduction and sale of Africans was almost concurrent with the earliest English settlement in Virginia in 1607. At the time, the English were completing their colonization and conquest of Ireland, whose inhabitants they considered unlike themselves, but instead “savages” living an “uncivilized” existence, lacking any “knowledge of God” or of private property, and naturally “lazy” and “loose.”22 From their earliest encounters, English colonists applied the same characterizations to American natives, thereby justifying their expropriation of Indian lands. In New England, the settlers went further by racializing Native Americans, asserting that their “savagery” and “laziness” were inborn traits, inaccessible to change. That racialization—identifying group differences as racial— was next applied to Africans. Initially, they were set apart as “heathens.” As they converted, they were starkly distinguished from the English by their color, which became associated with their caste as slaves, with biological inferiority, and with all those negative characteristics originally projected onto the Irish.22 Like Native Americans, African slaves were seen as
the antithesis of the English colonists in behavior, status, and, especially, skin shade. To be “American,” from the earliest years of the republic, was to be White. In 1790, the nation’s first naturalization law limited citizenship to free White persons. Two years later, legislation providing for the establishment of a militia defense force (one that might be used at the frontier or against slave revolts) restricted membership to “every free able-bodied white male citizen of the respective states”23(p25) (see also reference 22). By the 19th century, those who made racial distinctions found support in “scientific” evidence produced by biology, craniometry (measuring skulls to assign intelligence levels), anthropology, and medicine. Medicine, like its kindred disciplines, discovered that those distinctions were biologically determined—that morals, physical and intellectual capacity, and social differences between Blacks and Whites were inherited.24,25 (Although the terms used to categorize people of African descent changed over the 20th century, this article generally uses the term “Black” throughout; the term “Negro” is employed when quoting or referring to a quotation that uses it.) During the 19th century and into the first decades of the 20th century, physicians could argue that people of African descent differed naturally from Whites in their susceptibility to diseases. In 1910, for example, the author of an article in the Journal of the American Medical Association contended that Blacks inherited immunity to malaria, typhoid, tonsillitis, mumps, and influenza.26 Other experts held that they were more prone to tuberculosis, possibly because their lungs were inherently less developed.27 “Hybrid” or “mixed-race” Negroes were believed to be especially vulnerable to illness because they lacked both physical and mental stamina.28 Black physicians fought these positions, contending that diseases like tuberculosis had the same causes in both races, that poor White Europeans also suffered high rates of disease, and that for Whites and Blacks, such rates decreased with environmental changes in housing, education, income, and medical care.29–32 Despite such efforts by Black physicians, the response of White medical professionals to Black medical problems was, at best, lackluster. Even public health interventions were inadequate; in 1913, a survey demonstrated that only 1 of 9 major southern health departments focused on Negro health issues in its annual report. “I feel that we are justified in assuming,” wrote the survey researcher, “that this absence of mention is a fair measure of health conservation efforts in [their] behalf.”33 In fact, the public health problems of the Black population were seen, in general, as problems of and for their communities. Articles in the Journal published July 2001, Vol. 91, No. 7
between 1914 and 1916 proposed that Negroes clean their communities, change their health habits, and dig privies and wells for themselves. But with little government interest or financial support at the time, such advice produced a limited yield. Even during the interwar years, when more philanthropic and public funding became available (and a network of Black public health professionals emerged), the ratio of health care resources to the health problems at hand remained minuscule.27,34,35 In general, before the 1920s, published material generally stressed the separate and specific nature of Black health, health habits, and (albeit rarely) health facilities.The medical and public health problems of Blacks were not continuous with those of the rest of the population. That dichotomization, of course, was never universal. Particularly after the acceptance of the germ theory, Blacks were frequently feared as vectors carrying contagion to White communities.27,33,34,36 As a consequence, certain diseases—tuberculosis and sexually transmitted diseases in particular—and health-related behaviors were of great interest to Whites. The “Black pest” thesis could be stated quite bluntly, as it was in a 1915 article in the Journal: Communicable diseases find their favorite propagating grounds in the dirty negro sections of our cities, and in insanitary negro homes in the country. From dirty homes, in these disease-infested sections, negro people come into intimate contact with white people every day that passes. . . . The fact is not pleasant to contemplate, but it is nevertheless true, that there are colored persons afflicted with gonorrhea, syphilis, and tuberculosis employed as servants in many of the best homes in the South. Various diseases often spread this way.37
In addition, through census data and vital statistics, Black health status gained greater visibility and could be compared with that of other groups. Blacks have been counted in every decennial census. Early in the 20th century, the United States initiated birth and death registration areas that collected data on all, regardless of race. It was not unusual for public health reports and investigations to draw on those sources to describe the local population under study. For example, the report of the Milbank Memorial Fund study of public health interventions in Syracuse, NY, during the 1920s provided population data by race for the inhabitants of that city, including Blacks (who were then, as usual, dropped from any further discussion).38 These race-specific population data were generally not arrayed, as they would be later, in categories—for example, of White, Black, and other. For many decades before 1930, the term “race” was applied in this country to national, often immigrant, groups—Celts, Hebrews, Italians, Teutons, and so forth, most of July 2001, Vol. 91, No. 7
whom, like Indians and Negroes, were distinguished from the nation’s White founders. Dissimilarities between these races were theoretically those of blood, biology, or germ plasm. Invariant inborn differences defined the races, each of which inherited unique moral and intellectual qualities, as well as physical characteristics like disease susceptibility, brain weight, head shape, facial features, and skin shade. (The authors of the 1911 Dictionary of Races or Peoples would note that “Poles are ‘darker than Lithuanians’ and ‘lighter than the average Russian.’”23(p79)) Within this carefully drawn taxonomy, some immigrant groups were inferior to others, depending on how alien they were, particularly in perceived skin color, from the great founding race of Anglo-Saxons.23,39–41 Even races that appeared to be as white as Anglo-Saxons and to share a fair degree of culture with them could rarely achieve their standards. As one theorist of race noted: The opinion is advanced that the public schools change the children of all races into Americans. Put a Scandinavian, a German, and a Magyar boy in at one end, and they will all come out Americans at the other end. Which is like saying, let a pointer, a setter, and a pug enter one end of a tunnel and they will come out three greyhounds at the other end.23(p5)
Among the racial theorists of the first decades of the 20th century, there was considerable concern over intermarriage between European races, a fear of “hybridization” and racial degradation, and therefore a need to police the sexual boundaries between the races. In fact, “hybridization” among Whites posed a problem serious enough for influential biomedical scientists to investigate, using the tools of their disciplines. Raymond Pearl, for example, first professor of biometry and statistics at the Johns Hopkins School of Hygiene, defined the issue as one of “racial fusion,” the outcome of which he thought could be tested by measuring whether different combinations of “racial assortive mating” could successfully produce a healthy infant.42 In short, the “White” population of this country, at least through the first 3 decades of the 20th century, was composed of a complex layer of races, frequently sorted, measured, and weighed to assess their rightful economic and political places (with these “racial” groups often using their differential status to reinforce their own cultural and political identities).Yet by the late 1920s, the lines of division running through that population, treated, as we have seen, as major, biologically determined boundaries, began to be seen instead as minor, manageable distinctions, almost entirely the consequences of varying historical, environmental, and cultural experiences. Even extreme racists like Lothrop Stoddard, who could write in 1920 that “[o]ur country, originally settled almost exclu-
sively by the Nordics, was toward the close of the nineteenth century invaded by hordes of immigrantAlpines and Mediterraneans, not to mention Asiatic elements like Levantines and Jews,” would argue by 1927 that non-Nordic Europeans were “so basically like us in blood, culture, and outlook that their eventual assimilation is only a matter of time.”23(p96,98) In this new formulation, culture trumped biology, and those previously separated by race were bound together as “Caucasians.” There are many reasons for this seismic shift. For one, the intricate language of White racial differences had reflected the anxious response of native White Americans to waves of immigration, beginning in the 1840s when the Irish (or Celts) entered US ports en masse, followed by nationals from Central, Southern, and Eastern Europe. Ironically, with the passage by Congress of a highly restrictive, eugenically grounded immigration act in 1924, one that heavily favored Northwestern Europeans at the expense of other nations, the impetus to maintain racial and racist distinctions faded as the number of newcomers plummeted.23 In addition, by the 1930s, the progeny of the earliest immigrant groups, increasingly assimilated into the major culture, appeared more American than alien, more greyhound than pug. But probably the most important reason for this dramatic shift was the mass migration and increased visibility of Blacks outside the rural South—the result of wartime mobilization, the draw of urban employment during World War I, and new opportunities for factory employment as the volume of immigrant labor declined. Northern cities experienced a significant increase in their Black populations. In 1910, 90% of the 9.8 million African Americans lived in the South; over the next 20 years, more than 1.2 million had moved north.43 In New York City, the number of people of African descent rose from approximately 92 000 in 1910 to 328 000 in 1930; in Detroit, the comparable figures were 6000 and 143000.44 The northern response was to enforce variants of Jim Crow discrimination outside the South. Sharply defined “racial” differences within the White population lost their salience in the face of the African American exodus. As Blacks became socially, economically, and politically visible, whiteness took on a consanguine and monolithic cast. Over the next decades, the European “races” slowly became “Caucasian.”As Matthew Jacobson has pointed out, the creation of that White race demanded a dialectic of inclusion and exclusion.23 Not only did the olderWhite population have to recognize the European immigrants as similar to themselves, those immigrants had to insist they shared both a fundamental “sameness” with the established White groups and a categorical difference from Blacks. That sharp division beAmerican Journal of Public Health
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tween White and Black was drawn not only by regressive political movements but also by liberal anthropologists like Ruth Benedict, who, particularly in the face of the Nazi “racial” codes, wrote passionately in favor of abolishing “race,” a pseudo-scientific term, but who still accepted “Negroid,” “Mongoloid,” and White as natural divisions of the human race. In addition, the liberal focus on “race relations” and civil rights, beginning in the 1930s as a response to racism, ironically served to reinforce the image of an undifferentiated White race in conflict with a monolithic Black race.23 Subsequently, between the 1930s and the 1960s, memory of a taxonomy of European races disappeared. Race, still the embodiment of inborn differences, of hierarchy, of biology as destiny, became synonymous with color. After the 1920s, the United States increasingly saw itself as a biracial, bicolored nation. Within the White population, however, old distinctions died protracted deaths. Former “biologically determined races,” particularly those who emigrated from Southern and Eastern Europe, became “ethnic groups” instead.23 Some of the biological variables previously associated with race—for example, degree of swarthiness, hair texture, facial features, and perceived intelligence—continued to be linked to certain ethnic groups. Still, culture trumped biology, and ethnic groups were fundamentally differentiated by what were seen as social factors: language, nationality, religion, values, and behavior. They were also defined by factors like economic success, class mobility, and access to power. For many White ethnic groups, structural success was slowed by exclusionary barriers; Jews, for example, confronted housing covenants, educational quotas, “gentlemen’s agreements,” and employment practices. Such structural restraints tended to protect the dominant position of the core population of traditional White groups, maintaining a semblance of the previous prejudice and hierarchical ordering. Despite (or because of) such prejudice and discrimination, immigrants were pressed to assimilate into the larger community. A historian of the period observed, “Immigrants were disparaged from [sic] their cultural peculiarities, and the implied message was, ‘You will become like us whether you like it or not.’”45(p42) Ethnic groups, for example, were rarely permitted to control their public schools; such institutions, rather than transmitting elements of their ethnic heritage to their children, served, as a matter of public policy, to “Americanize” them.44 Lacking their own territory or region (which made them different from ethnic minorities in Europe), they could only with great exertion shelter their culture from that of the larger society. Moreover, permitted entrance into the United States because of its need for 1052
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a large pool of cheap labor, these European immigrants and their children—unlike Black Americans, who were limited to the least dynamic sectors of the economy—found employment in the most modern, industrialized sectors, usually in rapidly developing cities; here, burgeoning economies and political bases lured immigrants to assimilate for the sake of upward mobility.45 The rapidity and degree to which these ethnic groups chose or were allowed to assimilate, and the extent to which such acculturation could (or should) be complete, have been open to debate for many decades.46–53 It is clear, however, that for these groups, cultural identifiers and bonds like language, nationality, religion, and family began to weaken. Over time, the proportion who spoke the language of their ethnic group dropped precipitously. A study of the progeny of those who emigrated before 1924 found that between the second and third generations of Italian Americans, for example, the number who continued to speak their “mother tongue” fell from 2300000 to 147000; among Yiddish speakers, the fall was from 422000 to 39000.45 By the third generation, a large majority of Irish, Germans, French, Poles, and Italians had married outside their ethnic group; there was evidence that up to a third had married outside their religion. And the fourth generation—the great-grandchildren of the initial wave, and the first to have no “direct ancestral memories that reach back to their countries of origin” 45(p68,69)—experienced a further dissolution of ethnic cultural identifiers. By the 1960s, the notion of monolithic White and Black races was so commonplace as to raise almost no questions. Instead, the distance between them—the economic, political, and social disparity that African Americans experienced compared with Whites—became the central domestic issue of the decade, forcing action and demanding explanation. The report of the National Advisory Commission on Civil Disorders—the Kerner Commission—which was established after the searing riots of 1967 in Newark, Detroit, and other American cities, spoke of a nation that was “moving toward two societies, one black, one white—separate and unequal.”43(p1) It documented the multiple areas where Black Americans suffered systematic deprivation, segregation, and violence, and it made many recommendations for government and private actions, particularly in the areas of employment, education, housing, and welfare. Like many liberal platforms, the commission report stressed the need to push significant structural reforms. Contemporary with the Kerner Commission report, leading social scientists and policymakers developed a seductive alternative explanation for inequality between Whites and
many minority populations. Their positions began with the assertion that all populations, including African Americans, were, properly speaking, ethnic groups comparable to European hyphenated Americans and could therefore be studied within the same analytic framework.54 Nathan Glazer and Daniel Moynihan, who subscribed to that view, argued that the term “ethnic group” could be applied “not only to minorities, but to all the groups of a society characterized by a distinct sense of difference owing to culture and descent.”55(p64) Inequality, they held, arises out of culture, a consequence of the unique norms and values historically selected and developed by each ethnic group. The relative social status of a group depends on how well its culture permits it to compete and prosper, given the dominant values, organization, and expected behavior of the time. In American society, those whose cultures do not sufficiently stress work, frugality, and delayed gratification are at a deep disadvantage. Subsequently, if ethnic groups suffer from poverty, marginalization, and powerlessness, the fault lies largely in themselves, in the culture they have formed and that in turn forms them. Although Glazer and Moynihan’s interpretation allows for political competition between ethnic groups, so that there is the future prospect of a change in the hegemonic culture, it fails to stress how currently dominant groups use the state, employment, and ideology to limit the success of disadvantaged groups. Another form of contemporary cultural determinism was encapsulated in “the culture of poverty” thesis. Widely used in the 1960s and 1970s, the phrase originated in the anthropological work of Oscar Lewis, who understood it as a subculture that was “both an adaptation and a reaction of the poor to their marginal position in a class-stratified, highly individuated, capitalistic society.”56(p49) This subculture was marked by, among other things, low or no wages, unstable or female-centered households, minimal social organization outside the family, fear, low aspiration, feelings of inferiority, present-time orientation, fatalism, and lack of impulse control. For Lewis, the culture of poverty was itself impoverished. Offering neither hope nor long-term satisfaction, it could be eliminated, wherever possible, by radical political and social reforms. But for many conservatives, cultural determinism not only explained why certain racial and ethnic groups (and liberal policies) were unsuccessful, it also strongly suggested that those groups needed to be taught or pressured into accepting middle-class values and behavior, including individual responsibility and accomplishment. Those views underpinned the Reagan-era policies, the dissolution of the welfare safety net, and the attacks on affirmative action.57 July 2001, Vol. 91, No. 7
Implications for a New Population Taxonomy What inferences and consequences can we draw from this history? How does it help inform our understanding of the recommendation made by the IOM to replace race with ethnicity? First, the need to divide people into hierarchical categories was present at the beginning of America’s settlement, and distinctions based on skin color came early—with racialization leading to racism. The centrality of “racialization” in the United States is highlighted by the use the native-born population made of perceived “whiteness,” judging more recent European arrivals on a White–Black scale. That such categorization was later recognized as unscientific and prejudicial, that Americans could transform by legerdemain biologically determined European races into culturally given ethnic entities, did not prevent members of dominant groups in society from believing that race was still a biologically valid category for other groups. In sum, racism and race have historically existed and persisted in the mind-set of this country. The United States is a “race-soaked” nation. If race and racism are powerful ideas, consistent with our life as a nation and still buttressed by political, economic, and cultural forces, they will persist indefinitely, and they will affect any term or domain that is supposed to replace them. Any change in terminology, including “ethnic group,” will probably be contaminated by racism. Sadly, we have seen how theories of cultural determinism can serve to offer explanations—and public policies, including public health policies58–62—consistent with the older school of biological determinism. We would be in danger of replacing racism with “ethnicism.” In addition, substituting ethnic group for race may have deleterious social effects. Studies of race and racism often tend to focus attention on forces like poverty, poor access to health care, and the distribution of environmental sources of pollution.63–65 They raise the issue of discrimination and prejudice. Would the excision of race as a category of analysis tend to blind researchers and their audiences to the existence and consequences of racism, including its impact on health?66 Just such a rejection of “race” as a category of interest, one critic charges, has left anthropology bereft of a critical insight: [By] 1942, sociocultural anthropology was thoroughly professionalized and well on its way to being color blind, indifferent to the skin-color differences that are . . . the basis of the American “racial” (folk) classification. “Race” no longer mattered and if “race” could be demonstrated not to exist, then racism was an irrelevant response to skin-
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color differences, one doomed by its own (scientific) inexactitude to fade away. This proposition helped insure that American anthropology won the battle [against race] and lost the war.67(p670)
For reasons that are both practical and political, should we dump “race” when most people—White, Black, Asian, etc.—tend to use the concept both in describing themselves and in perceiving and responding to others? African Americans and Native Americans have found in their racial identity a strong sense of history and a positive set of social relations.68 The very power of our racial taxonomy and the mark of its success is that most people accept it as something given in nature or society, and act accordingly. As W.I. Thomas, a member of the old Chicago school of sociology, wrote, “If men define situations as real, they are real in their consequences.”69 Race, if not a biological fact, is a social fact70 (which neither legitimates race nor prevents struggles against racism). In substituting “ethnic group” for “race,” to what extent can we transform currently lived reality? To what extent will research fall short of the subjective and objective experiences of the groups we are studying?71,72 Finally, if “ethnic group” is a relatively new term in this country, as the IOM report notes, it is not a neutral one. Like “race,” “ethnic group” carries its own historical, political, and social baggage, its own set of social relationships.23,24,45–47 It may be understood as a community that, bound by language, religion, descent, and cultural values, provides cohesion and a sense of order to its members. But “ethnic group” is often used otherwise, to connote a people outside of, alien to, and different from the core population. So applied, “ethnic group” is historically associated with relatively recent immigration, with discrimination and prejudice or the perception of being marginallyWhite or non-White, with the need to overcome marginal economic, political, and social status. It is noteworthy that in the index of the IOM report, the reader who looks up the term “ethnic group” is referred instead to “minority group.” Despite these considerable drawbacks, there are significant advantages to collecting data by ethnic group as well as race. First, race can no longer adequately describe or encapsulate the diversity of groups now living in the United States. For decades after the equating of nationality with race was discredited, race in the United States was effectively reduced to White and non-White. In 1930, the Census Bureau treated “Mexican” as a race; after protests by Mexican Americans, that practice was discontinued.18 In the 1940 census, and for 3 decades thereafter, Mexicans and others of “Latin descent” were generally categorized as “White.”73 When, in 1980, both the short and long forms of the census included Hispanic
ethnicity, Latinos were still bifurcated by color. If in recent decades the census has recognized the need to find new distinctions among racial groups (Pacific Islanders and Hawaiian natives were distinguished from Asians in the 2000 census), the results are still crude. Asian race, for example, is of limited usefulness; how is one to justify a classification that combines Japanese, Vietnamese, and Indians? Even comparing populations of these different nations is often inadequate. Bhopal and colleagues have pointed out, for example, that given the complex of peoples in India, its nationals living in Britain must be carefully delineated—with ample justification—for the sake of sound research.74 Unlike race, ethnicity allows these distinctions, offering a flexibility that becomes more important as the United States, among other nations, becomes more diversified. Bhopal and others have also noted how notoriously difficult it is to define and measure ethnic groups.74–76 In principle, once researchers elect to study such groups, they should have to explain how they understand “ethnic group” and what are the rules they use to select the population and the variables defining the community under investigation. As a research variable, race should also be justified, defined, specified, and critically scrutinized as other variables must be in epidemiologic studies; but it rarely is. Its assumed biological basis appeared, conventionally, to make such scrutiny unnecessary. Since “ethnic group” lacks such an “objective” basis, its use requires researchers to define their construction of it and to justify its validity, reliability, and consistency.There is a much greater probability, especially if peer review criticism is encouraged, that “ethnic group” will receive the same scrutiny that many other variables do. Finally, unlike race, “ethnic group” is more obviously a social construct. Its weakness is also a strength. It shifts the researcher’s focus away from race, which carries the taint of its biological heritage, and offers a powerful alternative approach—in the IOM’s words, “an appreciation of the range of cultural and behavioral attitudes, beliefs, lifestyle patterns, diets, environmental living conditions, and other factors”16(p83)—to seek explanations for the distribution and determinants of disease. As a social construct, each ethnic group contains a history (in addition to the factors on the IOM’s list) and alters over time; the use of ethnic group should make the researcher sensitive to the effects of generation, changing economic status, social class, relations with other groups, discrimination, and relative political power.
Conclusions What is to be done? As racialization and race remain powerful ideologic factors, they American Journal of Public Health
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will persist, at least into the near future, affecting any alternative taxonomic term. Instead of denying the force of these categories, it might be wiser to retain “race” while recognizing “ethnic group” as a separate set of population categories that overlap with race but, when properly used, differ from it. Respondents may be asked to report both race and ethnic group; and both, carefully defined and justified, might be used as crude research variables. The term “race/ethnicity” already exists and is widely used, both for descriptive and for analytic purposes.8,77–79 Ironically, what began as a designation of convenience, incorporating the old racial categories and a Hispanic ethnic group, may prove to be a useful concept that enriches the taxonomy of human populations. The American Anthropological Association currently accepts the concept of “race/ ethnicity,” but only as a transition to the elimination of race entirely by the next census.6 This may be wholly too optimistic. Nonetheless, the IOM report may be a sign that we are in a significant period of change. In principle, the report perceives Whites as one macroethnic group among others, and Blacks, like all macro-ethnic groups, are no longer taken to be monolithic. In fact, the emigration of Blacks from the many nations of the Caribbean, Americas, and Africa—people who vary in many ways, including health experiences80–82— underscores that ethnic variability. Over time, perhaps, the growing diversity of our population and the growing power of these different groups may force the United States to redefine the social relations inherent in the terms “race,” “ethnicity,” and “ethnic group” to ones of greater equality. Perhaps new terms will emerge that more adequately express the new associations between individuals, groups, institutions, and power. But it is the associations that must first change, and before that, our consciousness of such different forms of unequal relationships. The new population classifications, whatever they are, will crystallize out of that process.
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Acknowledgments This work was supported in part by Professional Staff Congress–City University of New York grant 6108300-30. For their critical reading and helpful comments on this paper, I would like to thank Ronald Bayer, Bhadra Paula Kleinman, Richard Neugebauer, Sharon Schwartz, Anne Stone, and 2 anonymous reviewers.
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