Elsevier

Social Science & Medicine

Volume 68, Issue 6, March 2009, Pages 1183-1190
Social Science & Medicine

“Race” and “ethnicity” in biomedical research: How do scientists construct and explain differences in health?

https://doi.org/10.1016/j.socscimed.2008.12.036Get rights and content

Abstract

Social and biomedical scientists, journal editors, and public health officials continue to debate the merits of the use of race and ethnicity in health-related research. As biomedical research focuses on issues of racial or ethnic health disparities, it remains unclear how biomedical scientists investigate race or ethnicity and health. This paper examines how biomedical researchers construct and analyze race or ethnicity in their studies and what conclusions they make about difference and health. Using content analysis of 204 biomedical research journal publications, which were supported by grants won from the National Cancer Institute of the National Institutes of Health in the USA, I demonstrate that although authors tended to see race or ethnicity as important and significant in their research, they rarely defined or operationalized the concepts adequately. Moreover, when presenting findings of racial or ethnic difference, authors generally did not provide explanations of the difference. I argue that this under-theorized and unspecified use of race or ethnicity and the biological conclusions drawn about health and difference have the potential to reify “race” and to limit our thinking about what these biomedical differences suggest about health disparities and inequalities in general.

Introduction

Despite the repudiation of scientific racism, scientists remain divided over what race means or ought to mean in scientific investigations as well as in lay discussions and policymaking. The concept may represent social, biological, and even genetic differences. Such variance is antithetical to the tenets of scientific research, which, in its ideal form, demands that analytical variables be consistent and their categories mutually exclusive (Bowker and Star, 1999, Timmermans and Berg, 2003). Due in part to this concern over research methods and perhaps apprehension over the biological reduction of race, biomedical researchers, social scientists, journal editors, and public health officials have all weighed in on the matter of what, if anything, race ought to mean in scientific investigations, the data collections that enable such research, the reporting of findings, and resulting policies that are informed by these discoveries (British Medical Journal, 1996, Cooper et al., 2003, Fullilove, 1998, Kaplan and Bennett, 2003, Phimister, 2003, Schwartz, 2001).

It is unclear what researchers do and mean when they use race or ethnicity in their investigations. The studies that have examined the use of these constructs in research have shed light on how scientists define and use them, but their scope has been limited to health services research (Drevdahl et al., 2001, Williams, 1994) and genetics (Race, Ethnicity, and Genetics, 2005, Sankar et al., 2007). This study expands this inquiry by exploring how biomedical researchers conceptualize and incorporate race or ethnicity in their investigations. The issue of if and how race or ethnicity are used in biomedical research is particularly important now given the rise in attention to health disparities as a political issue and emphasis on biomedical solutions for such matters (Halfmann, Rude, & Ebert, 2005). In this paper, I examine how biomedical researchers, funded by the National Cancer Institute (NCI) of the National Institutes of Health (NIH), construct and use the concepts of race or ethnicity as analytical variables and what kinds of conclusions they make about health and difference. The study investigated 204 biomedical research journal articles, which were supported by grants won from the NCI in the years between 1990 and 1999—a watershed decade that ushered in numerous policy changes tied to health and biomedical research. Using content analysis of the publications, I demonstrate a number of findings. Authors tended to see race or ethnicity as important and significant in their research. However, despite seeing the importance of race or ethnicity in their research, authors rarely defined or operationalized the concepts adequately. Moreover, when presenting findings of racial or ethnic difference, authors generally did not provide explanations of the difference. I argue that this under-theorized and unspecified use of race or ethnicity and the biological conclusions drawn about health and difference have the potential to reify “race” and to limit our thinking about what these biomedical differences suggest about health disparities and inequalities in general.

Section snippets

Race and ethnicity in biomedical research

Before going further, I first provide an overview of the debates and issues surrounding the use of race and ethnicity in biomedical research and historical background of related government regulations. In this section and throughout the paper, I adopt a social constructionist approach to understanding the contestations and uses of race or ethnicity in biomedical research. I recognize that as a social construct its meanings are neither fixed nor essential. Despite this constructivist approach, I

Data and methods

The study examined how race and/or ethnicity are defined, operationalized, and utilized in publications that have been supported by research grants from the National Cancer Institute in the USA. It did not look at the impact of any given institutional shift on the use of race or ethnicity in research and cannot provide a causal explanation for why the use of race or ethnicity takes the forms that they do. Nevertheless, I provide tentative results that suggest some possible influence that

Racial or ethnic differences are important

Given the initial search criteria of the grants, it is not surprising that most of the articles mentioned race or ethnicity in some form. Authors referred to “race,” “ethnicity,” or other euphemistic terms in 166 or 81% of the 204 articles, which included studies of both multi-ethnic or multi-racial and single-group samples. In 47 or 23% of the articles, authors used the term “race” only. In 55 or 27% of the articles, authors used the term “ethnicity” but not “race.” Researchers used both

Defining and using “race” and “ethnicity”

Despite the frequent invocation of the terms “race” and/or “ethnicity,” authors rarely offered a definition or operationalization of the concepts. There was an a priori assumption that readers would simply recognize or understand what the terms meant. In just 39 or 23% of the 166 articles that mentioned race or ethnicity, authors provided some sort of explanation of race or ethnicity. No author explicitly articulated a definition of race—that is, the investigators did not explain if they

Findings of difference are not explained

Whether or not definitions were offered, when authors used race or ethnicity as an analytical variable or presented racial or ethnic data, they rarely provided explanations of how or why race or ethnicity was important. Authors reported findings of racial or ethnic differences in 58 articles and similarities across racial or ethnic groups in 12 articles. Scientists did not always explain what could account for the racial or ethnic difference. In 40 or 69% of the 58 articles in which authors

Conclusion

The potentially fuzzy and imprecise nature of the use of race or ethnicity in biomedical research is not discipline or field specific. Social scientists who investigate race or ethnicity can also be faulted for not defining or ill-defining these terms. They regularly make conclusions about racial or ethnic variations then fail to explicate the social mechanisms by which race or ethnicity is meaningful for determining social outcomes such as educational achievement or income attainment (Loveman,

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    The author thanks Rod Hayward, Joanna Kempner, Scott Murry, Bhaven Sampat, Kristen Springer, and the anonymous reviewers for their comments; Meghan Cameron and Feng Pan for their assistance; and the Robert Wood Johnson Scholars in Health Policy Research Program for its support.

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