Human Categories and Health: The Power of the Concept of Ethnicity

Abstract

The inclusion of ethnic minorities in cancer prevention studies is a scientific, logistic, cultural, and ethical issue. Ethnic minorities made up approximately significant percentage of the population of the USA, yet many issues raised above remain unanswered. In this chapter we describe the disparities that occur across the continuum of cancer, from early detection, to treatment quality, to survival. While disparities are regularly reported, one problem affecting research in ethnicity and health is that researchers employ the term to measure every important indicator associated with inequality or difference: socioeconomic status, cultural lifestyles and values, and genetic predispositions are all being measured by the ethnicity variable. The independent importance of this variable, however, is evident in the fact that even if we control for other factors, race and ethnicity are predictors of disparities (Palacio H, Kahn JG et al (2002) Effect of race and/or ethnicity in use of antiretrovirals and prophylaxis for opportunistic infection: a review of the literature. Public Health Rep 117(3):233–251; discussion 231–232; Cohen JJ (2003) Disparities in health care: an overview. Acad Emerg Med 10(11):1155–1160; Opolka JL, Rascati KL et al (2003) Role of ethnicity in predicting antipsychotic medication adherence. Ann Pharmacother 37(5):625–630; Guller U, Jain N et al (2004) Insurance status and race represent independent predictors of undergoing laparoscopic surgery for appendicitis: secondary data analysis of 145, 546 patients. J Am Coll Surg 199(4):567–575; discussion 575–577). We begin this chapter with a discussion of cancer disparities and then turn to a discussion of the definitions of race and ethnicity and the importance of incorporating an understanding of the interaction of genes and the environment in human development and in the development of disease.