Skip to main content
Log in

Overcoming the Racial Hierarchy: the History and Medical Consequences of “Caucasian”

  • Perspective Article
  • Published:
Journal of Racial and Ethnic Health Disparities Aims and scope Submit manuscript

Abstract

The term Caucasian is ubiquitous in the medical field. It is used without a significant consideration of its history or medical necessity. First, the term Caucasian has racist historical origins in a beauty-based hierarchy with implied superiority. It is derived from a 1700’s historical scheme which places Caucasians above the other, degenerated racial groups. Second, the pseudo-scientific justification for this hierarchy has been co-opted to legally justify discrimination against minority groups in the USA. Third, the unnecessary and incorrect application of antiquated racial identifiers negatively impacts patient care. Disentangling real, clinically meaningful genetic differences from superficial racial determinations remains an ongoing challenge. Framing patient care through Caucasian or white lens leads to the unequal care and the otherization of minority groups. Fourth, we must develop a more appropriate, racially sensitive system for patient identification in clinical practice and research. This demands intentionality, precision, and consistency.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Kaplan JB, Bennett T. Use of race and ethnicity in biomedical publication. JAMA. 2003;289(20):2709–16. https://doi.org/10.1001/jama.289.20.2709.

    Article  PubMed  Google Scholar 

  2. Painter NI. The history of white people. 1st ed. New York: W. W. Norton & Company; 2010.

    Google Scholar 

  3. Bhopal R. The beautiful skull and Blumenbach’s errors: the birth of the scientific concept of race. BMJ. 2007;335(7633):1308–9. https://doi.org/10.1136/bmj.39413.463958.80.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Krieger N. Stormy weather: race, gene expression, and the science of health disparities. Am J Public Health. 2005;95(12):2155–60. https://doi.org/10.2105/AJPH.2005.067108.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Gould SJ. The geometer of race. In: Discover. Discover magazine. (1994). http://discovermagazine.com/1994/nov/thegeometerofrac441. Accessed 11 Oct 2017.

  6. Dewan S. Has Caucasian lost its meaning? In: The New York Times Sunday Review. http://www.nytimes.com/2013/07/07/sunday-review/has-caucasian-lost-its-meaning.html (2013). Accessed 11 Oct 2017.

  7. Sutherland. Takao Ozawa vs US. In: FindLaw. The supreme court of the United States. http://caselaw.findlaw.com/us-supreme-court/260/178.html (1922). Accessed 11 Oct 2017.

  8. Sutherland. US vs. bhagat singh thind. In: FindLaw. The supreme court of the United States. http://caselaw.findlaw.com/us-supreme-court/261/204.html (1923). Accessed 11 Oct 2017.

  9. Daniels J, Schulz A. Constructing whiteness in health disparities research. In: Schulz A, Mullings L, editors. Health and illness at the intersections of gender, race and class. San Francisco: Jossey-Bass Publishing; 2006. p. 89–127.

    Google Scholar 

  10. Yudell M, Roberts D, DeSalle R, et al. Taking race out of human genetics. Science. 2016;351:564–5.

    Article  CAS  Google Scholar 

  11. Jorde LB, Wooding SP. Genetic variation, classification and ‘race’. Nat Genet. 2004;36(11s):S28–33. https://doi.org/10.1038/ng1435.

    Article  CAS  PubMed  Google Scholar 

  12. Miller TR, Lawrence BA, Carlson NN. Perils of police action: a cautionary tale from US data sets. Inj Prev. 2016;23:27–32.

    Article  PubMed  Google Scholar 

  13. Braun L, Fausto-Sterling A, Fullwiley D, Hammonds EM, Nelson A, Quivers W, et al. Racial categories in medical practice: how useful are they? PLoS Med. 2007;4(9):e271. https://doi.org/10.1371/journal.pmed.0040271.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Ackerman H, Usen S, Jallow M, Sisay-Joof F, Pinder M, Kwiatkowski DP. A comparison of case-control and family based associated methods: the example of sickle cell and malaria. Ann Hum Genet. 2005;69(5):559–65. https://doi.org/10.1111/j.1529-8817.2005.00180.x.

    Article  CAS  PubMed  Google Scholar 

  15. Freedman BI, Pastan SO, Israni AK, Schladt D, Julian BA, Gautreaux MD, et al. APOL1 genotype and kidney transplantation outcomes from deceased African American donors. Transplantation. 2016;100(1):194–202. https://doi.org/10.1097/TP.0000000000000969.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Feagin J, Bennefield Z. Systemic racism and US health care. Soc Sci Med. 2014;103:7–14. https://doi.org/10.1016/j.socscimed.2013.09.006.

    Article  PubMed  Google Scholar 

  17. Hoffman KM, Trawalter S, Axt JR, Oliver MN. Racial bias in pain assessment and treatment recommendations, and false beliefs about biological differences between blacks and whites. PNAS. 2016;113(16):4296–301. https://doi.org/10.1073/pnas.1516047113.

    Article  CAS  PubMed  Google Scholar 

  18. Race, Ethnicity, and Genetics Working Group. The use of racial, ethnic, and ancestral categories in human genetics research. Am J Hum Genet. 2005;77(4):519–32.

    Article  Google Scholar 

  19. Mukhopadhyay C. Getting rid of the word “Caucasian”. In: Pollack M, editor. Everyday antiracism: getting real about race in school. NY: The New Press; 2008. p. 12–6.

    Google Scholar 

  20. Schwalbe M, Godwin S, Holden D, et al. Generic processes in the reproduction of inequality: an interactionist analysis. Soc Forces. 2000;79(2):419–52. https://doi.org/10.1093/sf/79.2.419.

    Article  Google Scholar 

Download references

Acknowledgements

I thank James Anderson, Anantanand Rambachan, and Apoorva Pasricha for their helpful comments and feedback on earlier drafts.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Aksharananda Rambachan.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Rambachan, A. Overcoming the Racial Hierarchy: the History and Medical Consequences of “Caucasian”. J. Racial and Ethnic Health Disparities 5, 907–912 (2018). https://doi.org/10.1007/s40615-017-0458-6

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40615-017-0458-6

Keywords

Navigation