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1 Laura E. Gómez Typing the word “disparities” into the search engine of the American Diabetes Association web site generates nearly 1,700 hits that relate to racial and/or ethnic gaps in diabetes rates and care (http://www.diabetes.org, accessed July 5, 2012). Similarly, an agency of the U.S. Health and Human Services Department proclaims that the risk of diabetes is “much greater for minority populations than the white population” (“Diabetes Disparities among Racial and Ethnic Minorities Fact Sheet” 2012). These warnings reflect multiple biomedical studies that have identified differential rates of diabetes among Whites (6.2 percent), American Indians (9 percent), Mexican Americans (10.6 percent), and African Americans (10.8 percent; Mokdad et al. 2000), as well as those that have reported that some non-White groups have diabetes-related complications at rates as much as 50 percent higher than Whites (Carter et al. 1996). The temptation is to attribute such disparities to genetic differences because people often assume that “racial” groups correspond to biological differences. Moreover, in a capitalist society in which much medical research is driven by pharmaceutical companies’ pursuit of individualized solutions to health problems (see Kahn, this volume), we often look for a genetic basis for health outcomes. Yet much data suggests that the notion of biological race is a poor proxy for other social dynamics. For example, epidemiologist Thomas LaVeist and colleagues have challenged the conventional wisdom that differential rates of diabetes reflect essential, biological differences (2009). They studied diabetes in a racially mixed Baltimore neighborhood that included large numbers of both African American and White residents who were of the same socioeconomic class and who had comparable access to healthcare. In contrast to the Introduction Taking the Social Construction of Race Seriously in Health Disparities Research Chapter 1 2 Laura E. Gómez government studies previously referenced, they found that African Americans and Whites in this neighborhood had quite similar rates of diabetes (LaVeist et al. 2009). “I don’t mean to suggest that genetics play no role in race differences in health,” LaVeist said, explaining the study’s conclusions, “but before we can conclude that health disparities are mainly a matter of genetics we need to first identify a gene, polymorphism or gene mutation that exists in one race group and not others. And when that gene is found we need to then demonstrate that that gene is also associated with diabetes. On the other hand, there is [already] overwhelming evidence that behavior, medical care and the environment are huge drivers of race differences in health” (“Racial Disparities . . .” 2009). In other words, looking for race-based health disparities may at best jump-start a productive scientific inquiry when it leads researchers, policy makers, and health care providers to ask further questions about why race seems to be important in the context of a specific disease or health problem. But, at its worst, looking for race-based health disparities blinds us to seeing the full range of possible causes of health inequalities. The broader point that we collectively make in this book goes a step further: we must be skeptical of claims about race-based health disparities precisely because “race” is the product of historically rooted ideas and political contestation (Gómez 2012). Anthropologist Michael Montoya puts it this way: “the ascertainment of ethnicity or race is a profoundly social enterprise anchored in contemporary history,” and racial categories, both historically and today, “correspond best to the imaginations of the scientists and not the presumably defining and stable features being measured” (Montoya 2007). Using the example of diabetes in his book Making the Mexican Diabetic, Montoya explores how the process of racializing diabetes—that is, the process of scientists and health professionals learning to take for granted that diabetes has a distinct impact and perhaps even etiology in people of different races—has occurred in laboratories , in government funding circles, in peer-reviewed scientific publications, and in the practice of medicine (2011). What explains biomedical researchers’ categorization of humans into groups, and then the linkage of those groups to specific health problems such as diabetes, is the social process of making race—of constituting race as socially, politically, and scientifically important. Thus, our research agenda must include actively studying this racialization process; says Montoya: “when we carefully examine the selection of a group to study, the labeling of that group, the representation of that group in scientific papers, we see a science of population labeling based squarely on sociocultural...

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