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92 6 Race, Social Contexts, and Health Examining Geographic Spaces and Places David T. Takeuchi, University of Washington Emily Walton, University of Washington ManChui Leung, University of Washington and ethnic groups (CDC 2007). Asian Americans are 20 percent more likely to have hepatitis B than whites and comprise almost 50 percent of chronic hepatitis B infections; these rates are related to a higher incidence and mortality of liver cancer among Asians (CDC 2006; Miller et al. 2008). While racial variations in diseases are observed , the meaning and measurement of race is frequently contested. An early explanation for racial differences, which continues into the present but with less scientific support, attributes these variations to genetic differences. Essentialism, or biological determinism, sees racial categories as fixed, distinct, and constant over time. Essentialism suggests that some racial groups are less healthy and more apt to become ill and to die prematurely because they have physical, moral, or mental deficiencies based on their genetic or biological makeup. Genetic theories for explaining racial differences in health status are not widely supported in the contemporary scientific literature . Few genetic differences exist across racial groups, and social scientists challenge essentialist notions of race by arguing that people make attributions about groups based on stereotypes and prejudices that are tied to some physical traits (Omi and Winant 1994; Rosenberg et al. 2002). Race continues to have a strong association with health outcomes. African Americans, for example, have a higher incidence, greater prevalence, and longer duration of hypertension than do whites. These higher rates are a major risk factor for heart disease, kidney disease, and stroke (CDC 2007; Morenoff et al. 2007). The age-adjusted death rates for African Americans exceed those of whites by 46 percent for stroke, 32 percent for heart disease, 23 percent for cancer, and 787 percent for HIV disease (CDC 2007). Among Latinos, Puerto Rican Americans have the highest rate of lifetime asthma prevalence (196 per 1,000) making them almost 80 percent more likely to be diagnosed with asthma. Mexican American adults are 100 percent more likely than white adults to have been diagnosed with diabetes by a physician. Cancer incidence and death rates are higher for Native Hawaiians and Pacific Islanders (549 per 100,000) than for whites (448.5 per 100,000) due to higher rates for cancers of the prostate, lung, liver, stomach, and colorectum among men, and cancers of the breast and lung among women (CDC 2007; Miller et al. 2008). Native Americans, especially males ages fifteen to twenty-four, have substantially higher death rates (232 percent) for motor vehicle-related injuries and for suicide (194 percent) than other racial Race, Social Contexts, and Health 93 Despite the ambiguities and complexities of racial categories, race still matters in many quality-of-life indicators (Smelser, Wilson, and Mitchell 2001). Sociologists consider race categories to be socially created boundaries that change in meaning and importance depending on the social and political climate of the time. Racial categories carry with them implicit and explicit images and beliefs about racial groups that provide rationales for treatment of group members (Takeuchi and Gage 2003). Race is particularly critical and meaningful when individuals have difficulty obtaining desired goods and resources because of their group membership (Williams and Williams-Morris 2000). While the social science debate about the relative merits of different conceptualizations and measurements of race continues, it is clear by most measures that the population of the United States has become increasingly diverse and complex . Demographers predict that there will be significantly more changes over the next fifty years. Through the 1950s, African Americans comprised the primary racial minority group, with about 10 percent of the adult and 12 percent of the children ’s population (U.S. Bureau of the Census 2002). In the 2000 census, Latinos were identified as the largest minority group (U.S. Bureau of the Census 2001a); the 281,421,906 people living in the United States reflected the following racial representation: white (75 percent), Latino (13 percent), black or African American (12 percent), American Indian and Alaska Native (1 percent), Asian (4 percent), Native Hawaiian and Pacific Islander (0.1 percent), and other racial groups (6 percent). The complexity of race is magnified when mixed-race individuals are included in the picture. In 2000, when the U.S. census gave respondents the opportunity to check more than one racial group, 6.8 million people (2 percent of the population) identified themselves with two or more races. Given the increased...

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