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Using “socially assigned race” to probe White advantages in health status

Using “socially assigned race” to probe White advantages in health status. Using “socially assigned race” to probe White advantages in health status. Camara Phyllis Jones, MD, MPH, PhD Benedict I. Truman, MD, MPH Laurie D. Elam-Evans, PhD, MPH Camille A. Jones, MD, MPH

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Using “socially assigned race” to probe White advantages in health status

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  1. Using “socially assigned race”to probeWhite advantages in health status

  2. Using “socially assigned race”to probeWhite advantages in health status Camara Phyllis Jones, MD, MPH, PhD Benedict I. Truman, MD, MPH Laurie D. Elam-Evans, PhD, MPH Camille A. Jones, MD, MPH Clara Y. Jones, MD, MPH Ruth Jiles, PhD Susan F. Rumisha, MSc Geraldine S. Perry, DrPH

  3. What is racism? Source: Jones CP, Phylon 2003

  4. What is racism? A system Source: Jones CP, Phylon 2003

  5. What is racism? A system of structuring opportunity and assigning value Source: Jones CP, Phylon 2003

  6. What is racism? A system of structuring opportunity and assigning value based on the social interpretation of how one looks (“race”) Source: Jones CP, Phylon 2003

  7. What is racism? A system of structuring opportunity and assigning value based on the social interpretation of how one looks (“race”) • Unfairly disadvantages some individuals and communities Source: Jones CP, Phylon 2003

  8. What is racism? A system of structuring opportunity and assigning value based on the social interpretation of how one looks (“race”) • Unfairly disadvantages some individuals and communities • Unfairly advantages other individuals and communities Source: Jones CP, Phylon 2003

  9. What is racism? A system of structuring opportunity and assigning value based on the social interpretation of how one looks (“race”) • Unfairly disadvantages some individuals and communities • Unfairly advantages other individuals and communities • Saps the strength of the whole society through the waste of human resources Source: Jones CP, Phylon 2003

  10. “Reactions to Race” module • Six-question optional module on the Behavioral Risk Factor Surveillance System • Piloted by six states in 2002 • Now available to all states Camara Phyllis Jones, MD, MPH, PhD

  11. States using “Reactions to Race” Arkansas2004 California2002 Colorado2004 Delaware200220042005 District of Columbia2004 Florida2002 Michigan2006 Mississippi2004 New Hampshire2002 New Mexico2002 North Carolina2002 Ohio20032005 Rhode Island20042007 South Carolina20032004 Washington2004 Wisconsin200420052006 Camara Phyllis Jones, MD, MPH, PhD

  12. States using “Reactions to Race” module on 2004 BRFSS Arkansas, Colorado, Delaware, District of Columbia, Mississippi, Rhode Island, South Carolina, Wisconsin Camara Phyllis Jones, MD, MPH, PhD

  13. Socially-assigned “race” • How do other people usually classify you in this country? Would you say: • White • Black or African-American • Hispanic or Latino • Asian • Native Hawaiian or Other Pacific Islander • American Indian or Alaska Native • Some other group Camara Phyllis Jones, MD, MPH, PhD

  14. General health status • Would you say that in general your health is: • Excellent • Very good • Good • Fair • Poor Camara Phyllis Jones, MD, MPH, PhD

  15. Camara Phyllis Jones, MD, MPH, PhD

  16. Camara Phyllis Jones, MD, MPH, PhD

  17. Camara Phyllis Jones, MD, MPH, PhD

  18. General health status and “race” • “White” social experience associated with better health Camara Phyllis Jones, MD, MPH, PhD

  19. Self-identified ethnicity • Are you Hispanic or Latino? • Yes • No Camara Phyllis Jones, MD, MPH, PhD

  20. Self-identified “race” • Which one or more of the following would you say is your race? • White • Black or African-American • Asian • Native Hawaiian or Other Pacific Islander • American Indian or Alaska Native • Other • Which one of these groups would you say best represents your race? Camara Phyllis Jones, MD, MPH, PhD

  21. Self-identified “race”/ethnicity • Hispanic • “Yes” to Hispanic/Latino ethnicity question • Any response to race question • White • “No” to Hispanic/Latino ethnicity question • Only one response to race question, “White” • Black • “No” to Hispanic/Latino ethnicity question • Only one response to race question, “Black” • American Indian/Alaska Native • “No” to Hispanic/Latino ethnicity question • Only one response to race question, “AI/AN” Camara Phyllis Jones, MD, MPH, PhD

  22. Two measures of “race” How usually classified by others How self-identify Camara Phyllis Jones, MD, MPH, PhD

  23. Two measures of “race” How usually classified by others How self-identify Camara Phyllis Jones, MD, MPH, PhD

  24. Two measures of “race” How usually classified by others How self-identify Camara Phyllis Jones, MD, MPH, PhD

  25. General health status, by self-identified and socially-assigned "race", 2004 100 80 60 58.6 53.7 percent of respondents 39.8 40 20 0 Hispanic-Hispanic Hispanic-White White-White Report excellent or very good health Camara Phyllis Jones, MD, MPH, PhD

  26. General health status, by self-identified and socially-assigned "race", 2004 100 Test of H0: No difference in proportions reporting excellent or very good health Hispanic-Hispanic versus White-White p < 0.0001 80 60 58.6 percent of respondents 39.8 40 20 0 Hispanic-Hispanic White-White Report excellent or very good health Camara Phyllis Jones, MD, MPH, PhD

  27. General health status, by self-identified and socially-assigned "race", 2004 100 Test of H0: No difference in proportions reporting excellent or very good health Hispanic-Hispanic versus Hispanic-White p = 0.0019 80 60 53.7 percent of respondents 39.8 40 20 0 Hispanic-Hispanic Hispanic-White Report excellent or very good health Camara Phyllis Jones, MD, MPH, PhD

  28. General health status, by self-identified and socially-assigned "race", 2004 100 Test of H0: No difference in proportions reporting excellent or very good health Hispanic-White versus White-White p = 0.1895 80 60 58.6 53.7 percent of respondents 40 20 0 Hispanic-White White-White Report excellent or very good health Camara Phyllis Jones, MD, MPH, PhD

  29. Two measures of “race” How usually classified by others How self-identify Camara Phyllis Jones, MD, MPH, PhD

  30. Two measures of “race” How usually classified by others How self-identify Camara Phyllis Jones, MD, MPH, PhD

  31. General health status, by self-identified and socially-assigned "race", 2004 100 80 60 58.6 52.6 percent of respondents 40 32 20 0 AIAN-AIAN AIAN-White White-White Report excellent or very good health Camara Phyllis Jones, MD, MPH, PhD

  32. General health status, by self-identified and socially-assigned "race", 2004 100 Test of H0: No difference in proportions reporting excellent or very good health AIAN-AIAN versus White-White p < 0.0001 80 60 58.6 percent of respondents 40 32 20 0 AIAN-AIAN White-White Report excellent or very good health Camara Phyllis Jones, MD, MPH, PhD

  33. General health status, by self-identified and socially-assigned "race", 2004 100 Test of H0: No difference in proportions reporting excellent or very good health AIAN-AIAN versus AIAN-White p = 0.0122 80 60 52.6 percent of respondents 40 32 20 0 AIAN-AIAN AIAN-White Report excellent or very good health Camara Phyllis Jones, MD, MPH, PhD

  34. General health status, by self-identified and socially-assigned "race", 2004 100 Test of H0: No difference in proportions reporting excellent or very good health AIAN-White versus White-White p = 0.3070 80 60 58.6 52.6 percent of respondents 40 20 0 AIAN-White White-White Report excellent or very good health Camara Phyllis Jones, MD, MPH, PhD

  35. General health status and “race” • “White” social experience associated with better health • Even within the same self-identified “race”/ethnic group Camara Phyllis Jones, MD, MPH, PhD

  36. Camara Phyllis Jones, MD, MPH, PhD

  37. Camara Phyllis Jones, MD, MPH, PhD

  38. Camara Phyllis Jones, MD, MPH, PhD

  39. Camara Phyllis Jones, MD, MPH, PhD

  40. General health status and “race” • “White” social experience associated with better health • Even within the same self-identified “race”/ethnic group • Even within the same educational level Camara Phyllis Jones, MD, MPH, PhD

  41. Camara Phyllis Jones, MD, MPH, PhD

  42. Camara Phyllis Jones, MD, MPH, PhD

  43. Camara Phyllis Jones, MD, MPH, PhD

  44. Camara Phyllis Jones, MD, MPH, PhD

  45. General health status and “race” • “White” social experience associated with better health • Even within the same self-identified “race”/ethnic group • Even within the same educational level • “White” social experience associated with higher education Camara Phyllis Jones, MD, MPH, PhD

  46. Key questions • WHY is socially-assigned “race” associated with self-reported general health status? • Even within the same self-identified “race”/ethnic group • Even within the same educational level • WHY is socially-assigned “race” associated with educational level? Camara Phyllis Jones, MD, MPH, PhD

  47. Racism A system of structuring opportunity and assigning value based on the social interpretation of how one looks (“race”) • Unfairly disadvantages some individuals and communities • Unfairly advantages other individuals and communities • Saps the strength of the whole society through the waste of human resources Source: Jones CP, Phylon 2003

  48. Our tasks • Name racism • Ask, “How is racism operating here?” • Organize and strategize to act Camara Phyllis Jones, MD, MPH, PhD

  49. Camara Phyllis Jones, MD, MPH, PhD 4770 Buford Highway NE Mailstop K-67 Atlanta, Georgia 30341 (770) 488-5268 phone (770) 488-5965 fax cdj9@cdc.gov

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