The Conceptualization of Race and Racism in the Discourse Addressing Racial and Ethnic Health Inequities

Abstract

The conceptualization of race, racism, and Whiteness through language and discourse influences policy agendas to eliminate racial and ethnic health disparities/inequities. The manner in which these terms are conceptualized within health promotion agendas also influence the ways social welfare/health professionals take action to address them. The definition of terms like "race," "racism," or "Whiteness" can potentially reinforce or challenge previously held understandings of these concepts. The meaning assigned to racial concepts also reveals who has the resources to interpret, reproduce, and benefit from the sanctioned knowledge. The purpose of the current qualitative study was to explore how policy agendas and social welfare/health professionals conceptualized race, racism, and Whiteness. Additional considerations included the possible influence of those conceptualizations on their actions to address racial and ethnic health disparities/inequities was examined. The primary sources of data were published policy agendas designed to address racial and ethnic health disparities at the city, state, national, and international levels. Furthermore, social welfare/health professionals working in West Baltimore also participated in qualitative interviews as an additional source of information. Grounded theory theme identification (GT; Charmaz, 2014) and critical discourse analysis (CDA; Fairclough, 2009, 2012) provided the methodologies to analyze both sources of data. The city, state, and national policy agendas to eliminate racial health disparities/inequities focused on two complementary discourses, state-sanctioned racial categorizations and racial differences, as the basis for individual-focused interventions. Similarly, the professionals' discourses included skin color identification/categorization and racial [pre]judgments/discrimination. Finally, the common discourses professionals used to describe actions taken to address racial and ethic health disparities were: a) collaboration, engagement, and outreach; b) health provision and promotion; and c) race training, awareness, and diversity. Conversely, the international policy agendas included discourses of government accountability, political context, and theorizing social power. The language and discourse assigned to racial concepts within the professional context can act as barriers or bridges to the formation of comprehensive policies and practices to address the injustice of racialized health outcomes. In turn, the meanings we assign through language and discourse inform the types of analyses and interventions we implement to eliminate racial and ethnic health outcomes.