Ebook: Gender, Ethnicity, and Health Research

Health researchers routinely evaluate health and illness across subgroups defined by their sex, gender, ethnicity, and race. All too often, these classifications are proffered as an explanation for any differences that may be detected, for example, in access to care, frequency of disease, or response to treatment. Relatively few researchers, however, have examined what these classifications mean on a theoretical level or in the context of their own research. Assume, for example, that a researcher concludes from his or her data that African- Americans utilize certain surgical procedures less frequently than whites. This conclusion may mean little without an examination of the various underlying issues. Is there such a construct as race at all? How were whites and African-Americans classified as such? Does this finding reflect inappropriate overutilization of the specific procedures among whites or inappropriate underutilization among African-Americans? To what extent are socioeconomic status and method of payment related to the less frequent use? Are there differences in the manner in which health care providers present the various treatment options to whites and to African- Americans that could account for these differences in utilization? Are there differences in health care-seeking and health care preferences between the two groups that would explain the difference in utilization? Is the racial classification a surrogate measure for another variable that has remained unidentified and unmeasured? All too often, unfortunately, such issues are ignored or lightly dismissed with an entreaty for additional research.

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This text examines the basic constructs of gender, sex, ethnicity, and race. These constructs are routinely used in the analysis of data in a number of fields, including epidemiology, health services research, sociology, and medical anthropology. Despite the widespread use of these terms, little thought has been given to what they really mean. What does it mean, for instance, to say that African Americans are at a higher risk of AIDS than other groups? Is this really a surrogate for sexual behavior? For access to medical care? For an unknown genetic difference in the immune system? Since ethnicity/race is not a mutable characteristic, are we accomplishing anything by focusing on it as a risk factor or risk marker, or should we be examining its underlying meaning? Should we continue to utilize these constructs and, if so, how? What are the implications for intervention programs and intervention research? This text addresses these constructs of gender and ethnicity in a manner that challenges the conventional wisdom within the health sciences. Additionally, the text will provide a good review of these constructs, as well as socioeconomic status, access to care, and quality of care.