Epidemiologist Explores Racism in Health Outcomes
When
President Bill Clinton officially named February 2000 as National African
American History Month, he said that the 21st century offers "a unique
opportunity to write our own chapter in the history of African Americans
and of our nation." HSPH researcher Camara
Phyllis Jones might add that such a chapter should include serious
reexamination of health care policies concerning African Americans.
African Americans' health suffers as a result of racism, says Jones, assistant professor of health and social behavior and epidemiology.
"Race is a social construct," said Jones. "It is not a biological variable, and yet the way that epidemiologists deal with race often leaves the basis of race-associated differences unexplained."
Traditionally, epidemiologists have used factors such as age, gender and race to track health-related patterns among populations. Some have documented health outcome differences among races, but Jones wants the documentation to go further into the outcomes' origins.
"The way that we conduct our science is negligent because we continue to routinely document race-related differences in health outcomes, but we don't vigorously investigate the basis," she said.
Jones's research has revealed that African Americans tend to present blood pressure rates similar to white Americans 10 years their senior after both groups enter middle age. She found a similar phenomenon in New Zealand where she conducted research last year after winning the Ian Axford Fellowship for Public Policy. Jones found that the indigent Maori tended to have blood pressure levels similar to whites who were five years older.
Jones believes that the accelerated aging related to blood pressure results from the general stress of living in a race-conscious society. She cited studies that showed that blood pressure levels of whites in the US tended to drop at night while those of African Americans stayed at higher, daytime levels.
"It is something like gunning a car constantly," said Jones. "The stresses of the levels of racism cause the higher blood pressure."
Jones wants to develop measures of racism that may help explain the health outcomes. She also is investigating if accelerated aging can explain race-cited differences in other health outcomes.
Jones first became interested in race as an indicator of disease as a physician. When designating a patient's chief complaint, Jones said, physicians often include race as a factor. "What is this information supposed to convey?"
When Jones became an epidemiologist, she began to develop a system of comparing statistical data that shows differences over time, space and other strata. Her work led her to understand that "race is a poor proxy for socioeconomic status, a poorer proxy for culture, and an even poorer proxy for genetic endowment. However, race exactly measures the way in which an individual is classified in a race-conscious society."
In 1995, Jones created a new course at HSPH called "Race" and Racism. In the course, she breaks down the construct of racism to explain why racism persists and how it continues to affect stigmatized and other populations. The course has received the highest rating in evaluations since its inception.
At HSPH, Jones would like to see more recruitment and retention of faculty and doctoral students of African descent.
She also would like the US federal government to make reparations for the enslavement of African Americans, but proposes new applications of the funds. Jones would like to invest the money in the education of African-American students and the development of schools.
"We waste the potential of whole populations because we do not
invest in their education or health. We have written off people in barrios
and on reservations and in ghettos as not being important, as if we as
a nation can progress very well without them," said Jones. "Just
think of where we could be if all of that genius that is laying fallow
in these communities were developed."
