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Race, Ethnicity, and Young People's Health


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Race, Ethnicity, and Young People's Health

  2. 2. OBJECTIVES 1. Compare and contrast ancestry, nationality, ethnicity, and race. 2. Describe the biological and social factors that shape these concepts. 3. Explain how these concepts and their historical uses give rise to heterogenous patterns of health in young people.
  3. 3. In what ways are ancestry, nationality, ethnicity, and race related?
  4. 4. Y-Chromosomal Adam Mitochondrial Eve 120,000 – 156,000 Years Ago 100,000 – 120,000 Years Ago Most Recent Common Ancestor 3,500 - 15,000 Years Ago Haplogroups A group of individuals with similar haplotypes (i.e., genes inherited from a single parent) that share a common ancestral lineage usually dating back a few thousand years. Mutation A Mutation B ANCESTRY
  5. 5. ANCESTRY 60,000 Years Ago
  6. 6. ANCESTRY 50,000 Years Ago
  7. 7. ANCESTRY 40,000 Years Ago
  8. 8. ANCESTRY 30,000 Years Ago
  9. 9. ANCESTRY 20,000 Years Ago
  10. 10. ANCESTRY 10,000 Years Ago
  11. 11. Tropics Subtropics Mid-latitudes High latitudes ANCESTRY
  12. 12. RACE Loss of body hair & positive selection for dark skin All humans have dark skin Northern migration & positive selection for light skin 5 Million Years Ago 1.7 Million Years Ago 30-60 Thousand Years Ago 6-20 Thousand Years Ago Light skin emerges UV-B Radiation Protection Regulation of body temp. Vitamin D production Agricultural Diet
  13. 13. RACE Tropics & Subtropics
  14. 14. Is “race” a valid biological concept?
  15. 15. GENETICS Genetic Drift PopulationSize Time Bottle Neck Event Extinction Recovery Location 1 Founder Effect Location 2 RelativePopulationPrevalence
  16. 16. RACE PredictiveAccuracy,byRace Number of Genetic Loci Included Walsh et al. “Global Skin Colour Prediction” (2017) 0.993 0.981 0.830 0.783 0.763
  17. 17. R2=0.79 HaplotypefrequencyinAfrican–Americans Haplotype frequency in European–Americans Within Races Between Races Genetic Diversity PairwiseComparisons RACE Bamshad et al. “Deconstructing the relationship between genetics and race” (2004)
  18. 18. 0.1% genetic difference between two randomly selected humans. • 5-10% of this is “racial” • 5-10% of this is “continental separation” • 80-90% individual variation. BantuNigerian Bushmen Iranian LappItalian English N. AmericanAustralian Aborigine New Guinean Maylay Micronesian Micronesian Japanese Chinese Brazilian Alaskan Esikimo Between Group Genetic VariationAfrican Caucasian Oceanic East Asian Indigenous
  19. 19. Ronquillo et al. (2007) - Greater amygdala activity was observed for Black faces than White faces.Moreover, Amygdala activity was observed at equivalent levels for light- and dark-skinned Black targets, but dark-skinned White targets elicited greater amygdala activity than light- skinned White targets. Golby et al. (2001) - Individually defined areas in the fusiform region that responded preferentially to faces had greater response to same-race versus other-race faces. Across both groups, memory differences between same-race and other-race faces correlated with activation in left fusiform cortex and right parahippocampal and hippocampal areas. Cunningham (2004) - When the faces were presented for 30 ms, activation in the amygdala-a brain region associated with emotion-was greater for Black than for White faces. When the faces were presented for 525 ms, this difference was significantly reduced, and regions of frontal cortex associated with control and regulation showed greater activation for Black than White faces. RACIALIZATION
  20. 20. ETHNICITY& NATIONALITY Ethnicity - Social construct based primarily on shared language and culture. Nationality - Legal construct based primarily on geography.
  21. 21. PATRIARCHY An economic system where wealth, status, and power is preserved within families through primogeniture (i.e., passed down from father to eldest son).
  22. 22. How has patriarchy uniquely impacted ethnic and racialized peoples?
  23. 23. DOMINATION Slavery – the treatment of subjugated people as a de jure forms of property. Colonialism – Expansion of political boundaries, norms, beliefs, or cultural practice by means of manipulative and forceful tactics.
  24. 24. KYRIARCHY Focused on intersecting and reinforcing structural positions that are -assigned at birth, Kyriarchy is a non-gendered descriptor for systems of power, derived from the Greek: κύριος, kyrios, "lord, master" and ἄρχω, archō, "to lead, rule, govern." male white cisgender european straight able-bodied credentialed young attractive upper class anglophones light or pale gentile fertile female person of color trans/ queer non-european LGBTQ disability nonliterate old unattractive working class ESL dark jewish infertile
  25. 25. BREAK TIME
  26. 26. IN REVIEW… Ancestry is based on a person’s heritage, often with an emphasis on where their progenitors were born. Nationality is based on place of birth or on immigration status. Ethnicity is based on membership in a group that often shares a common language and culture. Race is based on a combination of shared physical traits, ancestry, genetics, and cultural traits – often with an emphasis on skin colour and other folk taxonomies.
  27. 27. RACE 69 71 72 74 76 78 78 61 64 64 68 69 71 73 0 20 40 60 80 1950 1960 1970 1980 1990 2000 2006 White Black There are surprisingly few studies examining racial disparities in health using representative Canadian data. Those which do often fail to distinguish between Canadian and Visible Born Minorities, leading to differences being obscured by the “healthy migrant effect.” Studies also treat visible minorities as a monolithic category, when in fact they are heterogenous populations.
  28. 28. of all genetic material is shared by humans. of all genetic variation occurs within populations, not between them. Race, as a biological construct, does not explain pandemic differences in birthweight, maternal mortality, life expectancy, survival, or disparities in cancer, heart disease, lung disease, or diabetes. RACE
  29. 29. How does kyriarchy impact the health of racialized and ethnic young people?
  30. 30. Discrimination – the intentional or unintentional prejudicial treatment of different categories of people. Racism – the explicit or implicit acceptance of racist ideology. Over-policing – excessive observation, regulation, and criminalization of minority communities, individuals, and their behaviour. Segregation – the forced or unenforced separation of different racial groups. Race Kyriarchy Health Mechanisms
  31. 31. Overt Hate Crimes Poor Treatment Covert Implicit Bias Structural Ideology Policies Segregation
  32. 32. Williams & Mohammed (2009) – Review of 115 Studies • Discrimination linked to worse mental, sexual, and physical health. • Discrimination linked to less health care seeking and adherence behaviors • Discrimination linked to greater severity and poorer course of disease Pascoe & Richman (2011) – Meta-analysis of 134 Studies • Perceived discrimination has negative effects on mental and physical health. • Perceived discrimination results in a heightened stress response. • Perceived discrimination results in participation in unhealthy behaviours. • Perceived discrimination results in non-participation in health behaviours. DISCRIMINATION Regardless of whether stigma is enacted (i.e., experienced) or merely felt (i.e., perceived), it has a negative impact on health. CONCLUSION
  33. 33. RACISM Warmth Disgust Welfare Recipients Homeless Pity Poor Elderly Competence Envy Wealthy Elites Pride Middle Class College Students Racism Prejudice directed against someone of a different race based on the belief that one's own race is superior. Implicit Bias Automatic and unconscious social cognition shaped by pervasive attitudes or stereotypes of others and their actions. Internalized Racism Acceptance of racist beliefs or stereotypes by racialized peoples.
  35. 35. Myrdal (1944) …"basic" to understanding racial inequality in America. Kenneth Clark (1965) …key to understanding racial inequality. Kerner Commission (1968) …the "linchpin" of U.S. race relations and the source of the large and growing racial inequality in SES. John Cell (1982) …"one of the most successful political ideologies" of the last century and "the dominant system of racial regulation and control" in the U.S. Massey and Denton (1993) …"the key structural factor for the perpetuation of Black poverty in the U.S." and the "missing link" in efforts to understand urban poverty. SEGREGATION Canada – Ethnic Diversity Index Toronto – Segregation Map U.S. Segregation U.S. Segregation
  36. 36. How do you think segregation reinforced racism and discrimination?
  37. 37. Culturally Competent Care Disparities-Targeted Health Programming Addressing Racism & Discrimination 1 2 3
  38. 38. Culturally Competent Care1 Brach & Fraser (2000) – Review of 205 Articles While there is substantial research evidence to suggest that cultural competency should work, health systems have little evidence about which cultural competency techniques are effective. Anderson et al. (2003) – Review of 43 Articles We could not determine the effectiveness of any of these interventions… Hobgood et al. (2006) – Review of 50 Articles The literature addressing the true efficacy of such programs…remains insufficient. Horvat et al. (2014) – Review of 5 Randomized Control Trials The quality of evidence is insufficient to draw generalizable conclusions… Black Latino White Asian 15% 13% 1% 11% “I would receive better healthcare if I was a different race or ethnicity” Racial Composition of Doctors *Poor Data Quality
  39. 39. Disparities-Targeted Health Programming2 Parity requires that remuneration of status and resources to be equal (i.e., the same) for all people, whereas, Equity requires “more than treating persons the same way, but also requires special measures and the accommodation of differences.”
  40. 40. Addressing Racism & Discrimination3 In-group/Out-group dichotomies can be minimized by: • Lessening hierarchical differences. • Focusing on shared goals, values, and attributes. • Bringing people together on equal terms. • Supporting interventions that underscore individuation over essentialism. • Individuation – Emphasizing within- group heterogeneity and breaking down stereotypes by focusing on individuals rather than groups. • Essentialism – The belief that a set of attributes are fundamental to the essence of a group. Physiological Needs Safety Needs Belonging and Love Needs Esteem Needs Self-Actualization
  41. 41. What else can public health and community leaders do to reduce disparities experienced by racialized and ethnic groups?
  42. 42. REMINDERS • Next week we will cover technology, the media, and young people’s health. • Please check the syllabus for updated order of readings changed • Outline and annotated bibliography due in next week’s tutorial. • Grades for literature review should be ready by the end of next week.