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![Library of Congress Cataloging-
in-
Publication Data
Mapping race : critical approaches to health disparities research / edited by Laura E. Gómez
and Nancy López.
p. ; cm. —(Critical issues in health and medicine)
Includes bibliographical references and index.
ISBN 978–
0–
8135–
6137–
0 (hardcover : alk. paper) —ISBN 978–
0–
8135–
6136–
3 (pbk. :
alk. paper) — ISBN 978–0–8135–6138–7 (e-book)
I. Gómez, Laura E., 1964–II. López, Nancy, 1969–III. Series: Critical issues in health
and medicine. [DNLM: 1. Continental Population Groups—
United States. 2. Health Status
Disparities—
United States. 3. Health Services Accessibility—
United States. WA 300 AA1]
362.1'0973—dc23 2012042036
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in-
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Individual chapters copyright © 2013 in the names of their authors
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Manufactured in the United States of America](https://image.slidesharecdn.com/25951338-250520021900-90df3686/75/Mapping-Race-Critical-Approaches-To-Health-Disparities-Research-8-2048.jpg)
![2 Laura E. Gómez
government studies previously referenced, they found that African Americans
and Whites in this neighborhood had quite similar rates of diabetes (LaVeist et
al. 2009). “I don’t mean to suggest that genetics play no role in race differences
in health,” LaVeist said, explaining the study’s conclusions, “but before we can
conclude that health disparities are mainly a matter of genetics we need to first
identify a gene, polymorphism or gene mutation that exists in one race group
and not others. And when that gene is found we need to then demonstrate that
that gene is also associated with diabetes. On the other hand, there is [already]
overwhelming evidence that behavior, medical care and the environment are
huge drivers of race differences in health” (“Racial Disparities . . .” 2009). In
other words, looking for race-
based health disparities may at best jump-
start
a productive scientific inquiry when it leads researchers, policy makers,
and health care providers to ask further questions about why race seems to
be important in the context of a specific disease or health problem. But, at
its worst, looking for race-
based health disparities blinds us to seeing the full
range of possible causes of health inequalities.
The broader point that we collectively make in this book goes a step further:
we must be skeptical of claims about race-
based health disparities precisely
because “race” is the product of historically rooted ideas and political contes-
tation (Gómez 2012). Anthropologist Michael Montoya puts it this way: “the
ascertainment of ethnicity or race is a profoundly social enterprise anchored in
contemporary history,” and racial categories, both historically and today, “cor-
respond best to the imaginations of the scientists and not the presumably defin-
ing and stable features being measured” (Montoya 2007). Using the example
of diabetes in his book Making the Mexican Diabetic, Montoya explores how
the process of racializing diabetes—
that is, the process of scientists and health
professionals learning to take for granted that diabetes has a distinct impact
and perhaps even etiology in people of different races—
has occurred in labora-
tories, in government funding circles, in peer-
reviewed scientific publications,
and in the practice of medicine (2011). What explains biomedical researchers’
categorization of humans into groups, and then the linkage of those groups
to specific health problems such as diabetes, is the social process of making
race—
of constituting race as socially, politically, and scientifically important.
Thus, our research agenda must include actively studying this racialization
process; says Montoya: “when we carefully examine the selection of a group to
study, the labeling of that group, the representation of that group in scientific
papers, we see a science of population labeling based squarely on sociocultural
factors particular to each group, each region, and each historical period” (Mon-
toya 2007).](https://image.slidesharecdn.com/25951338-250520021900-90df3686/75/Mapping-Race-Critical-Approaches-To-Health-Disparities-Research-24-2048.jpg)
![Introduction 5
suburb of Chicago), which he estimated has four hundred days of cash on
hand (and daily spends $5 to $10 million; Roberts 2011, 125); in the health
care sector, hospitals are rated by bond agencies according to how many days
of cash they have on hand.
Whitman interprets the data as showing that while Black women’s breast
cancer treatment stayed stagnant in the last two decades of the twentieth cen-
tury, White women’s breast cancer prognoses dramatically improved due to early
detection via mammograms and advances in treatment including radiation ther-
apy and new medication regimes (Roberts 2011, 125). Roberts found that Black
neighborhoods in Chicago had few facilities with mammograms (so that women
had to travel long distances to get them, decreasing the likelihood that they
would do so); that public hospitals used older, inferior mammogram equipment
(often lacking both digital technology and trained mammographers); that until
the 2010 Patient Protection and Affordability Act (President Barack Obama’s
healthcare initiative), even middle-
class women with insurance were deterred
from getting mammograms because of high insurance copayments (the 2010
law mandated the elimination of payments for women over age fifty); and that
racially segregated neighborhoods meant that White women more frequently
had access to the best breast cancer treatment facilities, which Whitman said
were usually located in “the fancy institutions—
they are all in white neighbor-
hoods” (2011, 125–
27).
How are we to understand the role of race in the Chicago breast cancer
example? The typical approach is to view race as an individual characteristic.
For example, researchers often speak of self-
identified race, wherein a research
subject selects her or his racial category from a list of limited options (which
almost always correspond to the Office of Management and Budget [OMB] racial
categories, themselves derived from U.S. Census categories). The OMB categories
include “five racial categories (White, Black, American Indian or Alaskan Native,
Asian, and Native Hawaiian and other Pacific Islander) and one ethnic category
(Hispanic),” which most biomedical researchers collapse into six categories of
“self-
identified race” that respondents may choose from among (Williams et al.
2010, 70). When researchers view race as an individual characteristic, they often
fall into the pattern of biologizing race in terms of ancestry or genetics. This in
turn invites the tendency to view health disparities as a question of individual
failure (for less healthy individuals) or individual success (for more healthy indi-
viduals) and to identify solutions to disparities that focus on the individual body,
such as pharmaceutical solutions (see Kahn, this volume).
But Roberts tells a very different story about the racial disparity in breast
cancer survival in Chicago. She urges us to think about how racial discrimination](https://image.slidesharecdn.com/25951338-250520021900-90df3686/75/Mapping-Race-Critical-Approaches-To-Health-Disparities-Research-27-2048.jpg)
![6 Laura E. Gómez
has structured all sorts of inequalities, including health inequities. In her nar-
rative, the emphasis is on how Chicago’s existing pattern of residential segrega-
tion of African Americans produces tangible gaps at every stage of healthcare.
In a similar way, Williams and colleagues offer a nuanced picture of how neigh-
borhood segregation leads to poor health via six “pathways”:
First, segregation limits socioeconomic mobility by limiting access to
quality elementary and high school education, preparation for higher
education and employment opportunities. Second, the conditions cre-
ated by concentrated poverty and segregation make it more difficult for
residents to adhere to good health practices. . . . Third, the concentration
of poverty can lead to exposure to elevated levels of economic hard-
ship and acute stressors at the individual, household and neighborhood
level. Fourth, the weakened community and neighborhood infrastruc-
ture in segregated areas can also adversely affect interpersonal relation-
ships and trust among neighbors. Fifth, the institutional neglect and
disinvestment in poor, segregated communities contributes to increased
exposure to environmental toxins, poor quality housing and criminal
victimization. Finally, segregation adversely affects both access to care
and the quality of care. (2010, 79)
An even broader context would situate current residential segregation as
part of a larger history of government-
sponsored, legally enforced policies that
created today’s urban spaces. In this broader narrative, today’s health dispar-
ities are inextricably intertwined with the past because that past has direct
impacts today—
via laws that restricted Blacks, other non-
Whites (and some-
times Jews) from buying houses in certain neighborhoods (racially restrictive
covenants); via federal housing policies and agencies that created White-
only
suburbs, supported the redlining of Black neighborhoods by banks and insur-
ance companies, and that destroyed vibrant minority neighborhoods with the
placement of highways and public transportation axes; and via neighborhood-
based public schools that created a system of “naturally” occurring segregated
schools that themselves became a self-
fulfilling prophecy for marking neighbor-
hoods as “good” (White) and “bad” (non-
White).
The starting point for Dorothy Roberts’s analysis is the claim that “race is
not a biological category that is politically charged [but rather it] is a political
category that has been disguised as a biological one” (2011, 4). It is the cumu-
lative, social meaning of race in particular times and places that has shaped
and continues to shape both racial discrimination (and racism) and racial
meaning. To put it another way, we should not consider racial disparities in](https://image.slidesharecdn.com/25951338-250520021900-90df3686/75/Mapping-Race-Critical-Approaches-To-Health-Disparities-Research-28-2048.jpg)
![Introduction 9
between other variables” (Martin and Yeung 2003, 532). Anthropologists Clar-
ence Gravlee and Elizabeth Sweet contend that similar problems characterize
the health disparities literature, where many researchers reflexively (rather
than self-
consciously) use race as a proxy “for some unspecified combination
of environmental, behavioral, and genetic factors” (2008, 49). They identify
two resulting problems as the tendency to obscure the actual causes of health
inequities and the promotion (explicit or implicit) of the idea that racial differ-
ences are genetic and innate (Gravlee and Sweet 2008, 49).
Studies that use race in this or similarly narrow ways have had several, per-
haps unintended, consequences. For one thing, these studies have cumulatively
contributed to the popularization of a simplistic measure of race as a dichotomous
variable (Black/White or White/non-
White) usually based on either bureaucratic
assignment (racial assignment by someone collecting government data, such as
a county coroner) or subject self-
identification. This common approach to race
has in turn contributed to the idea, accreted over time, that race is fixed and bio-
logically rooted. In this respect, scholars’ frequent, but unremarked upon use of
race (especially as an independent variable) mimics the social phenomenon of
Americans being repeatedly asked to report their race in a variety of life contexts,
as noted by sociologist Ann Morning (2011). Framing the question as a simple
one (with which of these listed groups do you identify racially?) and asking it
repeatedly have led Americans to see race “as a permanent and individual char-
acteristic: something that is embedded within us and [that] does not change over
time” (Morning 2011, 3–
4)—
in other words, to reify race, rather than to see race
as a complex and dynamic set of social processes.
The problem of failing to conceptualize and/or define race spans the meth-
odological spectrum. Sociologist Edward Morris argues for “greater transpar-
ency in how race is measured in qualitative studies and increased reflection on
this concept as it is socially situated” (2007, 411). It is not enough, he contends,
to simply declare that race is a social construction; he urges scholars to go fur-
ther by expressly acknowledging “how they choose to identify race as well as
recognizing the limitations of this choice and being attentive to the enactment
of race in a particular context” (Morris 2007, 422). In other words, scholars who
include race as a facet of their studies (whether a major or minor facet) should
deliberately conceptualize race, regardless of their chosen methods.
While such problems certainly transcend methodological orientation, there
appear to be particular limitations with the tendency, in quantitative research,
to use race as a control variable or as a crude proxy for some other social fact
or process. Political scientist Taeku Lee has characterized the fundamental
problem succinctly: “Although we acknowledge that race, like ethnicity, is a](https://image.slidesharecdn.com/25951338-250520021900-90df3686/75/Mapping-Race-Critical-Approaches-To-Health-Disparities-Research-31-2048.jpg)
![Introduction 19
Notes
1. A range of limitations plague federal data collection for non-
Black minority
group members, and especially for Latinos and Asian Americans. Williams and
colleagues report that “national data on mortality are more accurate for blacks
and whites than for Hispanics, Asians, and Native Americans. A major problem
affecting the quality of mortality data is related to the undercount in the num-
ber of deaths because of misclassification of nontrivial proportions of Hispanics,
Asians, and especially American Indians as white on death certificates” (2010,
71). Nationwide data for Latinos and Asian Americans was not systematically col-
lected before 1980, when immigrants from Latin America and Asia became signifi-
cant nationally after the lifting of pre-
1965 restrictions on immigration from these
regions (see also Takeuchi and Gage 2003, 440 [noting that social scientists did not
historically treat Latinos and Asians in a racial framework]). Moreover, since both
groups combine many different national origin subgroups, the data is subject to
more variation and interpretive debate (for two studies that explore intragroup dif-
ferences with the Latino and Asian American categories, respectively, see Sanchez
and Ybarra and Iwamato, Kindaichi, and Miller, this volume). There are a variety
of structural reasons for ongoing misclassification, however, including the histori-
cal racial ambiguity of Mexican Americans (see Gómez 2007) and other non-
Black
minority groups. In addition, data such as that on birth and death certificates is
subject to substantial regional variation in the United States (Pascoe 2009), further
adding to the possible misclassification by race.
2. As noted in the preface, the NIH Office of Research on Minority Health funded the
2011 workshop that was the catalyst for this book.
3. Note that this inequality or social justice view of the cause (and solution) to race-
based health disparities is the minority view in both the scientific literature and
the popular media. One study of almost four thousand articles on health dispari-
ties that appeared in forty major newspapers between 1996 and 2005 concluded
that only rarely were race-
based health disparities framed by the media as a ques-
tion of social injustice—
that theme appeared in less than 4 percent of the articles
(Kim et al. 2010, S229).
4. Sociologist Catherine Lee makes the important point that the failure of research-
ers to define race is simply bad science because it is “antithetical to the tenets of
scientific research, which, in its ideal form, demands that analytical variables be
consistent and their categories mutually exclusive” (2009, 1183).
5. For example, these authors have identified this weakness in the following fields:
Gómez 2012 (socio-
legal studies); Gravlee and Sweet 2008 (medical anthropology);
Harrison 1999 (cultural anthropology); Helms 2007 (psychology); Jones et al. 1991
(epidemiology); C. Lee 2009 (biomedical research); T. Lee 2009 (political science);
Martin and Yeung 2003 (sociology); Morris 2007 (sociology); Mukhopadhyay and
Moses 1997 (cultural anthropology); Saperstein 2008 (demography).
6. At the same time, Morning contends that the social constructionist conception of
race has by no means completely displaced essentialist views of race rooted in
biology. In fact, she finds that, among scientists who teach at the university level,
an essentialist view of race as rooted in biology remains alive and well (2011, 6,
38–47, 221).
7. Of course, this claim has been made historically by those advocating for race-
conscious legal remedies and government policies to alleviate racial discrimination.](https://image.slidesharecdn.com/25951338-250520021900-90df3686/75/Mapping-Race-Critical-Approaches-To-Health-Disparities-Research-41-2048.jpg)
![The Politics of Framing 29
charts, measurements, and statistical observations all purporting to establish
the biological inferiority of the “American Negro” not only in basic mortality
but in such physiological traits as “chest expansion,” “physical strength,” or
resistance to disease. Such observations built on Hoffman’s prior conclusion
that “the time will come, if it has not already come, when the negro, like the
Indian, will be a vanishing race” (Hoffman 1892, 542).
Of course, academics and expert commentators had been declaring the
inferiority of the “negro race” for decades before Hoffman came on the scene
(Braun 2002, 160–
63). What is distinctive about his work for Prudential is that
it demonstrates the use of actuarial data to provide a gloss of objective scien-
tific rigor to the construction of biological racial difference in a legal context in
order to gain economic advantage in a competitive marketplace. This is the flip
side of the BiDil story, where the drug’s developers used a purported race-
based
biological difference to include African Americans in a patent (Kahn 2004).
Here, Prudential was using biological difference to exclude African Americans
from insurance coverage. Both strategies involve constructing race as biological
in order to serve underlying commercial interests.
Hoffman’s work did not go unchallenged. W.E.B. Du Bois, in particular, pre-
sented a powerful critique, questioning Hoffman’s methodology and noting that
the health outcomes of African Americans were comparable to those of immi-
grant groups with similar economic resources. Acknowledging “that in certain
diseases the Negroes have a much higher rate than the whites,” Du Bois asked,
“the question is: Is this racial? Mr. Hoffman would lead us to say yes, and to
infer that it means that Negroes are inherently inferior in physique to whites”
(Du Bois 1906, 275). Du Bois asserted, however, that such differences “can be
explained on other grounds than upon race” (Du Bois 1906, 275). Examining the
data behind various differentials in morbidity and mortality, Du Bois concluded
“that the Negro death rate and sickness are largely matters of [social] condition
and not due to racial traits and tendencies” (Du Bois 1906, 276).
Hoffman’s thesis was published in 1896, the same year that the U.S.
Supreme Court issued its infamous “separate but equal” decision in the case
of Plessy v. Ferguson (163 U.S. 537 [1896]). Homer Plessy, a resident of New
Orleans, was seven-
eighths White and one-
eighth Black—
an “octoroon.” On
June 7, 1892, he bought a first-
class ticket on the East Louisiana Railway for
passage from New Orleans to Covington, Louisiana, and took a seat reserved
for White passengers. He was arrested for violating the Separate Accommoda-
tions Act of 1890, which required “all railway companies carrying passengers
on their trains, in this state, to provide equal, but separate, accommodations for
the white and colored races” (11 So. 948 [La. 1892]).](https://image.slidesharecdn.com/25951338-250520021900-90df3686/75/Mapping-Race-Critical-Approaches-To-Health-Disparities-Research-49-2048.jpg)
![30 Jonathan Kahn
The Supreme Court ultimately upheld the Louisiana law, rejecting Plessy’s
argument “that the enforced separation of the two races stamps the colored race
with a badge of inferiority,” concluding that “if this be so, it is not by reason of
anything found in the act, but solely because the colored race chooses to put that
construction upon it” (163 U.S. 537 [1896]). Writing for the majority, Justice Henry
Brown declared “Legislation is powerless to eradicate racial instincts, or to abolish
distinctions based upon physical differences, and the attempt to do so can only
result in accentuating the difficulties of the present situation. . . . If one race be
inferior to the other socially, the constitution of the United States cannot put them
upon the same plane” (163 U.S. 537). Just as Du Bois offered a trenchant critique
of Hoffman’s work that placed social forces front and center in analyzing mortality
differentials, Justice John Harlan’s eloquent dissent in Plessy argued that the social
consequences of state action must be accorded constitutional recognition. “The
arbitrary separation of citizens, on the basis of race,” Harlan declared, “while they
are on a public highway, is a badge of servitude wholly inconsistent with the civil
freedom and the equality before the law established by the constitution. It cannot
be justified upon any legal grounds” (163 U.S. 562).
Legal scholar J. Allen Douglas argues that Plessy and its progeny can be under-
stood as attempts “to locate racial identity in the body in the form of an object or
property—
an immutable, natural ‘thing’ possessed—
to ensure a means for ‘quiet-
ing title’ in whiteness” (Douglas 2003, 889). In its attempt to locate racial identity
in the “immutable, natural” object of Plessy’s body, Brown’s brief opinion echoed
Hoffman’s massive compilation of statistics, which similarly grounded its defense
of a “segregated” approach to life insurance underwriting by locating racial dif-
ference in the bodies of African Americans. Brown also located responsibility for
stigma that might result from the law in the social realm, beyond the purview
of the Court. As Brown declared, “Legislation is powerless to eradicate racial
instincts, or to abolish distinctions based upon physical differences” (163 U.S. 551
[1896]). Louisiana could draw legal distinctions based upon such physical differ-
ences without violating the Equal Protection clause of the Fourteenth Amendment,
but if African Americans felt degraded by the law, that was their problem. The
state could act on biological difference but had no responsibility to redress harms
related to social difference. The Supreme Court’s opinion in Plessy thus legiti-
mated the racial segregation of physical space by denying the legal significance of
social differences that might be engendered by the law. Hoffman similarly tried to
justify the social (that is, non-
state-
sponsored) segregation of insurance coverage
by asserting the legal significance of purported biological differences among races.
Each of these foundational documents of twentieth-
century race theory
characterized the relative legal significance of social and biological difference](https://image.slidesharecdn.com/25951338-250520021900-90df3686/75/Mapping-Race-Critical-Approaches-To-Health-Disparities-Research-50-2048.jpg)
![The Politics of Framing 31
in commercial contexts. In justifying racial subordination, they deny or obscure
the significance of social or political forces while elevating biological difference
as a justification for state-
sanctioned discrimination. This schema naturalizes
racial difference and places any responsibility for addressing its implications
beyond the purview of the state, more appropriately addressed by individual
action or structured by commercial market considerations. For the past century,
this characterization of racial difference has existed in tension (and often direct
conflict) with the approach of those like Du Bois and Harlan who have sought to
foreground the social basis of racial difference and assert a public, state responsi-
bility for both creating and redressing inequalities embedded in such differences.
The 1954 case of Brown v. Board of Education repudiated Plessy’s con-
cept of “separate but equal” as “inherently unequal” (347 U.S. 483 [1954]). It
did so by upending the logic that relegated the “social” beyond legal consid-
eration, noting that “to separate [school children] from others of similar age
and qualifications solely because of their race generates a feeling of inferiority
as to their status in the community that may affect their hearts and minds in
a way unlikely ever to be undone” (347 U.S. 494). The opinion also marked a
transition in the social sciences, away from Hoffman’s biologization of racial
difference toward Du Bois’s focus on the impact of social forces on the status
and situation of racial groups. The Warren Court famously cited the work of
social scientists such as Kenneth Clark and Gunnar Myrdal in supporting its
legal recognition of the impact of segregation upon the hearts and minds of
African American children (347 U.S. 494 fn. 11; Hovenkamp 1985, 671–
72).
Where Hoffman and Justice Brown foregrounded race as a biological concept
in order to locate the responsibility for inequality in Black bodies and minds,
Clark, Myrdal, and the Warren Court foregrounded the social dynamics of race
to locate responsibility for inequality in the state and the polity.
From Brown to the passage of the Civil Rights Act in 1964 and the Voting
Rights Act of 1965, the emergent civil rights revolution focused on securing gov-
ernment guarantees of fundamental citizenship rights for African Americans.
Journalists Thomas and Mary Edsall, in their influential book Chain Reaction,
have argued that the politics of this first era focused on equality of opportunity
in a manner that galvanized a majority of the country and overcame conser-
vative forces of racial resistance. After 1965, however, the civil rights agenda
shifted its focus to “broader goals of emphasizing equal outcomes or results
for Blacks” (Edsall and Edsall 1992, 7). Statistics were necessary for measur-
ing such outcomes, and it is around this time that race-
specific data from the
Census Bureau became essential for gauging social, economic, and political
discrimination in this country (Robbin 2000b, 435; Robbin 2000a, 129). It is in](https://image.slidesharecdn.com/25951338-250520021900-90df3686/75/Mapping-Race-Critical-Approaches-To-Health-Disparities-Research-51-2048.jpg)
![32 Jonathan Kahn
this context, speaking before the Second National Convention of the Medical
Committee for Human Rights that Dr. Martin Luther King Jr. made his statement
about injustice in health care being shocking and inhumane (King 1966).
The civil rights shift in focus from access to fundamental rights of citizen-
ship to outcomes secured through affirmative government action also gave rise to
a conservative backlash, operationalized via Richard Nixon’s “southern strategy”
that used race as a wedge issue to “divide voters over values, and to isolate one
disproportionately poor segment of the population from the rest of the elector-
ate” (Edsall and Edsall 1992, 5). The new Republican strategy, carried to its acme
by Ronald Reagan in the 1980s, focused on the concept of “equal opportunity”
as opposed to “affirmative action” and included among its supporters “radical
conservatives, including those who were in fact anti-
black, as well as much of
the moderate center and the ideological right” (Edsall and Edsall 1992, 143). As
the Edsalls note, “The changing politics of civil rights permitted the Republican
Party to achieve its central goal—
the establishment of a putatively egalitarian,
ideologically respectable, conservatism. In 1980, Reagan and the GOP portrayed
opposition to central elements of civil rights enforcement—
opposition to the use
of race and sex preferences in hiring and in college admittance, to court-
ordered
busing, and to the introduction of means-
tested programs for the poor—
as deriv-
ing from a principled concern for fairness: as a form of populist opposition to
the granting of special privilege” (Edsall and Edsall 1992, 144). The language of
equal opportunity—
often framed in terms of access—
was clearly more accept-
able than the language of affirmative action to the “emerging Republican major-
ity” (Phillips 1969). This was part of a broader shift from a “‘liberal’ paradigm
centered on ‘social responsibility,’ in favor of a conservative paradigm centered
around ‘legitimate self-
interest’” (Edsall and Edsall 1992, 97).
In the legal arena, this approach manifested itself in the Reagan Department
of Justice (DOJ) position on school desegregation and affirmative action, charac-
terized as follows by the Edsalls: “the function of government intervention was
not to correct contemporary employment, or contracting, or student assignment
patterns that grew out of historic discrimination . . . Instead, the function of gov-
ernment was to protect individuals from specific acts of discrimination” (Edsall
and Edsall 1992, 188). The Reagan DOJ’s assault on the 1971 Supreme Court
decision in Griggs v. Duke Power (401 U.S. 424 [1971]) was emblematic of this
shift. In Griggs, the Court found that employment policies that are facially neu-
tral with regard to race—
such as aptitude test scores—
that nonetheless resulted
in a highly disparate impact on a minority racial group could violate Title VII of
the Civil Rights Act. To justify such tests, an employer would have to meet the
high standard that there was a “business necessity for such test” (401 U.S. 431).](https://image.slidesharecdn.com/25951338-250520021900-90df3686/75/Mapping-Race-Critical-Approaches-To-Health-Disparities-Research-52-2048.jpg)
![The Politics of Framing 33
The critique was framed in terms of individual merit being subordinated to racial
quotas. For example, Linda Gottfredson of the University of Delaware argued that
the logic of Griggs ignored “the whole issue of individual rights, and individual
fairness . . . there is no provision for the constitutional rights, the civil rights of
whites” (qtd. in Edsall and Edsall 1992, 252).
Ultimately the Reagan DOJ’s approach made headway with the Supreme
Court, as more conservative appointees shifted the Court’s ideological balance
to the right. Later cases, beginning with City of Richmond v. J. A. Croson Com-
pany (488 U.S. 469 [1989], decided under Chief Justice William Rehnquist) and
culminating in Parents Involved in Community Schools v. Seattle School District
No. 1 (551 U.S. 701 [2007], decided under Chief Justice John Roberts), effec-
tively rolled back affirmative mandates in employment and school desegregation
reaching back to Brown. A particular focus of these cases was on individuals
as a locus for constitutional protection. In cases such as Richmond v. Croson,
this meant requiring institutions wishing to implement affirmative action pro-
grams to show particularized injury suffered by identifiable minority groups in
the recent past. In her opinion for the majority, Justice Sandra Day O’Connor
expressed the concern that “to accept [a] claim that past societal discrimination
alone can serve as the basis for rigid racial preferences would be to open the
door to competing claims for ‘remedial relief’ for every disadvantaged group. . . .
Those whose societal injury is thought to exceed some arbitrary level of tolerabil-
ity then would be entitled to preferential classification. We think such a result
would be contrary to both the letter and the spirit of a constitutional provision
whose central command is equality” (488 U.S. 505–
6 [1989]; emphasis added).
O’Connor’s dismissal of the legal significance of the “societal injury” “thought”
to be experienced by “minority groups” echoes Justice Brown’s similar dismissal,
in Plessy, of claims about the stigma of segregation by asserting “if this be so, it
is not by reason of anything found in the act, but solely because the colored race
chooses to put that construction upon it” (163 U.S. 551 [1896]). He might just
as easily have said that African Americans’ claims to “societal injury” resulting
from enforced segregation were merely “thought to exceed some arbitrary level
of tolerability” and hence did not deserve constitutional consideration. Despite
writing nearly a century apart, both Justices Brown and O’Connor characterized
the social realities of racial discrimination as troublesome intrusions into legal
analysis. Brown wants to ignore them, O’Connor to transcend them. Both saw
race as obscuring a more proper focus on individual rights and identities.
Similarly, in Parents Involved, Chief Justice Roberts used a rhetoric of indi-
vidual rights to strike down race-
specific school assignments meant to achieve
the ideal of desegregation called for in Brown v. Board of Education. Roberts](https://image.slidesharecdn.com/25951338-250520021900-90df3686/75/Mapping-Race-Critical-Approaches-To-Health-Disparities-Research-53-2048.jpg)
![34 Jonathan Kahn
struck down the assignment plans because they did not “provide for a meaning-
ful individualized review of applicants but instead rely on racial classifications
in a ‘nonindividualized, mechanical’ way” (551 U.S. 701 [2007]). The state,
here, was forbidden from considering race as a primary basis for assigning stu-
dents to public schools. At first blush, this might seem to be the logical culmi-
nation of Brown’s repudiation of Plessy’s state-
mandated racial segregation. On
closer examination, however, it is revealed to be quite the opposite. In mandat-
ing a “color-
blind” approach to remedying the past effects of racial discrimina-
tion, Roberts effectively locates responsibility for addressing the consequences
of racial discrimination in the private sphere of social life, beyond the purview
of the state—
exactly where Justice Brown located it in his Plessy opinion. This
“privatization” of discrimination is fully in line with the Reagan-
era legacy of
neoliberal (or neoconservative) valorization of private, market-
based solutions
as the appropriate means to address social problems.
To the extent that the Rehnquist or Roberts courts accord any legal recogni-
tion to the social conditions of racial discrimination, they have done so as an
interim concept that is to be transcended. Thus, in City of Richmond v. Croson,
Justice O’Connor juxtaposed group-
based racial remedies against “the dream of a
Nation of equal citizens in a society where race is irrelevant to personal opportu-
nity and achievement” (488 U.S. 505–
6 [1989]). O’Connor reiterated her dream of
a world where race was “irrelevant” in her 2003 opinion in Grutter v. Bollinger,
where she anticipated that “25 years from now, the use of racial preferences will
no longer be necessary to further the interest approved today” (539 U.S. 306, 343
[2003]). O’Connor’s dream of a country where “race is irrelevant” resonates with
contemporary promises by biomedical researchers and clinicians yearning for a
time when genetic information will similarly render race irrelevant. O’Connor,
though, was speaking of making race socially and legally irrelevant, whereas
pharmacogenomic experts now speak of making race biologically irrelevant.
The two sentiments are connected, though, by their common disdain for
the social realities of group-
based racial harms. Both view social concepts of
race as impediments to progress, to be transcended and left to the dustbin of
history. Both also valorize the individual as the ultimate target of intervention,
whether legal or medical. Neoconservative race theorists tolerate the use of race
only where such schemes retain a primary focus on considering the individual
attributes of persons being classified. As Justice Scalia wrote in his concur-
ring opinion in the 1995 case of Adarand v. Pena, “Individuals who have been
wronged by unlawful racial discrimination should be made whole; but under
our Constitution there can be no such thing as either a creditor or a debtor
race” (515 U.S. 200, 239 [1995]). Similarly, biomedical researchers using race](https://image.slidesharecdn.com/25951338-250520021900-90df3686/75/Mapping-Race-Critical-Approaches-To-Health-Disparities-Research-54-2048.jpg)
Mapping Race Critical Approaches To Health Disparities Research
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- 6. Critical Issues inHealth and Medicine Edited by Rima D. Apple, University of Wisconsin– Madison, and Janet Golden, Rutgers University, Camden Growing criticism of the U.S. health care system is coming from consumers, politicians, the media, activists, and healthcare professionals. Critical Issues in Health and Medicine is a collection of books that explores these contemporary dilemmas from a variety of perspectives, among them political, legal, histori- cal, sociological, and comparative, and with attention to crucial dimensions such as race, gender, ethnicity, sexuality, and culture. For a list of titles in the series, see the last page of the book.
- 7. Rutgers University Press NewBrunswick, New Jersey, and London Edited by Laura E. Gómez and Nancy López Mapping “Race” Critical Approaches to Health Disparities Research
- 8. Library of CongressCataloging- in- Publication Data Mapping race : critical approaches to health disparities research / edited by Laura E. Gómez and Nancy López. p. ; cm. —(Critical issues in health and medicine) Includes bibliographical references and index. ISBN 978– 0– 8135– 6137– 0 (hardcover : alk. paper) —ISBN 978– 0– 8135– 6136– 3 (pbk. : alk. paper) — ISBN 978–0–8135–6138–7 (e-book) I. Gómez, Laura E., 1964–II. López, Nancy, 1969–III. Series: Critical issues in health and medicine. [DNLM: 1. Continental Population Groups— United States. 2. Health Status Disparities— United States. 3. Health Services Accessibility— United States. WA 300 AA1] 362.1'0973—dc23 2012042036 A British Cataloging- in- Publication record for this book is available from the British Library. This collection copyright © 2013 by Rutgers, The State University Individual chapters copyright © 2013 in the names of their authors All rights reserved No part of this book may be reproduced or utilized in any form or by any means, electronic or mechanical, or by any information storage and retrieval system, without written permis- sion from the publisher. Please contact Rutgers University Press, 106 Somerset Street, New Brunswick, NJ 08901. The only exception to this prohibition is “fair use” as defined by U.S. copyright law. Visit our website: http://rutgerspress.rutgers.edu Manufactured in the United States of America
- 9. v List of Figuresand Tables vii Foreword ix R. Burciaga Valdez Preface xiii Chapter 1 Introduction: Taking the Social Construction of Race Seriously in Health Disparities Research 1 Laura E. Gómez Part I Charting the Problem 23 Chapter 2 The Politics of Framing Health Disparities: Markets and Justice 25 Jonathan Kahn Chapter 3 Looking at the World through “Race”- Colored Glasses: The Fallacy of Ascertainment Bias in Biomedical Research and Practice 39 Joseph L. Graves Jr. Chapter 4 Ethical Dilemmas in Statistical Practice: The Problem of Race in Biomedicine 53 Jay S. Kaufman Chapter 5 A Holistic Alternative to Current Survey Research Approaches to Race 67 John A. Garcia Part II Navigating Diverse Empirical Settings 85 Chapter 6 Organizational Practice and Social Constraints: Problems of Racial Identity Data Collection in Cancer Care and Research 87 Simon J. Craddock Lee Contents
- 10. vi Contents Chapter 7Lessons from Political Science: Health Status and Improving How We Study Race 104 Gabriel R. Sanchez and Vickie D. Ybarra Chapter 8 Advancing Asian American Mental Health Research by Enhancing Racial Identity Measures 117 Derek Kenji Iwamoto, Mai M. Kindaichi, and Matthew Miller Part III Surveying Solutions 131 Chapter 9 Representing the Multidimensionality of Race in Survey Research 133 Aliya Saperstein Chapter 10 How Racial- Group Comparisons Create Misinformation in Depression Research: Using Racial Identity Theory to Conceptualize Health Disparities 146 Janet E. Helms and Ethan H. Mereish Chapter 11 Jedi Public Health: Leveraging Contingencies of Social Identity to Grasp and Eliminate Racial Health Inequality 163 Arline T. Geronimus Chapter 12 Contextualizing Lived Race- Gender and the Racialized- Gendered Social Determinants of Health 179 Nancy López Notes on Contributors 213 Index 217
- 11. vii Figures andTables Figures 3.1 Age- SpecificMortality, Selected Years (1963– 2004), Black/White Americans 40 4.1 Mary Gets a Score of 100 on a Verbal Ability Test 62 6.1 Conceptual Schematic of Identity Data Collection in a Cancer Service Line 99 12.1 Multidimensional “Race” Data at the Individual, Micro-level 192 12.2 Multidimensional Ethnicity as Distinct from “Race” 198 12.3 Racialized and Gendered Social Determinants of Health: Multilevel “Race” Data at the Micro- , Meso- , and Macro- levels 200 Tables 3.1 Life of Homo sapiens Condensed into a Calendar Year 46 5.1 Heuristic Chart of Holistic Race Measures 70 6.1 Initial Draft Policy Categories 92 7.1 Determinants of Health Status among Full/Latino Sample (Ordered Logistic Regression) 111 8.1 PRIAS- 15 and PRIAS- 12 Items Derived from Confirmatory Factor Analysis on the Original PRIAS 122 8.2 Multiple Regression Using the PRIAS, PRIAS- 15, and PRIAS- 12 Measures as Predictors and Psychological Well- Being as the Outcome 123 10.1 Some Examples of Risk Factors Used as Proxies for Race in Depression Research 150 10.2 Racial Identity Schemas for People of Color and White People 156
- 13. ix Foreword In 2008, theNational Institutes of Health hosted over five thousand scholars at its first Science of Eliminating Health Disparities Summit. The subsequent annual summits were designed to encourage integration of science, practice, and policy to build a healthier society. As the opening plenary keynote speaker for the first one, I was asked to address “Health Disparities and the Intersection of Science and Policy.” I deliberately anchored my talk in an explanation of health disparities as a reflection of social stratification and inequitable resource allocations along “racial” and “ethnic” lines. But what do we mean by “racial” and “ethnic” lines? The scholars in this volume challenge us to be more precise about how we define and operationalize this type of stratification. Why? Because individuals are born into our society that neither treats people nor distributes opportunity equally. We observe discrimination, poverty, and other forms of oppression play out at the community level affecting overall community environment and opportunities. Especially in resource- poor communities, the stresses of daily life bear down on the minds and bodies of residents, inviting illness through environmental exposures and other types of stress that are expressed biologi- cally in what we recognize as disease. While Congress has required documenting these “racial” and “ethnic” dis- parities annually by the Agency for Health Research and Quality, it has done little to remedy the situation. Over the last few years, private philanthropies, such as the Robert Wood Johnson Foundation and the California Endowment, have recognized the need to prevent disparities by addressing the inequities in our society as well as addressing health care disparities— creating a more just society and thus a more healthy nation. Interdisciplinary research plays an increasingly important role in address- ing highly complex social issues such as health disparities. It allows schol- ars to reach beyond the boundaries of their own disciplines and to adapt or develop new methods of analysis. Institutional policies that support integrat- ing the social and biological sciences could represent the twenty- first- century breakthrough similar to what we experienced in the twentieth century when biological and chemical scientists developed the fields of biochemistry, molec- ular biology, and molecular genetics that led to the sequencing of the human genome. Supporting interdisciplinary health and social science investigations
- 14. x R. BurciagaValdez and the development of transdisciplinary fields requires our nation’s funding institutions and universities to be more flexible and open to new ways of see- ing things. The Institute for the Study of “Race” and Social Justice within the RWJF Center for Health Policy at the University of New Mexico is one example of such efforts. Sequencing the human genome provided definitive proof that there is no genetic or biological evidence for the concept of “race.” Yet in our society we often rely on assumptions about “race” that erroneously assume that it is inter- changeable with genes to explain the world and our understanding of it. Scien- tists are not immune from using the myth of race as biology in dangerous ways. When I arrived in New Mexico in 2008, I had the opportunity to participate in the annual Cancer Center retreat. Researchers shared the marvelous molecu- lar discoveries brought about by genomic research advances, which offer pros- pects for innovations in treatment for a wide variety of cancers; however, I was taken aback when colleagues resorted to explaining statistical propensities for groups of people in New Mexico using wildly inaccurate racial stereotypes. These genetic reductionist interpretations of health disparities denied Ameri- can Indian spiritual beliefs, challenged the history of Hispanic settlement in the region, and posed findings in ways that could be misinterpreted in policy implementation. Despite all the problems inherent in the erroneous assumptions associated with the concept of “race,” it is imperative that we continue to collect data that captures the lived experiences and practices that contribute to the racialized inequality that is reproduced at all levels of society. While some may argue for a color- blind society and an end to the collection of “race” or “ethnic” data, this book deliberately understands “race” as a social construction that can be mapped vis- à- vis legal efforts to eliminate racism in all its forms— individual, institutional, and systemic. For example, in the areas of banking and housing we have largely eliminated public policies restricting groups of people from living in certain areas; however, informal practices in the mortgage and real estate industries continue to produce de facto segregation. Over the last several decades, we have negligently accepted racial catego- ries in our work without the typical scrutiny we use to define variables for our analyses. Instead of interrogating and capturing the social construction of race in our research, we have at times blindly treated race as if it were a static characteristic that allows for the comparison of the health of different groups in our society. Or we have misused race as a proxy for many unmeasured fac- tors in our studies, for example, class or culture, thereby masking what may be amenable to clinical intervention or social policy intervention.
- 15. Foreword xi It isimportant that a paradigm shift take place in health disparities research, and Mapping “Race” helps catalyze it. Researchers should depart from the premise that racial and ethnic identities are fluid in both governmen- tal and social settings. In order to combat discrimination, in 1976 Congress created the term “Hispanic” to group together a population that differs enor- mously by history, nationality, social class, legal status, and generation in the United States; it has little or no meaning outside of the U.S. political context. As scholars, scientists, and policy makers, we must challenge ourselves to be more precise with our categories of analysis and interpretation. The subjective meaning of such labels and whether they are situationally asserted are open empirical questions that need to be investigated. R. Burciaga Valdez July 2012
- 17. xiii Preface The story ofhow this book came to exist is somewhat unusual, and thus we include it here as a way of charting the intellectual genesis of Mapping “Race.” We intentionally invoke the word “mapping” in the book’s title as a metaphor to capture the complexity of “race” and to emphasize the need for research- ers to grapple with that complexity. In early 2010, we received funding from National Institutes of Health (NIH) National Center on Minority Health and Health Disparities (NCMHHD) to hold a workshop called “Mapping ‘Race’ and Inequality: Best Practices for Theorizing and Operationalizing ‘Race’ in Health Policy Research.”1 Under the auspices of the Institute for the Study of “Race” and Social Justice at the University of New Mexico, which we co- founded in 2009 and then co- directed (2009– 2011), and which López now directs, we con- vened a group of nineteen scholars for a meeting in Albuquerque held April 29–30, 2011. The participants in that intensive dialogue included scholars from the health, social, and biological sciences. They were an almost even mix of schol- ars whose primary methodological orientation was quantitative analysis versus those who used mixed methods or purely qualitative methods. Beyond those parameters, we self- consciously sought to include scholars who represented diverse race, gender, and ethnic backgrounds, as well as scholars at varied career stages. It is from that initial group of nineteen scholars that the contribu- tors to Mapping “Race” emerged.2 Mapping “Race” has benefitted from the collective excitement and synergy we experienced leading up to the workshop, during our two- day meeting, and in our subsequent conversations. One of the striking things was the degree to which scholars from different disciplines and different methodological tradi- tions were vexed about the same phenomenon: the frequent refusal by scholars doing research on race- based disparities to explicitly conceptualize (much less define) “race” and the accompanying problem of how to most effectively opera- tionalize socially constructed “race.” We were stunned by the similar stories told by participating scholars in the biological sciences (including biology and genetics), the medical sciences (including epidemiology, medicine, and pub- lic health), and the social sciences (including anthropology, political science, psychology, and sociology) about how existing research in their fields typically engages race in superficial ways that largely ignores theoretical insights relating
- 18. xiv The Editors toconceptualizing race as socially constructed and, therefore, as historically contingent, dynamic, and multifaceted. And yet, while we agreed on the problem, it was not obvious what the solutions were. Over the course of many conversations, disagreements, and even heated intellectual exchanges, we pushed each other to identify potential solutions and to speak across the traditional boundaries that separated us, such as method, discipline and scientific domain. Mapping “Race” embodies our progress and signals our desire to take this important conversation to a broader audience. We hope that it encompasses the voices of the original workshop participants and the exciting synergy of that collective conversation, as well as the contributions of the authors whose work has evolved into these chapters. We are grateful to many people for helping us realize this publication. We are deeply indebted to the faculty, fellows, administrators, and staff at the Rob- ert Wood Johnson Foundation (RWJF) Center for Health Policy at UNM. At the Center, we found a generous intellectual community that welcomed us as rela- tive outsiders to health research when we began this journey and that encour- aged our efforts to cross disciplinary, science, and methodological boundaries. We are especially grateful to Executive Director Robert Valdez for seeing early promise in our ideas and for supporting us at each step of the way, including in our working group and speakers’ series and symposium on topics related to this research.3 Many Center staffpersons played a role in helping us at vari- ous stages, and we are especially grateful to Lia Abeita- Sanchez, Lila Chavez, Sheri Lessanese, Thu Luu, Anita Parmar, Gina Sandoval, Vanessa Tafoya, Maria Vahtel, and Denise Wallen. Antoinette Maestas was especially helpful, work- ing closely with us at several different stages. We thank Cirila Estela Vasquez Guzman, an RWJF Center for Health Policy doctoral fellow in sociology and our research assistant at the Institute (2010– 2012), for her assistance on multiple facets of this project. Estela and three other RWJF doctoral fellows contributed immensely as observers at the NIH workshop: Sonia Bettez (sociology), Yahaira Pena- Esparza (psychology), and Vickie Ybarra (political science). We would also like to thank chairs and staff at the School of Law and in the Department of Sociology at the University of New Mexico for their assistance at various stages of this project, including Beverly Burris, Dorothy Esquivel, David Fricke, Margaret Harrington, Cyndi Johnson, Dona Lewis, Melissa Lobato, and Richard Santos. We thank our deans at UNM and University of California, Los Angeles (UCLA) for supporting our research, including Brenda Claiborne, Rachel Moran, Mark Peceny, and Kevin Washburn. For research assistance during various stages of this project, we thank librarians and student assistants at the UNM School of Law and the UCLA School of Law. For help
- 19. Preface xv getting thismanuscript to the final stages of production, we thank Tal Grietzer and especially Rusty Klibaner at the UCLA School of Law. It has been a pleasure to work with the editors and staff at Rutgers Univer- sity Press, and we thank acquisitions editor Peter Mickulas, David Takeuchi and other reviewers of our manuscript, and the entire staffs in the production and marketing departments. We are honored that Mapping “Race” is included in the Rutgers University Press series “Critical Issues in Health and Medicine,” edited by Rima D. Apple and Janet Golden. Last, but certainly not least, we thank our families for their love and patience (and for putting up with too many early mornings, late nights, and weekends when they expected us to be “free”): Alejandro Gómez, Antonio Gómez, Eloyda Gómez, Luna Romero, Sierra Romero, Emma Romero and Augustine Romero. Laura Gómez and Nancy López July 2012 Notes 1. Funding for the workshop (April 29– 30, 2011) that made this book possible (in part) was by 1R13MD006054– 01 from the National Center on Minority Health and Health Disparities (NCMHD), the Agency for Healthcare Research and Quality (AHRQ), and the Eunice Kennedy Schriver National Institute of Child Health and Human Devel- opment (NICHD). The views expressed in written conference materials or publica- tions and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention by trade names, commercial practices, or organizations imply endorsement by the U.S. government. 2. The participating scholars and their institutional affiliations were the following: John Garcia, University of Michigan; Arline Geronimus, University of Michigan; Laura Gómez, (then) University of New Mexico; Joseph Gone, University of Michi- gan; Joseph Graves Jr., North Carolina AT State University and University of North Carolina, Greensboro; Clarence Gravlee, University of Florida; Janet Helms, Boston College; Kimberly Huyser, University of New Mexico; Derek Iwamoto, University of Maryland; Camara Jones, Centers for Disease Control; Jonathan Kahn, Hamline Uni- versity School of Law; Jay Kaufman, McGill University; Sandra Lee, Stanford Uni- versity; Simon J. Craddock Lee, University of Texas Southwestern Medical Center; Nancy López, University of New Mexico; Michael Montoya, University of Califor- nia, Irvine; Maribel Rodriguez- Torres, Fundación de Investigación and Universidad de Ponce; Gabriel Sanchez, University of New Mexico; Aliya Saperstein, (then) Uni- versity of Oregon. 3. For more information, see Trans- disciplinary Guidelines for Researching “Race,” Institute for the Study of Race and Social Justice, RWJF Center for Health Policy, University of New Mexico, http://healthpolicy.unm.edu/about/initiatives/isrsj, last accessed July 25, 2012.
- 21.
- 23. 1 Laura E. Gómez Typingthe word “disparities” into the search engine of the American Diabetes Association web site generates nearly 1,700 hits that relate to racial and/or ethnic gaps in diabetes rates and care (http://www.diabetes.org, accessed July 5, 2012). Similarly, an agency of the U.S. Health and Human Services Depart- ment proclaims that the risk of diabetes is “much greater for minority popu- lations than the white population” (“Diabetes Disparities among Racial and Ethnic Minorities Fact Sheet” 2012). These warnings reflect multiple biomedi- cal studies that have identified differential rates of diabetes among Whites (6.2 percent), American Indians (9 percent), Mexican Americans (10.6 percent), and African Americans (10.8 percent; Mokdad et al. 2000), as well as those that have reported that some non-White groups have diabetes-related complications at rates as much as 50 percent higher than Whites (Carter et al. 1996). The temp- tation is to attribute such disparities to genetic differences because people often assume that “racial” groups correspond to biological differences. Moreover, in a capitalist society in which much medical research is driven by pharmaceutical companies’ pursuit of individualized solutions to health problems (see Kahn, this volume), we often look for a genetic basis for health outcomes. Yet much data suggests that the notion of biological race is a poor proxy for other social dynamics. For example, epidemiologist Thomas LaVeist and colleagues have challenged the conventional wisdom that differential rates of diabetes reflect essential, biological differences (2009). They studied diabetes in a racially mixed Baltimore neighborhood that included large numbers of both African American and White residents who were of the same socioeco- nomic class and who had comparable access to healthcare. In contrast to the Introduction Taking the Social Construction of Race Seriously in Health Disparities Research Chapter 1
- 24. 2 Laura E.Gómez government studies previously referenced, they found that African Americans and Whites in this neighborhood had quite similar rates of diabetes (LaVeist et al. 2009). “I don’t mean to suggest that genetics play no role in race differences in health,” LaVeist said, explaining the study’s conclusions, “but before we can conclude that health disparities are mainly a matter of genetics we need to first identify a gene, polymorphism or gene mutation that exists in one race group and not others. And when that gene is found we need to then demonstrate that that gene is also associated with diabetes. On the other hand, there is [already] overwhelming evidence that behavior, medical care and the environment are huge drivers of race differences in health” (“Racial Disparities . . .” 2009). In other words, looking for race- based health disparities may at best jump- start a productive scientific inquiry when it leads researchers, policy makers, and health care providers to ask further questions about why race seems to be important in the context of a specific disease or health problem. But, at its worst, looking for race- based health disparities blinds us to seeing the full range of possible causes of health inequalities. The broader point that we collectively make in this book goes a step further: we must be skeptical of claims about race- based health disparities precisely because “race” is the product of historically rooted ideas and political contes- tation (Gómez 2012). Anthropologist Michael Montoya puts it this way: “the ascertainment of ethnicity or race is a profoundly social enterprise anchored in contemporary history,” and racial categories, both historically and today, “cor- respond best to the imaginations of the scientists and not the presumably defin- ing and stable features being measured” (Montoya 2007). Using the example of diabetes in his book Making the Mexican Diabetic, Montoya explores how the process of racializing diabetes— that is, the process of scientists and health professionals learning to take for granted that diabetes has a distinct impact and perhaps even etiology in people of different races— has occurred in labora- tories, in government funding circles, in peer- reviewed scientific publications, and in the practice of medicine (2011). What explains biomedical researchers’ categorization of humans into groups, and then the linkage of those groups to specific health problems such as diabetes, is the social process of making race— of constituting race as socially, politically, and scientifically important. Thus, our research agenda must include actively studying this racialization process; says Montoya: “when we carefully examine the selection of a group to study, the labeling of that group, the representation of that group in scientific papers, we see a science of population labeling based squarely on sociocultural factors particular to each group, each region, and each historical period” (Mon- toya 2007).
- 25. Introduction 3 As thediabetes example shows, there is a thriving literature documenting what appear to be enduring race- based health disparities in the United States. In their comprehensive review of the literature on health disparities, sociologist David Williams and his colleagues confirm that the long- standing gap between health outcomes among Whites and other racial groups has persisted into the twenty- first century (2010). In particular, a wide variety of data sources show a continuing gulf between Whites and Blacks; for example, as a general measure of health, consider life expectancy. Whites’ life expectancy is 78.3 years, com- pared to 73.1 years for Blacks, so that it would take another quarter- century to close the current White/Black life expectancy gap (Williams et al. 2010, 70). Similarly, the data show widening contemporary disparities between Native Americans and Whites (Williams et al. 2010, 74). Although, for a variety of reasons, the data is more limited than for African Americans and Native Ameri- cans, other data show that Latinos and Asian Americans have inferior health outcomes relative to Whites in many categories (Williams et al. 2010, 71).1 To a large extent, the current boom in the study of race- based health dis- parities is the result of the process of institutionalizing, at the federal level, research and data collection along gender and racial lines. Since 1990, Con- gress has mandated a number of policy changes that have impacted how biomedical researchers and social scientists study health disparities (C. Lee 2009). For example, in 1990 the National Institutes of Health (NIH) created the Office of Research on Minority Health (C. Lee 2009, 1185).2 In 1993, when Congress funded the NIH, it directed the agency to require all grant awardees to include women of all races and minority men in clinical research (C. Lee 2009, 1185). During the same era, the federal government also created special- ized departments to explore racial disparities within the Department of Health and Human Services and the Centers for Disease Control (Abu El- Haj 2007, 292– 93). Sociologist Stephen Epstein (2007) has documented the fascinating political context and institutional dynamics that produced these changes, but no one doubts that these norms have become entrenched in today’s biomedical research establishment. If the federal government mandates various types of data collection to document such gaps and that data show racial gaps in health outcomes, what is wrong with health disparities research on race? Nothing, so long as that research is scientifically rigorous and accurate. The purpose of Mapping “Race” is to improve how health disparities research is conducted by challenging some central premises. The book’s core argument is that biomedical researchers and social scientists have not sufficiently grappled with how the conceptualization of race as socially constructed implicates how we operationalize and analyze
- 26. 4 Laura E.Gómez race in health disparities research. Although they represent a variety of disci- plines across the branches of the medical, biological, and social sciences and take varied methodological approaches, the authors in this book agree that seri- ous negative consequences will result if researchers continue to follow the cur- rent course. Significantly, it is not our claim that research on race or race- based health disparities is illegitimate or inappropriate. We align ourselves with those scholars who have called for more and better research on race and racism (American Sociological Association 2003), rather than with those who have argued that the race is too complicated and fraught to be effectively studied scientifically (American Anthropological Association 1998). Thinking Critically about Racial Disparities In order to make the point that researchers must chart a different course, let us start with an example that seems to be a classic case of a race- based health disparity. While White women in Chicago are slightly more likely than Black women in Chicago to get breast cancer, Black women are twice as likely to die from it. As legal scholar Dorothy Roberts has noted, what is most shocking about this fact is that the Black/White gap emerged after 1980, when public awareness of breast cancer was at an apex and when there were great advances in detection and treatment (2011, 123). What happened between 1980 and the turn of the twenty- first century to widen the gap between White and Black women’s breast cancer outcomes? If we were to think in narrow terms about “race,” we might be tempted to explore genetic (or epigenetic) differences as a symbol of what many people believe to be the biological differences among racial groups. A different approach is to think about the social context that produces racial disparities, which in turn involves thinking about race and racial dynamics as socially constructed. In Chicago, that means understanding the difference in access to health care that White and non- White women typically receive. When Roberts interviewed Dr. Steven Whitman, whose research first documented the breast cancer survival disparity, she did so in his office at Mount Sinai Hospital, which she described as “small and shabby” and with- out air conditioning. Roberts noted that the hospital is located in “an all- black community called North Lawndale on Chicago’s West Side, a block from the border of South Lawndale, which is predominantly Mexican . . . The patient population here at Mount Sinai is about half black and half Mexican,” Whit- man told Roberts (2011, 124). He went on to say that Mount Sinai has, at most, one day of cash on hand to operate the hospital, compared to Northwestern University Hospital (located in majority- White, affluent Evanston, a northern
- 27. Introduction 5 suburb ofChicago), which he estimated has four hundred days of cash on hand (and daily spends $5 to $10 million; Roberts 2011, 125); in the health care sector, hospitals are rated by bond agencies according to how many days of cash they have on hand. Whitman interprets the data as showing that while Black women’s breast cancer treatment stayed stagnant in the last two decades of the twentieth cen- tury, White women’s breast cancer prognoses dramatically improved due to early detection via mammograms and advances in treatment including radiation ther- apy and new medication regimes (Roberts 2011, 125). Roberts found that Black neighborhoods in Chicago had few facilities with mammograms (so that women had to travel long distances to get them, decreasing the likelihood that they would do so); that public hospitals used older, inferior mammogram equipment (often lacking both digital technology and trained mammographers); that until the 2010 Patient Protection and Affordability Act (President Barack Obama’s healthcare initiative), even middle- class women with insurance were deterred from getting mammograms because of high insurance copayments (the 2010 law mandated the elimination of payments for women over age fifty); and that racially segregated neighborhoods meant that White women more frequently had access to the best breast cancer treatment facilities, which Whitman said were usually located in “the fancy institutions— they are all in white neighbor- hoods” (2011, 125– 27). How are we to understand the role of race in the Chicago breast cancer example? The typical approach is to view race as an individual characteristic. For example, researchers often speak of self- identified race, wherein a research subject selects her or his racial category from a list of limited options (which almost always correspond to the Office of Management and Budget [OMB] racial categories, themselves derived from U.S. Census categories). The OMB categories include “five racial categories (White, Black, American Indian or Alaskan Native, Asian, and Native Hawaiian and other Pacific Islander) and one ethnic category (Hispanic),” which most biomedical researchers collapse into six categories of “self- identified race” that respondents may choose from among (Williams et al. 2010, 70). When researchers view race as an individual characteristic, they often fall into the pattern of biologizing race in terms of ancestry or genetics. This in turn invites the tendency to view health disparities as a question of individual failure (for less healthy individuals) or individual success (for more healthy indi- viduals) and to identify solutions to disparities that focus on the individual body, such as pharmaceutical solutions (see Kahn, this volume). But Roberts tells a very different story about the racial disparity in breast cancer survival in Chicago. She urges us to think about how racial discrimination
- 28. 6 Laura E.Gómez has structured all sorts of inequalities, including health inequities. In her nar- rative, the emphasis is on how Chicago’s existing pattern of residential segrega- tion of African Americans produces tangible gaps at every stage of healthcare. In a similar way, Williams and colleagues offer a nuanced picture of how neigh- borhood segregation leads to poor health via six “pathways”: First, segregation limits socioeconomic mobility by limiting access to quality elementary and high school education, preparation for higher education and employment opportunities. Second, the conditions cre- ated by concentrated poverty and segregation make it more difficult for residents to adhere to good health practices. . . . Third, the concentration of poverty can lead to exposure to elevated levels of economic hard- ship and acute stressors at the individual, household and neighborhood level. Fourth, the weakened community and neighborhood infrastruc- ture in segregated areas can also adversely affect interpersonal relation- ships and trust among neighbors. Fifth, the institutional neglect and disinvestment in poor, segregated communities contributes to increased exposure to environmental toxins, poor quality housing and criminal victimization. Finally, segregation adversely affects both access to care and the quality of care. (2010, 79) An even broader context would situate current residential segregation as part of a larger history of government- sponsored, legally enforced policies that created today’s urban spaces. In this broader narrative, today’s health dispar- ities are inextricably intertwined with the past because that past has direct impacts today— via laws that restricted Blacks, other non- Whites (and some- times Jews) from buying houses in certain neighborhoods (racially restrictive covenants); via federal housing policies and agencies that created White- only suburbs, supported the redlining of Black neighborhoods by banks and insur- ance companies, and that destroyed vibrant minority neighborhoods with the placement of highways and public transportation axes; and via neighborhood- based public schools that created a system of “naturally” occurring segregated schools that themselves became a self- fulfilling prophecy for marking neighbor- hoods as “good” (White) and “bad” (non- White). The starting point for Dorothy Roberts’s analysis is the claim that “race is not a biological category that is politically charged [but rather it] is a political category that has been disguised as a biological one” (2011, 4). It is the cumu- lative, social meaning of race in particular times and places that has shaped and continues to shape both racial discrimination (and racism) and racial meaning. To put it another way, we should not consider racial disparities in
- 29. Introduction 7 any isolatedsense but instead consider the social context of racial categories and racial discrimination. Thinking about race- based health disparities, then, must also involve engaging the social meaning of race and racism— the objec- tive of this book.3 Mapping “Race” asserts that we must think critically about how ideas about race are used in making claims about health disparities. We focus on three common deficits in the health disparities literature: (1) the failure to ade- quately define and/or conceptualize “race;”4 (2) the frequent and uncritical use of race as a control variable; and (3) the analytical slippage that often results when scholars (who have often engaged in the first two problematic steps) over- state or misrepresent the effects of race. The combined effect of these three weaknesses in the current literature on race- based health disparities is to lead researchers and policymakers to think of race as fixed and biologically rooted. And this, in turn, leads to two major flaws that have significant public health implications. First, as Pamela Sankar and colleagues have noted, there are real dangers in taking an overly simplistic view of race, including the ten- dency to privilege genetics rather than environmental factors and the tendency to “blame the victim” by attributing poor health outcomes to particular racial groups (2004, 2987– 88). Moreover, at the level of large- scale public health interventions, misidentifying race as the culprit leads to misplaced govern- ment resources coupled with the failure to implement genuine solutions. Let me illustrate the problem by returning to the example of diabetes that opened the chapter. Today, our approach is largely one of education to encourage early medical intervention, testing, and treatment; in other words, we spend a great deal of money widely publicizing to African Americans, Latinos, and Native Americans that they are especially susceptible to diabetes. But if LaVeist and colleagues are correct that diabetes rates more likely reflect patterns of social class and neighborhood/environmental factors that often are linked to race and racial discrimination at the macro- , meso- , and micro levels, then we are not effectively addressing the problem. Instead, an overly simplistic focus on individual- level race masks the actual causes of health disparities— the racialized- gendered social determinants of health (see López, this volume)— that policies should address. Our education efforts would be better spent tar- geting the populations most vulnerable to poor access to healthcare, rather than using racial group membership as a crude proxy. Moreover, this approach involves thinking about how racial status and racism interact with socioeco- nomic status and discrimination in a complex, mutually constitutive way (rather than thinking about social class as determining race, as has been histori- cally prevalent in the literature; see Takeuchi and Gage 2003, 439).
- 30. 8 Laura E.Gómez Mapping “Race” asks students and scholars of health inequalities to make the following four commitments in their research. First, they should work hard to understand what it means to say that race is socially constructed as part of interrogating and explicating their own conception of race. Second, they should understand the substantial scientific costs of continuing to mismea- sure race in their research; in other words, they must be accountable for the limitations of their findings, given their reliance on a cramped measurement of race rather than one that corresponds to a robust notion of socially constructed race. Third, no matter what toolbox of methods they deploy, researchers must become proactive in seeking ways to measure race that more accurately reflect their chosen conceptualization. Finally, scholars of health disparities should be cautious when they make claims about race- based disparities. In other words, they should avoid making claims that attribute causation to race without suffi- ciently exhausting other causes— particularly social and environmental causes and structural racism— and they should acknowledge the ways in which race is inextricably intertwined with other causes of health inequalities. Flaws in the Current Approach Much empirical research on race shares a common problem— the tendency to conceptualize race narrowly as phenotype and to crudely measure race via sub- ject self- identification from a closed list of options. This is a weakness in health disparities research as well as in a variety of other subfields and disciplines.5 In essence, there are two problems. The first is that scholars use race without say- ing what they mean by the term, without articulating a particular conception of race, and without justifying why race matters in their analysis. The second is that, when they attempt to operationalize race in the context of their research, too many scholars fall into a default mode in which race is a “control variable” or, in qualitative studies, a background variable that has not been adequately conceptualized and specified (C. Lee 2009). For example, in their review of more than one thousand articles published in the American Sociological Review (ASR), Martin and Yeung found that, between 1937 and 1999, the number of ASR articles became increasingly quan- titative (mostly relying on regression analyses) and that these studies increas- ingly used race as a control variable. The rise of regression methods increased the likelihood that scholars would take race into account, and yet scholars’ ten- dency to “simply add race as a control variable in a regression model” implic- itly is a very narrow way of conceptualizing race. They conclude that this way of introducing race into the analysis “implies that, while race makes a differ- ence, it is not a profound one, in that race does not affect the relationships
- 31. Introduction 9 between othervariables” (Martin and Yeung 2003, 532). Anthropologists Clar- ence Gravlee and Elizabeth Sweet contend that similar problems characterize the health disparities literature, where many researchers reflexively (rather than self- consciously) use race as a proxy “for some unspecified combination of environmental, behavioral, and genetic factors” (2008, 49). They identify two resulting problems as the tendency to obscure the actual causes of health inequities and the promotion (explicit or implicit) of the idea that racial differ- ences are genetic and innate (Gravlee and Sweet 2008, 49). Studies that use race in this or similarly narrow ways have had several, per- haps unintended, consequences. For one thing, these studies have cumulatively contributed to the popularization of a simplistic measure of race as a dichotomous variable (Black/White or White/non- White) usually based on either bureaucratic assignment (racial assignment by someone collecting government data, such as a county coroner) or subject self- identification. This common approach to race has in turn contributed to the idea, accreted over time, that race is fixed and bio- logically rooted. In this respect, scholars’ frequent, but unremarked upon use of race (especially as an independent variable) mimics the social phenomenon of Americans being repeatedly asked to report their race in a variety of life contexts, as noted by sociologist Ann Morning (2011). Framing the question as a simple one (with which of these listed groups do you identify racially?) and asking it repeatedly have led Americans to see race “as a permanent and individual char- acteristic: something that is embedded within us and [that] does not change over time” (Morning 2011, 3– 4)— in other words, to reify race, rather than to see race as a complex and dynamic set of social processes. The problem of failing to conceptualize and/or define race spans the meth- odological spectrum. Sociologist Edward Morris argues for “greater transpar- ency in how race is measured in qualitative studies and increased reflection on this concept as it is socially situated” (2007, 411). It is not enough, he contends, to simply declare that race is a social construction; he urges scholars to go fur- ther by expressly acknowledging “how they choose to identify race as well as recognizing the limitations of this choice and being attentive to the enactment of race in a particular context” (Morris 2007, 422). In other words, scholars who include race as a facet of their studies (whether a major or minor facet) should deliberately conceptualize race, regardless of their chosen methods. While such problems certainly transcend methodological orientation, there appear to be particular limitations with the tendency, in quantitative research, to use race as a control variable or as a crude proxy for some other social fact or process. Political scientist Taeku Lee has characterized the fundamental problem succinctly: “Although we acknowledge that race, like ethnicity, is a
- 32. 10 Laura E.Gómez social construct marked by fluidity, multiplicity, and contingency, we continue to measure racial and ethnic identities as fixed, categorical variables” (T. Lee 2009, 113). He has been most critical of his own brand of quantitative political science— “multivariate statistical models in which some political variable of interest is explained by including a dummy variable for a given racial/ethnic category” (T. Lee 2008, 462)— due to the trio of methodological problems it presents. First, this logic assumes that self- identified race influences the depen- dent variable (such as the health outcome), without any explanation or justifi- cation (T. Lee 2008, 462). Second, it makes the unwarranted assumption that self- identified race does not covary with other independent variables in the model (T. Lee 2008, 462). Third, such research typically fails to consider how self- identified race (or some other measure of race) could be unreliable because of such factors as how the subject’s racial self- identification might vary depend- ing on the race of the person asking the question (same or other race of subject), the place where the question was asked (home, work, or school), the language of the question, or myriad other circumstances (T. Lee 2008, 463). Some scholars make the mistake of assuming that what “race” means is obvi- ous. Yet we should make the opposite assumption: what “race” means is highly contested in popular culture, politics, law, and, as a result, science. In her research on how laypeople and scientists conceptualize race, sociologist Ann Morn- ing (2009) finds three popular, contemporary conceptions of race: a biological notion, a culture- based notion, and the idea that race is socially constructed. Moreover, she finds that people do not hold one conception of race to the exclu- sion of others but move back and forth between these three conceptions in order to explain different situations they encounter where race is relevant. In a similar way, major institutions such as the federal and state courts move back and forth among several conceptions of race, even within a particular time period or legal area (see Gotanda 1991; Haney López 1996; Pascoe 2009). Without making a conscious effort to do so, scholars are no more able to put aside folk notions of race than are laypeople. As Morning contends, “Despite the special authority that scientists enjoy, their beliefs are by no means inde- pendent of the broader society in which they train and practice. If lay people are influenced by what ‘experts’ say about race, the reverse is true too: scientific notions of race are informed by the broader political and social currents of their times” (2011, 4; see also Almaguer and Jung 1999, 234). In the context of the contemporary assault on race- conscious law and policy and the entrenchment of color- blind ideology in law and politics, it becomes all the more important for scholars to make clear the conception of race that they employ. Research that fails to expressly define race implicitly endorses a notion of race as fixed
- 33. Introduction 11 and biologicallyrooted— a position that does not fit comfortably with the con- ception of race as socially constructed. Benefits of Viewing Race as Socially Constructed Thinking of race as socially constructed presents a stark alternative to this way of thinking about race (or, more accurately, the default mode of not thinking carefully about race). To say that race is socially constructed is to acknowl- edge that we use phenotype or other visible characteristics to sort people into social groups, that we impute qualities of good and bad to these groups, and that the resulting racial order structurally and ideological supports a system of racial stratification that is socially contingent and historically rooted (Omi and Winant 1994). Rather than conceiving of race as shorthand for some essential, biologically rooted human difference, the constructionist view of race fore- grounds the use of racial categories to justify racial hierarchy and inequality in particular times and places. This should lead us to focus on the effects of racial categories and racial ideology, namely, racial stratification, racial discrimina- tion, and racism. An important aspect of the constructionist account has to do with histori- cally situating scientific racism (in the social, biological, and medical sciences) as having played a critical role by creating and promoting biological claims about race in order to justify Whites’ racial domination of people of color (Har- tigan 2008, 185; Taekuchi and Gage 2003, 436). Anthropologist John Hartigan Jr. makes the point that from “the earliest developments of colonialism to the current, emergent operations of biocapital,” the effort to differentiate the world’s populations on the basis of usually racialized biological characteris- tics has been the basis for justifying the sorting of distinctly racial labor pools (2008, 185). According to him, “Current assertions that race is socially con- structed do important work by keeping both this history and these contempo- rary misuses of race in view, while also challenging the evidentiary ground for making claims about linkages between race and genetics” (Hartigan 2008, 185). This is a point worth emphasizing: viewing race as socially constructed fore- grounds the racist nature of past conceptions of race, including those embraced by scientists. From the sociological vantage point, the claim that race is socially con- structed has salience at all three levels of analysis: micro (individual), meso (community and organizational), and macro (institutional and structural). At the micro level, a constructionist approach acknowledges that race is dynamic over the life course (as one ages and develops) and that race varies by situation (for example, one might describe one’s racial identity differently at work or at
- 34. 12 Laura E.Gómez school than one would in the context of one’s neighborhood or extended fam- ily). At the meso level, a constructionist approach treats race as the product of organizational policies and practices that institutionalize ideas about race and that form a racial hierarchy that, over time, become natural and taken for granted by members of the organization. At the macro level, a constructionist approach to race directs our attention to aspects of the social structure that help reproduce the racial order and that justify that racial order as both right and inevitable. Let me illustrate each with an example. Consider a study by sociologists Andrew Penner and Aliya Saperstein; they used a random sample of nearly 13,000 Americans to test whether racial perceptions were, in fact, fixed or fluid (Penner and Saperstein 2008; see also Saperstein and Penner 2010). Respondents were interviewed annually over two decades and were asked to self- identify their race, and Penner and Saper- stein used these responses to code the subjects as “White,” “Black,” or “Other” (2008, 19630). In addition to this measure of racial self- identification in the dataset, interviewers were instructed to classify the subjects’ race at the end of the interview, using the same categories (“White,” “Black,” or “Other) (2008, 19629– 30). If race was fixed and rooted in objectively understood phenotype, we would expect little change in the interviewer- ascribed race of the 13,000 respondents. Instead, 20 percent of the individuals experienced at least one change in how interviewers classified them (2008, 19628). Penner and Saper- stein found that, even when controlling for a wide array of possible factors, three characteristics of the respondent stood out as statistically significant pre- dictors of the interviewers’ switching a respondent’s racial category: incarcera- tion, unemployment, and income below the poverty line. The study suggests, then, that knowing one of those facts (about incarceration history, unemploy- ment status, or poverty status) changed whether the interviewer saw the study participant as more or less “White” or more or less “Black,” suggesting that racial status is far from fixed and uncontested in one- on- one interactions. More- over, the magnitude of change in racial perception was significant, affecting two in ten study participants in this large, random sample. As an example of meso- level dynamics, sociologist Nancy López’s eth- nographic research on New York City schools illustrates how socially con- structed race works— via “formal and informal institutional practices within schools”— to racialize students (2003, 41). For example, she found that hyper- segregated urban schools usually had “dumbed down curriculums” boring to students who responded by “engaging in willful laziness,” thereby perpetuat- ing a cycle in which mostly White teachers thought of their students, all of whom were people of color in this school, as intellectually incapable (2003,
- 35. Introduction 13 42). Anotherway that schools harden racial and gender boundaries is under the guise of “discipline.” López spent extensive time at a Manhattan high school that was characterized by hyper- policing despite the fact that security officials told her that most student- to- student disputes were fights about property and that there had not been a single gun incident in more than five years. For exam- ple, the school’s head of security explained that enforcement of the rule against wearing hats was motivated by his need to demand respect from students. The rule was enforced selectively, only against male students (all of whom were Black and Latino), and it became a site for hardening racial categories because the boys took as many opportunities as they could to resist the rule (2003, 76– 77). Overall, López concludes that the school’s discipline policies consti- tute a pipeline between over- policed public urban high schools and the larger society’s criminalization of men of color via the prison industrial complex (2003, 76– 77). In this way, we see schools’ powerful work to reproduce racial hierarchy and racial ideology. One by- product is that young men of color are primed to experience greater stress and racist microaggressions that will con- tribute to a lifetime of stress that will feed into various mental and physical health problems (for example, see the chapters by Geronimus and Helms and Mereish, this volume). The dynamic nature of racial categories and racial ideology is also observ- able at the macro, or societywide, level. For example, my analysis of how Mexican Americans were incorporated into the American racial hierarchy in the nineteenth- century Southwest shows that time and place matter and that “race” is not the same across space, time, or groups (Gómez 2007). Largely because doing so served the interests of the national campaign to invade Mex- ico and take its northern territory in order to reach the Pacific (often justified by the rhetoric of Manifest Destiny), 115,000 Mexican Americans living in the former Mexico became naturalized American citizens overnight in 1848. This occurred despite the fact that, at the time, U.S. laws excluded all non- Whites from becoming citizens; in this sense, Mexican Americans were recognized as legally White. At the same time, there were multiple ways in which Mexican Americans and Mexicans were treated as racially subordinate and non- White between 1848, when the war with Mexico came to an end, and 1912, when Congress made New Mexico a state despite its majority- Mexican, Spanish- speaking population (Gómez 2007). Mexican Americans came to play a role as what I term an off- White wedge group on the national scene, between African Americans below them (who were both socially and legally marked as racially inferior) and Whites above them (who were both socially and legally marked as racially superior), as well as in the more specific racial order in New Mexico, in
- 36. 14 Laura E.Gómez which Mexican Americans were an intermediate group between Native Ameri- cans below them and Whites above them. To say that race is socially constructed means to acknowledge that racial status is dynamic and situational: rather than being fixed at birth, life has any number of feedback loops that can change one’s race at the level of individual interactions, at the level of how organizations and communities operate, and at the level of societywide structure and ideology. The view that race is socially constructed has become the dominant approach in the social sciences (Ameri- can Anthropological Association 1998; American Sociological Association 2003; Hartigan 2008; C. Lee 2009), and the idea has gained traction in many other fields and even in popular discourse (Morning 2009, 1171).6 Indeed, the constructionist view of race has become so popular that it has been embraced by proponents of a color- blind perspective in many domains, from popular culture to medicine and law. According to this color- blind world view, the fact that race is socially constructed means that race is not “real,” and therefore it should never be the basis of government policies such as affirmative action. This position deeply misunderstands the basic premise of sociology and anthropology: the fact that how we collectively understand the world pow- erfully shapes how we interact in it and therefore reality as we know and experience it (Berger and Luckmann 1967). For example, proponents of the color- blind view often emphasize the role of individual preferences and mar- ket behavior, and yet, these aspects of social life are themselves key aspects of the socially constructed social fabric: Ideas, norms, and rituals evolve at the group or societal level and help to constitute individual identities, needs, pref- erences, and behavior. Individual action cannot be understood apart from the social environment that gives meaning to that action. Both “preferences” and market behavior are governed by taken- for- granted notions of what is natural, right, and rational (Edelman 2004, 186). With respect to race, enduring notions about the biological basis for race support and interact with other racial ideas to create the taken- for- granted, natural world in which racial identity and racial categories persist, in which we routinely (and often without thinking) classify people whom we encounter into racial categories, and in which we make a host of decisions (conscious and unconscious) based on those categorizations. Or, as epidemiologist Jay Kaufman puts it, “Despite this widespread understanding that racial categories are a product of our cultural imagination, we are still no more able to dismiss them. Race is not in our heads because it is real, but rather it is real because it is in our heads” (1999, 101). The fact that biology— or what we often use as proxies for biology, such as ancestry, phenotype, genes— is seen as related to race and even, in many
- 37. Introduction 15 people’s contemporaryunderstandings of race, what produces racial differ- ence, is indeed an important part of the social meaning of race. Yet biology is no less socially constructed, as sociologist Troy Duster has noted, emphasizing that the social meanings of race and racial interactions themselves have “feed- back loops” into the biochemical, neurophysiological, and cellular aspects of bodies that can just as readily be studied scientifically (Duster 2003; Duster 2004). In other words, when human beings define situations as real, they can and often do have real social and biological consequences, consequences that can be translated into social facts that we as researchers can attempt to study and understand. Thus, saying race is socially constructed is not the same as saying that biology is irrelevant to race. As Hartigan suggests, rather “than deploying ‘social construction’ to reas- sert a distinction between the ‘biological’ and the ‘social’ or to assail the return of ‘atavistic beliefs’ about race, the more important move is to establish the primacy of cultural dynamics at work in shaping not just the genetic evidence and its interpretation, but the very interests and desires related to race that inform how this controversy unfolds both within and outside of the lab” (2008, 186; see also Gravlee 2009). Anthropologist Michael Montoya (2011) does some of this work in the context of unpacking how scientists, Mexican- origin DNA donors, and health professionals all came together in recent decades to con- struct diabetes as “a Mexican problem,” with the pharmacogentic implications that such a view entails. Montoya warns, What requires explanation are not the processes and practices that tech- noscientists reiterate in the making of the three or five “races of man.” Although necessary, this is an unsatisfactory level of resolution if we are to understand and transform those material and semiotic assemblages that perpetuate inequity. Rather, what demands explanations are why this occurs in spite of the scientific, ethical, social, and political conse- quences so carefully detailed by scholars and analysts from a spectrum of fields across the social and biological sciences and humanities. (Mon- toya 2011, 180) Implications for Health Disparities Research Consider that, of nearly 136,000 articles published in biomedicine (human research studies only), a whopping 51,039 used the concept “Negroid,” while 37,044 used the concept “Caucasian,” and 20,656 used the term “Mongoloid” (Graves 2010, 43). As biologist Joseph Graves has pointed out, while we know today that, on the one hand, these terms do not correspond to any discrete
- 38. 16 Laura E.Gómez population groups (so they could not correspond to mutually exclusive catego- ries that scientists could study), on the other hand, biomedical researchers (and laypersons) continue to deploy these terms ubiquitously and casually. Building on the just noted calls by Hartigan and Montoya, and in response to scientists’ continued use of these terms despite their lack of validity, our agenda should be to ask a different set of scientific questions: why do these terms persist (in science and in the popular imagination) as racial designations? What political work does continuing to talk in terms of “Negroids,” “Caucasians,” and “Mon- goloids” do in the contemporary discourse about race and racial difference? As an intellectual inquiry, such an analysis would involve conceiving of race as socially constructed— as a product of a particular place and time— as well as considering how racism and racial subordination have been and are pro- moted by this kind of language and categorization that is anything but scien- tifically neutral. This way of thinking about race as principally about socially created (and politically sustained) hierarchy and subordination differs dramatically from an approach that emphasizes race as an essential individual characteristic. Consider Dr. Sally Satel, who has gained notoriety by describing herself as a doctor who engages in “racial profiling”: “In practicing medicine, I am not col- orblind. I always take note of my patient’s race. So do most of my colleagues. We do it because certain diseases and treatment responses cluster by ethnicity. Recognizing these patterns can help us diagnose disease more efficiently and prescribe medications more effectively. When it comes to practicing medicine, stereotyping often works” (Satel 2002, 56). Satel’s comments in the New York Times deserve unpacking, for they have the potential to do serious damage. In an era when racial stereotyping is decried by almost everyone and when color- blindness has become the mantra of conservatives in politics, law, and popular culture (Bonilla- Silva 2010), Satel makes the provocative claim that race mat- ters.7 Yet Satel’s claim that race improves disease diagnosis and medication treatment is largely unsupported by the biomedical research. It is precisely the type of claim that Mapping “Race” seeks to counter: the evidence simply does not suggest that self- identified race today maps onto disease and treatment models in meaningful ways. We must recognize that what Satel is really asking us to do is think about race- based health dispari- ties in a simplistic, scientifically crude way that has fundamental implications. This way of seeing “race” presupposes that race is an individual characteristic about a patient that tells a health care provider something meaningful, imply- ing that race is an essential characteristic, a fixed characteristic, and a biologi- cally rooted characteristic (conjuring notions, in Satel’s narrative, of genetic
- 39. Introduction 17 or ancestralsignificance). As biologists Joseph Graves and Michael Rose have noted, this view of race in the clinical context may be quite dangerous because, “in addition to fostering social inequality by underscoring racial classification, racial medicine might kill people by neglecting the substantial genetic varia- tion within, and genetic overlap between, human populations” (2006, 492). Furthermore, and as many chapters in this book illustrate, it is no simple matter for a doctor to assign her patient to a racial category or even to ask a patient to self- identify racially, making the act of racial categorization in the biomedical context challenging (see López, this volume). For example, research shows that physicians and other health care personnel often are embarrassed or otherwise unwilling to directly ask a patient to identify her or his race, so that a health care provider might well be guessing a patient’s race based on inappropriate criteria (see Lee, this volume). An alternative approach to health inequalities that departs from the con- structionist viewpoint is founded on two different realities. First, “race” is com- plex and inherently hard for researchers to measure or operationalize. Second, health disparities researchers must be extremely cautious about attributing out- comes to self- identified race because seeming racially inflected dynamics often reflect larger process of racism and other forms of social inequality. For example, best practices for doing research on health disparities should include avoiding the assumption that race is important in favor of the premise that race is hard to measure and might be significant (for other approaches to making race more complicated, see the chapters by Garcia, López, and Saperstein, this volume). Consider the strategy taken by anthropologist Clarence Gravlee, whose research team set out to explore the connections between hypertension and race and, specifically, the claim that Blacks are more likely than Whites to experience high blood pressure and associated health problems (see Gravlee and Dressler 2005; Gravlee et al. 2005). Once they picked their research site in southeastern Puerto Rico, they implemented a three- stage, multi- method research design: first, using ethnographic methods, they assessed social norms about color and race in Puerto Rico; second, using interviews and surveys, they measured those ideas in the subject sample; and, third, using reflectom- etry, they objectively measured subjects’ skin pigment. Gravlee and his col- leagues conclude that: “both self- rated and culturally ascribed color— but not skin pigmentation— were associated with blood pressure through an interac- tion with income and education” (Gravlee and Dressler 2005). In other words, middle-and high- income people perceived by others as Black were more likely than those with objectively darker skin tone (at least as measured by the objec- tive reflectometry test) or than those who were perceived as Black but who were
- 40. 18 Laura E.Gómez low- income, to have hypertension. This finding suggests many public health questions about how we ought to think about identifying those at risk for high blood pressure and treating the disease. The authors also suggest that more research needs to be done to explore the dynamics of race- based microaggres- sions and structural racism that affect the mental and physical well- being of people of color, including hypertension, in ways that we are only beginning to understand. But the caution that a constructionist account raises is, who is in what “racial” category? “Whether people from Syria or the Indian subcontinent are placed in the ‘white’ group, whether Haitains, West Africans, or Cubans are cat- egorized as ‘black’— these are questions for which there are no materially valid answers, only vagarious compromises of one kind or another” (Kaufman 1999, 102). Kaufman would revert to self- identified race as “the gold standard”— “that people are who they say they are” (1999, 103), but this too has its limits, as I have noted. At the end of the day, one of the main reasons for thinking about race as socially constructed is so that we can recognize the ways in which race think- ing operates to solidify stratification and racial subordination. In particular, in the health context, the focus on race as measured via static self- identification obscures the ways in which racism operates to create inequities in health out- comes and access to health care. If we understand racial categories as socially constructed to serve political purposes, then we are better positioned to identify and combat racism. Epidemiologist and physician Camara Jones and colleagues counsel that “it is vitally important that we develop a detailed understanding of the characteristics and manifestations of racism,” including institutionalized racism, personally mediated racism, and internalized racism (1991; see also Williams et al. 2010). At least part of the solution lies in adjusting our research studies in order to make race more complex so that it looks more like race in the real world. Acknowledgments I thank Aliya Saperstein for helpful comments on an earlier draft of this chapter. I am grateful to Nancy López for many conversations about race and health disparities (often over good food), as well as for her sharp editing skills, both of which made this chapter better. For research assistance, I thank the librarians and student assistants at the libraries at the UNM School of Law and UCLA School of Law. Thanks to Rusty Klibaner for help with manuscript production.
- 41. Introduction 19 Notes 1. Arange of limitations plague federal data collection for non- Black minority group members, and especially for Latinos and Asian Americans. Williams and colleagues report that “national data on mortality are more accurate for blacks and whites than for Hispanics, Asians, and Native Americans. A major problem affecting the quality of mortality data is related to the undercount in the num- ber of deaths because of misclassification of nontrivial proportions of Hispanics, Asians, and especially American Indians as white on death certificates” (2010, 71). Nationwide data for Latinos and Asian Americans was not systematically col- lected before 1980, when immigrants from Latin America and Asia became signifi- cant nationally after the lifting of pre- 1965 restrictions on immigration from these regions (see also Takeuchi and Gage 2003, 440 [noting that social scientists did not historically treat Latinos and Asians in a racial framework]). Moreover, since both groups combine many different national origin subgroups, the data is subject to more variation and interpretive debate (for two studies that explore intragroup dif- ferences with the Latino and Asian American categories, respectively, see Sanchez and Ybarra and Iwamato, Kindaichi, and Miller, this volume). There are a variety of structural reasons for ongoing misclassification, however, including the histori- cal racial ambiguity of Mexican Americans (see Gómez 2007) and other non- Black minority groups. In addition, data such as that on birth and death certificates is subject to substantial regional variation in the United States (Pascoe 2009), further adding to the possible misclassification by race. 2. As noted in the preface, the NIH Office of Research on Minority Health funded the 2011 workshop that was the catalyst for this book. 3. Note that this inequality or social justice view of the cause (and solution) to race- based health disparities is the minority view in both the scientific literature and the popular media. One study of almost four thousand articles on health dispari- ties that appeared in forty major newspapers between 1996 and 2005 concluded that only rarely were race- based health disparities framed by the media as a ques- tion of social injustice— that theme appeared in less than 4 percent of the articles (Kim et al. 2010, S229). 4. Sociologist Catherine Lee makes the important point that the failure of research- ers to define race is simply bad science because it is “antithetical to the tenets of scientific research, which, in its ideal form, demands that analytical variables be consistent and their categories mutually exclusive” (2009, 1183). 5. For example, these authors have identified this weakness in the following fields: Gómez 2012 (socio- legal studies); Gravlee and Sweet 2008 (medical anthropology); Harrison 1999 (cultural anthropology); Helms 2007 (psychology); Jones et al. 1991 (epidemiology); C. Lee 2009 (biomedical research); T. Lee 2009 (political science); Martin and Yeung 2003 (sociology); Morris 2007 (sociology); Mukhopadhyay and Moses 1997 (cultural anthropology); Saperstein 2008 (demography). 6. At the same time, Morning contends that the social constructionist conception of race has by no means completely displaced essentialist views of race rooted in biology. In fact, she finds that, among scientists who teach at the university level, an essentialist view of race as rooted in biology remains alive and well (2011, 6, 38–47, 221). 7. Of course, this claim has been made historically by those advocating for race- conscious legal remedies and government policies to alleviate racial discrimination.
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- 45. 25 Jonathan Kahn The increaseof using race as a biological construct in biomedical research and practice raises concerns over the dangers of reifying race in a manner that leads to new forms of discrimination. The most prominent example of racialized medicine is BiDil, the first drug ever approved by the FDA with a race- specific indication on its label— for use in “Black” patients. BiDil, however, is part of a much larger dynamic in which the purported “reality of race” as genetic is used to obscure the social reality of racism (Kahn 2008; Kahn 2012). To the extent that this dynamic succeeds in reductively reconfiguring health (and other types of) disparities in terms of genetic difference, it casts personal responsibility and the market as the appropriate arenas for addressing differential outcomes. It also undermines the rationale for deliberate state or institutional interventions that could more effectively address discrimination (Kahn 2005a; Kahn 2012). This is not to advocate “color- blind” medicine. To the contrary, there are very real health disparities in the United States that correlate with race. African Ameri- cans suffer a disproportionate burden of a number of diseases, including hyperten- sion and diabetes. Like heart failure, these are complex conditions caused by an array of environmental, social, and economic as well as genetic factors. Central among these is the fact that African Americans experience discrimination, both in society at large and in the health care system specifically. The question, once you identify these disparities in health outcomes, is how to address the underlying causes. Of course, outcomes can have multiple causes, both social and genetic. But health disparities are not caused by an absence of “Black” drugs. As studies by the Institute of Medicine (IOM) among others make clear, they are caused by social discrimination and economic inequality (Smedley, Stith, and Nelson 2003). The The Politics of Framing Health Disparities Markets and Justice Chapter 2
- 46. 26 Jonathan Kahn problemwith marketing race- specific drugs is that it becomes easier to ignore the social realities and instead focus on the molecules. Frames for “Disparities” and “Difference” Contemporary debates over the meaning and significance of racial dispari- ties in health have deep roots (Washington 2006; Williams and Jackson 2005). Tracing their development over the past century, particularly in relation to the legal construction of racial difference, elucidates a history of tension between two competing frames for characterizing social understandings and responses to disparities. I characterize these frames here as a distinct binary, but they really exist as a continuum with one side or another gaining different degrees of prominence in different eras or contexts. One the one side I place “markets,” on the other, “justice.” First, when identifying a race- based health disparity, one can locate its source or cause in human bodies or in social conditions. The former tends to biologize race, marking racialized bodies as somehow defective, weak, or dis- eased, often at the molecular level; examples would include characterizations of heart failure as a “different disease” in African Americans (Yancy 2002), framing the resulting health disparities as due more to biology than social or historical context. The latter tends to racialize social dynamics, marking society as some- how discriminatory or unjust; examples would include many of the findings of the IOM report Unequal Treatment: Confronting Racial and Ethnic Disparities in Healthcare that explicitly examined diverse social, historical, and economic factors as contributing to health disparities (Smedley, Stith, and Nelson 2003). Second, having identified the source of the problem, the next step is to frame a locus of responsibility for addressing it. If the source has been located in racialized human bodies, then the tendency is to situate responsibility for addressing the problem in the individuals whose bodies are affected. This often takes the form of calls for “personal responsibility” in taking care of one- self. Examples would include action in 2003 by the Department of Health and Human Services (DHHS) to emphasize personal responsibility when it reported to Congress on the IOM study (Kahn 2005a). DHHS also pushed to replace mul- tiple references to “disparities” with the term “difference,” thereby also focus- ing more on a biological basis for disparities. If the source of the problem is located in society, then the tendency is to situate responsibility for addressing the problem in the polity. Examples would include characterizations of health equality as a civil right, going back at least to Dr. Martin Luther King Jr.’s 1966 declaration that “of all the forms of inequality, injustice in health care is the most shocking and inhumane” (King 1966).
- 47. The Politics ofFraming 27 Third, having identified the source or the problem and located responsibil- ity for it, the final step is to formulate an approach to solving it. Going down one track, if you have located the source of the problem in human bodies, per- haps at the genetic level, and situated responsibility in the individuals whose bodies are affected, then the tendency is to formulate privatized, market- based approaches to address the problem. Examples would include BiDil, a drug for- mulated to address purported disparities in heart failure at the molecular level, to be purchased from a pharmaceutical corporation by individual consumers tak- ing responsibility for their condition (Kahn 2005a). This approach was evident in a 2006 statement by Alan Levine, secretary of Florida’s Agency for Healthcare Administration, declaring that “in the case of BiDil, we have clearly identified a product targeted toward closing the racial disparity gap” (AHCA 2006). Going down the other track, if you have located the source of the problem in social conditions, and situated responsibility in the political community as a matter of justice, then the tendency is to formulate government- based policy initiatives to address the problem. Examples would include any of an array of civil rights– related laws that seek to improve the social or economic conditions of minority populations thereby improving health (Epstein 2007; Omi and Winant 1994). Of course, many responses reflect different mixes of these frames of health disparities. Thus, for example, a federal program may encourage market- based mechanisms to improve minority access to drugs in the marketplace. The dis- parities frame of “access” often emerges as an area around which Democrats and Republicans share a measure of agreement as it implicates both government initiatives to reduce disparities and personal responsibility for individualized health care choices in the market. The “access” approach involves the political community in formulating policy responses to a problem, but it also ultimately locates the problem of disparities in the individual bodies of the affected peo- ple. Calls for improved access to health care, then, may involve federal ini- tiatives to help historically disadvantaged groups, but they are double- edged insofar as they promote market solutions to health disparities that characterize health care as a consumer good rather than as a civil right. Moreover, diverse well- intentioned federal initiatives have both directly and indirectly promoted the framing of health disparities in terms that locate the problem in the bod- ies of individual members of geneticized racial groups (Sankar 2004). In the context of using social identities such as race in public health research, Ellison and Jones have expressed the concern that recent “expansion in genetic tech- nology will lead to a further focusing of the medical gaze onto individual risk factors and away from social, environmental and ecological factors” (Ellison and Jones 2002). The critical point, then, is to be sensitive to which frame is
- 48. 28 Jonathan Kahn beingdeployed at any given point in a debate over the source, responsibility, or response to health disparities. This chapter will proceed by exploring the historical background to framing issues of racial inequality and justice with particular attention to legal develop- ments manifest in key Supreme Court decisions, from Plessy v. Ferguson in 1896, to Brown v. Board of Education in 1954, to the 2007 case of Parents Involved in Community Schools. I show how arguments about racial inequality over the course of more than a century have been critically shaped according to how they locate responsibility for such inequality at the individual or social level, with consequent implications for constructing (or ignoring) appropriate remedies to the situation. The chapter considers how this long- standing dynamic is manifest today in the politics of health disparities. I argue that during the first decade of the twenty- first century, concerted efforts were made to cast health care as a consumer good and health disparities as a function of biological difference best addressed through market- oriented, rather than political, means. Markets and Justice: The Historical Background At the turn of the twentieth century, Fredrick Hoffman published Race Traits and Tendencies of the American Negro for the American Economic Associa- tion (Hoffman 1896). Hoffman, a statistician at the Prudential Life Insurance Company, wrote the article for Prudential in response to a wave of state legisla- tion banning discrimination against African Americans. Hoffman’s aim was to establish the biological inferiority of the Negro as a basis for justifying Pruden- tial’s decision to exclude African Americans from access to insurance cover- age. Prudential had begun cutting back on providing life insurance to African Americans as early as 1881 on the grounds that they suffered higher rates of mortality. Other insurance companies soon followed suit. State legislatures, particularly in the North, were wary of the growing power of the insurance industry and soon enacted new statutes to regulate the industry; some of these included antidiscrimination provisions. Prudential decided to resist the new laws by asserting a “natural” biological basis for their discrimination. Leslie Ward, the vice president of Prudential, declared “We are quite sure that mortal- ity, even amongst the best of colored lives, would not compare favorably with the mortality amongst whites” (Wolff 2006, 89). Hoffman’s task was to provide rigorous scientific analysis to undergird such claims. In his 330- page treatise, Hoffman compiled statistics, anecdotal observations, and eugenic theories in order to argue that “it is not in the con- ditions of life, but in the race traits and tendencies that we find the causes of excessive mortality” (Hoffman 1896, 95). Hoffman’s work is replete with
- 49. The Politics ofFraming 29 charts, measurements, and statistical observations all purporting to establish the biological inferiority of the “American Negro” not only in basic mortality but in such physiological traits as “chest expansion,” “physical strength,” or resistance to disease. Such observations built on Hoffman’s prior conclusion that “the time will come, if it has not already come, when the negro, like the Indian, will be a vanishing race” (Hoffman 1892, 542). Of course, academics and expert commentators had been declaring the inferiority of the “negro race” for decades before Hoffman came on the scene (Braun 2002, 160– 63). What is distinctive about his work for Prudential is that it demonstrates the use of actuarial data to provide a gloss of objective scien- tific rigor to the construction of biological racial difference in a legal context in order to gain economic advantage in a competitive marketplace. This is the flip side of the BiDil story, where the drug’s developers used a purported race- based biological difference to include African Americans in a patent (Kahn 2004). Here, Prudential was using biological difference to exclude African Americans from insurance coverage. Both strategies involve constructing race as biological in order to serve underlying commercial interests. Hoffman’s work did not go unchallenged. W.E.B. Du Bois, in particular, pre- sented a powerful critique, questioning Hoffman’s methodology and noting that the health outcomes of African Americans were comparable to those of immi- grant groups with similar economic resources. Acknowledging “that in certain diseases the Negroes have a much higher rate than the whites,” Du Bois asked, “the question is: Is this racial? Mr. Hoffman would lead us to say yes, and to infer that it means that Negroes are inherently inferior in physique to whites” (Du Bois 1906, 275). Du Bois asserted, however, that such differences “can be explained on other grounds than upon race” (Du Bois 1906, 275). Examining the data behind various differentials in morbidity and mortality, Du Bois concluded “that the Negro death rate and sickness are largely matters of [social] condition and not due to racial traits and tendencies” (Du Bois 1906, 276). Hoffman’s thesis was published in 1896, the same year that the U.S. Supreme Court issued its infamous “separate but equal” decision in the case of Plessy v. Ferguson (163 U.S. 537 [1896]). Homer Plessy, a resident of New Orleans, was seven- eighths White and one- eighth Black— an “octoroon.” On June 7, 1892, he bought a first- class ticket on the East Louisiana Railway for passage from New Orleans to Covington, Louisiana, and took a seat reserved for White passengers. He was arrested for violating the Separate Accommoda- tions Act of 1890, which required “all railway companies carrying passengers on their trains, in this state, to provide equal, but separate, accommodations for the white and colored races” (11 So. 948 [La. 1892]).
- 50. 30 Jonathan Kahn TheSupreme Court ultimately upheld the Louisiana law, rejecting Plessy’s argument “that the enforced separation of the two races stamps the colored race with a badge of inferiority,” concluding that “if this be so, it is not by reason of anything found in the act, but solely because the colored race chooses to put that construction upon it” (163 U.S. 537 [1896]). Writing for the majority, Justice Henry Brown declared “Legislation is powerless to eradicate racial instincts, or to abolish distinctions based upon physical differences, and the attempt to do so can only result in accentuating the difficulties of the present situation. . . . If one race be inferior to the other socially, the constitution of the United States cannot put them upon the same plane” (163 U.S. 537). Just as Du Bois offered a trenchant critique of Hoffman’s work that placed social forces front and center in analyzing mortality differentials, Justice John Harlan’s eloquent dissent in Plessy argued that the social consequences of state action must be accorded constitutional recognition. “The arbitrary separation of citizens, on the basis of race,” Harlan declared, “while they are on a public highway, is a badge of servitude wholly inconsistent with the civil freedom and the equality before the law established by the constitution. It cannot be justified upon any legal grounds” (163 U.S. 562). Legal scholar J. Allen Douglas argues that Plessy and its progeny can be under- stood as attempts “to locate racial identity in the body in the form of an object or property— an immutable, natural ‘thing’ possessed— to ensure a means for ‘quiet- ing title’ in whiteness” (Douglas 2003, 889). In its attempt to locate racial identity in the “immutable, natural” object of Plessy’s body, Brown’s brief opinion echoed Hoffman’s massive compilation of statistics, which similarly grounded its defense of a “segregated” approach to life insurance underwriting by locating racial dif- ference in the bodies of African Americans. Brown also located responsibility for stigma that might result from the law in the social realm, beyond the purview of the Court. As Brown declared, “Legislation is powerless to eradicate racial instincts, or to abolish distinctions based upon physical differences” (163 U.S. 551 [1896]). Louisiana could draw legal distinctions based upon such physical differ- ences without violating the Equal Protection clause of the Fourteenth Amendment, but if African Americans felt degraded by the law, that was their problem. The state could act on biological difference but had no responsibility to redress harms related to social difference. The Supreme Court’s opinion in Plessy thus legiti- mated the racial segregation of physical space by denying the legal significance of social differences that might be engendered by the law. Hoffman similarly tried to justify the social (that is, non- state- sponsored) segregation of insurance coverage by asserting the legal significance of purported biological differences among races. Each of these foundational documents of twentieth- century race theory characterized the relative legal significance of social and biological difference
- 51. The Politics ofFraming 31 in commercial contexts. In justifying racial subordination, they deny or obscure the significance of social or political forces while elevating biological difference as a justification for state- sanctioned discrimination. This schema naturalizes racial difference and places any responsibility for addressing its implications beyond the purview of the state, more appropriately addressed by individual action or structured by commercial market considerations. For the past century, this characterization of racial difference has existed in tension (and often direct conflict) with the approach of those like Du Bois and Harlan who have sought to foreground the social basis of racial difference and assert a public, state responsi- bility for both creating and redressing inequalities embedded in such differences. The 1954 case of Brown v. Board of Education repudiated Plessy’s con- cept of “separate but equal” as “inherently unequal” (347 U.S. 483 [1954]). It did so by upending the logic that relegated the “social” beyond legal consid- eration, noting that “to separate [school children] from others of similar age and qualifications solely because of their race generates a feeling of inferiority as to their status in the community that may affect their hearts and minds in a way unlikely ever to be undone” (347 U.S. 494). The opinion also marked a transition in the social sciences, away from Hoffman’s biologization of racial difference toward Du Bois’s focus on the impact of social forces on the status and situation of racial groups. The Warren Court famously cited the work of social scientists such as Kenneth Clark and Gunnar Myrdal in supporting its legal recognition of the impact of segregation upon the hearts and minds of African American children (347 U.S. 494 fn. 11; Hovenkamp 1985, 671– 72). Where Hoffman and Justice Brown foregrounded race as a biological concept in order to locate the responsibility for inequality in Black bodies and minds, Clark, Myrdal, and the Warren Court foregrounded the social dynamics of race to locate responsibility for inequality in the state and the polity. From Brown to the passage of the Civil Rights Act in 1964 and the Voting Rights Act of 1965, the emergent civil rights revolution focused on securing gov- ernment guarantees of fundamental citizenship rights for African Americans. Journalists Thomas and Mary Edsall, in their influential book Chain Reaction, have argued that the politics of this first era focused on equality of opportunity in a manner that galvanized a majority of the country and overcame conser- vative forces of racial resistance. After 1965, however, the civil rights agenda shifted its focus to “broader goals of emphasizing equal outcomes or results for Blacks” (Edsall and Edsall 1992, 7). Statistics were necessary for measur- ing such outcomes, and it is around this time that race- specific data from the Census Bureau became essential for gauging social, economic, and political discrimination in this country (Robbin 2000b, 435; Robbin 2000a, 129). It is in
- 52. 32 Jonathan Kahn thiscontext, speaking before the Second National Convention of the Medical Committee for Human Rights that Dr. Martin Luther King Jr. made his statement about injustice in health care being shocking and inhumane (King 1966). The civil rights shift in focus from access to fundamental rights of citizen- ship to outcomes secured through affirmative government action also gave rise to a conservative backlash, operationalized via Richard Nixon’s “southern strategy” that used race as a wedge issue to “divide voters over values, and to isolate one disproportionately poor segment of the population from the rest of the elector- ate” (Edsall and Edsall 1992, 5). The new Republican strategy, carried to its acme by Ronald Reagan in the 1980s, focused on the concept of “equal opportunity” as opposed to “affirmative action” and included among its supporters “radical conservatives, including those who were in fact anti- black, as well as much of the moderate center and the ideological right” (Edsall and Edsall 1992, 143). As the Edsalls note, “The changing politics of civil rights permitted the Republican Party to achieve its central goal— the establishment of a putatively egalitarian, ideologically respectable, conservatism. In 1980, Reagan and the GOP portrayed opposition to central elements of civil rights enforcement— opposition to the use of race and sex preferences in hiring and in college admittance, to court- ordered busing, and to the introduction of means- tested programs for the poor— as deriv- ing from a principled concern for fairness: as a form of populist opposition to the granting of special privilege” (Edsall and Edsall 1992, 144). The language of equal opportunity— often framed in terms of access— was clearly more accept- able than the language of affirmative action to the “emerging Republican major- ity” (Phillips 1969). This was part of a broader shift from a “‘liberal’ paradigm centered on ‘social responsibility,’ in favor of a conservative paradigm centered around ‘legitimate self- interest’” (Edsall and Edsall 1992, 97). In the legal arena, this approach manifested itself in the Reagan Department of Justice (DOJ) position on school desegregation and affirmative action, charac- terized as follows by the Edsalls: “the function of government intervention was not to correct contemporary employment, or contracting, or student assignment patterns that grew out of historic discrimination . . . Instead, the function of gov- ernment was to protect individuals from specific acts of discrimination” (Edsall and Edsall 1992, 188). The Reagan DOJ’s assault on the 1971 Supreme Court decision in Griggs v. Duke Power (401 U.S. 424 [1971]) was emblematic of this shift. In Griggs, the Court found that employment policies that are facially neu- tral with regard to race— such as aptitude test scores— that nonetheless resulted in a highly disparate impact on a minority racial group could violate Title VII of the Civil Rights Act. To justify such tests, an employer would have to meet the high standard that there was a “business necessity for such test” (401 U.S. 431).
- 53. The Politics ofFraming 33 The critique was framed in terms of individual merit being subordinated to racial quotas. For example, Linda Gottfredson of the University of Delaware argued that the logic of Griggs ignored “the whole issue of individual rights, and individual fairness . . . there is no provision for the constitutional rights, the civil rights of whites” (qtd. in Edsall and Edsall 1992, 252). Ultimately the Reagan DOJ’s approach made headway with the Supreme Court, as more conservative appointees shifted the Court’s ideological balance to the right. Later cases, beginning with City of Richmond v. J. A. Croson Com- pany (488 U.S. 469 [1989], decided under Chief Justice William Rehnquist) and culminating in Parents Involved in Community Schools v. Seattle School District No. 1 (551 U.S. 701 [2007], decided under Chief Justice John Roberts), effec- tively rolled back affirmative mandates in employment and school desegregation reaching back to Brown. A particular focus of these cases was on individuals as a locus for constitutional protection. In cases such as Richmond v. Croson, this meant requiring institutions wishing to implement affirmative action pro- grams to show particularized injury suffered by identifiable minority groups in the recent past. In her opinion for the majority, Justice Sandra Day O’Connor expressed the concern that “to accept [a] claim that past societal discrimination alone can serve as the basis for rigid racial preferences would be to open the door to competing claims for ‘remedial relief’ for every disadvantaged group. . . . Those whose societal injury is thought to exceed some arbitrary level of tolerabil- ity then would be entitled to preferential classification. We think such a result would be contrary to both the letter and the spirit of a constitutional provision whose central command is equality” (488 U.S. 505– 6 [1989]; emphasis added). O’Connor’s dismissal of the legal significance of the “societal injury” “thought” to be experienced by “minority groups” echoes Justice Brown’s similar dismissal, in Plessy, of claims about the stigma of segregation by asserting “if this be so, it is not by reason of anything found in the act, but solely because the colored race chooses to put that construction upon it” (163 U.S. 551 [1896]). He might just as easily have said that African Americans’ claims to “societal injury” resulting from enforced segregation were merely “thought to exceed some arbitrary level of tolerability” and hence did not deserve constitutional consideration. Despite writing nearly a century apart, both Justices Brown and O’Connor characterized the social realities of racial discrimination as troublesome intrusions into legal analysis. Brown wants to ignore them, O’Connor to transcend them. Both saw race as obscuring a more proper focus on individual rights and identities. Similarly, in Parents Involved, Chief Justice Roberts used a rhetoric of indi- vidual rights to strike down race- specific school assignments meant to achieve the ideal of desegregation called for in Brown v. Board of Education. Roberts
- 54. 34 Jonathan Kahn struckdown the assignment plans because they did not “provide for a meaning- ful individualized review of applicants but instead rely on racial classifications in a ‘nonindividualized, mechanical’ way” (551 U.S. 701 [2007]). The state, here, was forbidden from considering race as a primary basis for assigning stu- dents to public schools. At first blush, this might seem to be the logical culmi- nation of Brown’s repudiation of Plessy’s state- mandated racial segregation. On closer examination, however, it is revealed to be quite the opposite. In mandat- ing a “color- blind” approach to remedying the past effects of racial discrimina- tion, Roberts effectively locates responsibility for addressing the consequences of racial discrimination in the private sphere of social life, beyond the purview of the state— exactly where Justice Brown located it in his Plessy opinion. This “privatization” of discrimination is fully in line with the Reagan- era legacy of neoliberal (or neoconservative) valorization of private, market- based solutions as the appropriate means to address social problems. To the extent that the Rehnquist or Roberts courts accord any legal recogni- tion to the social conditions of racial discrimination, they have done so as an interim concept that is to be transcended. Thus, in City of Richmond v. Croson, Justice O’Connor juxtaposed group- based racial remedies against “the dream of a Nation of equal citizens in a society where race is irrelevant to personal opportu- nity and achievement” (488 U.S. 505– 6 [1989]). O’Connor reiterated her dream of a world where race was “irrelevant” in her 2003 opinion in Grutter v. Bollinger, where she anticipated that “25 years from now, the use of racial preferences will no longer be necessary to further the interest approved today” (539 U.S. 306, 343 [2003]). O’Connor’s dream of a country where “race is irrelevant” resonates with contemporary promises by biomedical researchers and clinicians yearning for a time when genetic information will similarly render race irrelevant. O’Connor, though, was speaking of making race socially and legally irrelevant, whereas pharmacogenomic experts now speak of making race biologically irrelevant. The two sentiments are connected, though, by their common disdain for the social realities of group- based racial harms. Both view social concepts of race as impediments to progress, to be transcended and left to the dustbin of history. Both also valorize the individual as the ultimate target of intervention, whether legal or medical. Neoconservative race theorists tolerate the use of race only where such schemes retain a primary focus on considering the individual attributes of persons being classified. As Justice Scalia wrote in his concur- ring opinion in the 1995 case of Adarand v. Pena, “Individuals who have been wronged by unlawful racial discrimination should be made whole; but under our Constitution there can be no such thing as either a creditor or a debtor race” (515 U.S. 200, 239 [1995]). Similarly, biomedical researchers using race
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- 56. The capital ofMysore was now at the mercy of the conquerors— and the general’s first care was to seek out the dishonoured body of its once haughty master. As it was suspected that Tippoo had fallen in the northern gateway, the bodies that lay heaped within it were hastily removed. For a time the search was unsuccessful, and torches were obtained, as the archway was low and gloomy. At last, beneath a heap of slain Mussulmans, their ruler’s body was discovered. The heat had not yet left the corpse; and though despoiled of sword and belt, sash and turban, 8 the well-known talisman that encircled his right arm was soon recognised by the conquerors. The amulet, formed of some metallic substance of silvery hue, was surrounded by magic scrolls in Arabic and Persian characters, and sewed carefully in several pieces of richly-flowered silk. The eyes were unclosed; the countenance wore that appearance of stern composure, which induced the lookers-on for a time to fancy that the proud spirit of the haughty Sultaun was still lingering in its tenement of clay. 9 The pulse was examined—its throbs were ended—and life was totally extinct. The body was directly removed to the palace, and there respectfully deposited until the necessary preparations for an honourable interment were completed—the funeral being conducted with all the ceremonies which Eastern forms require. As the procession moved slowly through the city, a “keeraut” of five thousand rupees was distributed to the fakirs—and verses from the Koran were repeated by the chief of the priests, and responded by the assistants. Minute-guns were fired from the batteries; and a guard of honour, composed of European flank companies, followed the remains of the late ruler of Mysore to the sepulchre of his once haughty father. Tippoo, notwithstanding his cruelty and despotism, was highly regarded by his Mussulman subjects. His was no common character, —brave, munificent, and a bigot to his faith, he was just the sovereign to excite Eastern admiration. A rigid observer of the Prophet’s ordinances, he attended strictly to the formulae of his
- 57. religion—wine was strictlyinhibited—and every unbeliever, not excepting his favourite employées, were treated with scorn and distrust. His establishment and household were formed on a scale of regal splendour; and when, by accident or age, their services were no longer efficient, Tippoo never permitted a servant to be discharged, although their numbers became incredible. With all the sternness of character and high-souled energy for which the departed Sultaun was remarkable, it would appear that he was prone to superstition, and not endued with that blind reliance upon Providence which, among Mussulmans, distinguishes the true believer. It is said, that the day doomed to be fatal to his empire and himself had been announced; and that, forewarned of impending calamity, he had vainly endeavoured to avert misfortune by resorting to magic ceremonies, and obtaining the interference of the Brahmins with their gods. Though a devoted follower of Mahomet, he offered these priests an oblation of money, buffaloes, an elephant, black she-goat, and dresses of cloth-beseeching them to use their influence with Heaven for his prosperity. A presentiment of coming danger had evidently cast its shadows before, and those immediately around the Sultaun’s person 10 remarked that he was heavily depressed. Yet his confidence in the strength of the city and the matériel of its garrison was unbounded. He believed that Seringapatam was impregnable, and laughed to scorn the idea that the British would ever dream of carrying it by assault. His funeral was marked by natural occurrences, that seemed in happy keeping with the obsequies of him who had left an empire for a tomb. On the evening when Tippoo was committed to his kindred dust, the sky became overcast, and a storm broke suddenly in a torrent of rain, while heaven seemed in a blaze, 11 and peal after peal of thunder appeared to shake the city to its very foundations, and added to the fearful uproar. A tempest of more violence was hardly recollected; and it seemed as if an elemental convulsion had been decreed, to announce that the once haughty tyrant of Mysore was nothing now but dust and ashes.
- 58. The storming ofSeringapatam was certainly a bold and hazardous attempt—it was nobly executed, and deserved the success it gained. The moment for action was happily selected. An Indian sun, when in meridian power, obliges man to avoid its exhausting influence, and hence, that period of the day is habitually made in Hindoostan an hour of repose and sleep. Never supposing that at this season of relaxation any attempt upon the fortress would be made, with the exception of the guards alone, the Sultaun’s troops were sleeping in their respective barracks. When the alarm was given, a panic spread; and profiting by the confusion, the assailants increased it, and prevented any attempt being made for an efficient rally and defence. To other circumstances, however, the fortunate result of the attack may in a great measure be attributed. By an unpardonable oversight the breach was unprovided with a retrenchment, and the workmen’s passage, between the ditch and rampart, left undefended. Had the breach been properly retrenched, it could not have been surmounted in the face of such a garrison; and traverses, that could have been, and were, most obstinately defended, were lost to the besieged by their stupid neglect in having left a means of escalade from the ditch, which the labour of a dozen men would have rendered impracticable. How frequently in war do great results arise from trifling causes. Every care was taken to prevent plunder and violence in the night. The inhabitants were assured of protection; and the Sultaun’s children kindly received by General Baird, and for better security sent from the fortress to the camp. Even before Tippoo’s death was ascertained, great delicacy was observed in searching the palace, where it was supposed he had concealed himself. The zenana, which contained his women, was scrupulously respected—and a guard was merely drawn around it to prevent the Sultaun’s escape, in the event of his having made that his place of refuge. Though eight thousand of Tippoo’s garrison fell in the assault, very few of the inhabitants suffered. The British loss during the siege
- 59. and storm was,of course, severe; twenty-five officers were killed or wounded in the assault; and the total casualties were, of Europeans, twenty-two officers killed, forty-five wounded, eighty-one rank and file killed, six hundred and twenty-two wounded, and twenty-two missing; of the native army, one hundred and nineteen were killed, four hundred and twenty wounded, and one hundred missing, making a general total of one thousand five hundred and thirty-one hors de combat. Having made necessary arrangements for the protection of the town, Baird marched the 33rd and 74th regiments to the palace, and in one of its magnificent courts the soldiers piled arms, and established their bivouac. 12 Sentries were placed around the zenana for its security; and the general slept on a carpet spread for his accommodation under the verandah. There lay the conqueror of Seringapatam, surrounded by his victorious soldiers, and dispensing protection to the helpless family of the fallen Sultaun. There he lay, on whose breath hung life and death—yet but a few years back, and within three hundred yards of the spot he rested on, that man had occupied a dungeon, dragging on a cheerless captivity, and waiting until the poisoned cup should be presented by “the bondsman of a slave,” or the order delivered for his midnight murder. Is not the romance of real life oftentimes wilder far than any creation of the imagination?
- 60. Sir H. Raeburn.H. Cook. D. Baird The tyrant of Mysore was gone to his account, and “how his audit stood none knew save Heaven;” but assuredly a more tiger- hearted monster never disgraced the musnud. His conduct to the European prisoners after Hyder’s death was atrocious. Of those taken with Bailey, the greater proportion perished from starvation and disease; while Matthews and his officers, who had surrendered
- 61. under the usualconditions granted in honourable warfare, and guaranteed by Tippoo himself, were savagely murdered. Some of them were led out at night, taken to a retired spot, and hewn in pieces—while seventeen were poisoned with the milk of the cocoa- nut tree. The death of the unhappy general was probably the most horrible of all. Apprised by some means of the fate that was impending, he refused the food sent by the keeladar, and obtained, from the compassion of the guard and servants, as much of theirs as merely sustained existence—the havildar who had him in charge humanely conniving at the proceeding. But when Tippoo learned that his victim still lived, the havildar was sent for, and it was intimated that if his prisoner existed beyond a certain time, his own life should pay the penalty of his humanity. The wretched instrument of tyranny communicated what had passed to the devoted general, and gave him the alternative of death from poison or starvation. “For a few days the love of life maintained a struggle with the importunate calls of hunger. These, however, prevailed in the issue of the contest—he ate of the poisoned food, and drank too—whether to quench the rage of inflamed thirst, or to drown the torments of his soul in utter insensibility—of the poisoned cup; and in six hours after the fatal repast he was found dead.” 13 The last acts of Tippoo’s life were in fit keeping with a career marked throughout by perfidy and bloodshed. In the confusion of the night of the 5th, when Colonel Wellesley’s attack on Sultaunpet failed from darkness and the intricacy of the betel tope, twelve grenadiers of the 33rd were made prisoners, and brought into Seringapatam. At midnight they were murdered by threes—“the mode of killing them was by twisting their heads, while their bodies were held fast, and thus breaking their necks.” 14 The fact was ascertained beyond doubt, for a peon pointed out the place where these ill-fated soldiers were interred, and they were examined and identified by their own officers. Other English soldiers who had been taken in assaulting outposts during the siege, had also been put to death, “having nails driven through their skulls.” 15
- 62. In alluding tothe Sultaun’s death, the regretted biographer of Sir David Baird says, “One cannot but regret, for the honour of human nature, and even for the sake of England, the end of such a man as Tippoo, shot in cold blood by a man endeavouring to rob him. Let us hope the man was a sepoy.” The man was an Irish soldier, who many years afterwards stated the fact in confession, and when in articulo mortis. “Cold blood!” Could blood be cold during the storm of a defended city, and under an Indian sun almost at noon? The tyrant only met the doom he merited. For his talents we give him credit—his courage obtains our admiration—his munificence we admit—but for the murderer of the brave we feel neither sympathy nor regret.
- 63. ASSAYE. Effect of Tippoo’sdeath upon the Native Princes.— Dhoondia’s rise and fall.—War between Scindia and Holkar.—Their differences accommodated.—Hostilities commence again.—Operations.—Camp at Assaye.— Battle.—Death of Colonel Maxwell.—Results of the Victory at Assaye.—Honours conferred on General Wellesley.—He returns to England. The death of Tippoo Saib, and the fall of Seringapatam, were astounding tidings for the native chiefs. Their delusory notions regarding their individual importance were ended—and a striking proof had been given of what little reliance could be placed on Indian mercenaries and places of strength, when England went forth in wrath and sent her armies to the field. As the fear of Britain became confirmed, so did the hatred of the native princes to every thing connected with her name. A power that had proved herself so formidable was to be dreaded, fixed as she was in the very heart of India: and, as the difficulty increased, so did the desire of freeing themselves from that thrall, which daily appeared to press upon them more heavily. With political history we have no business, farther than regards the military operations we detail; but, as warfare originates in state policy, the elucidation of the one will occasionally require that brief allusions should be made to the other. Among the prisoners delivered by the British from their dungeons after the reduction of the capital of Mysore, was a
- 64. Mahratta trooper, whohad commenced his predatory career in the cavalry of Hyder Aly, and, after his death, continued in the service of his son. For some cause he deserted, headed a band of marauders, was enticed back by the false promises of Tippoo, flung into a dungeon, and there made a Mussulman, greatly against his own will, and much to the glory of the Prophet. “No sooner were his fetters off, than his feet were again in the stirrup; and many of Tippoo’s horsemen, men of desperate fortunes, without a country, a service, or a master, became his willing followers.” His predatory band became so numerous that he overran the district of Biddenore—and at last he became so formidable, that a strong British force was sent to crush him and his robber horde. It was effected—six hundred and fifty of his followers were cut to pieces, and himself driven across the Toombudra into the country of the Peishwah. But here he was not permitted to rest. Ghokla surprised him, and routed him totally, taking his cannon, elephants, tents, and baggage. With difficulty the freebooter escaped, fled none knew where, and in a short time, Dhoondia was almost forgotten. Suddenly, however, the daring freebooter appeared again; and moving south at the head of five thousand horse, threatened the frontier of the Mysore, and naturally occasioned immense alarm over a country so open to his predatory visits. No time was lost in despatching a sufficient force to crush him altogether, or compel him to retire, and Colonel Wellesley was intrusted with the command. Another force was directed to co-operate with that of the colonel; but fearing the marauder would escape unless promptly encountered, Wellesley pushed on alone, and by forced marches succeeded in coming up with him, while Dhoondia was encamped, as he imagined, in perfect security. The fellow, naturally daring, took up a strong position, and boldly waited for the British assault. Colonel Wellesley led the charge—it was admirably made, and the marauder’s fate was decided. His cavalry were cut to pieces or dispersed, Dhoondia himself sabred, and his body, secured upon a gun, was brought in triumph to the camp. Thus perished the king of
- 65. “the two worlds,”—forsuch was the unassuming title by which the freebooter was pleased to have himself designated by his banditti. An intended expedition against Batavia, in which Colonel Wellesley was promised a command, was for some reasons abandoned. Baird, with a division, was despatched to Egypt by the Desert rout; and Wellesley reappointed to the government of the Mysore. Affairs again began to assume a threatening look. The Mahratta chiefs exhibited an unfriendly attitude; and to cement an alliance with the Peishwah, and thus tranquillize the country, a portion of Tippoo’s territory was offered and rejected. Scindia, with his army, was at Poona—and his influence directed every act of that dependent court. A misunderstanding between Scindia and Holkar brought on a war between those chiefs. Holkar advanced on Poona, compelling Scindia to accept battle, in which he was defeated—the Peishwah deserting his ally in the hour of need, and concluding a treaty with the British. To effectuate this, Wellesley, now a major-general, took the field, with orders to drive Holkar from Poona, and secure the Peishwah’s return to his capital—and learning that the Mahrattas intended to plunder Poona, the general saved it by an extraordinary forced march, accomplishing sixty miles in thirty hours—a marvellous exertion indeed to be made under an Indian sun. All for a short time was quiet; but those restless chiefs again assumed a hostile position. Scindia and the Rajah of Berar moved towards the Nizam’s frontier; while the former was negotiating with Holkar, his late enemy, to arrange their differences, and make common cause against the English. To prepare for the threatened attack, the Marquis Wellesley invested the officers commanding the armies of Hindoostan and the Deccan with full powers; and to General Wellesley a special authority was given to make peace, or commence hostilities, as his own judgment should determine. In accordance with this power, a
- 66. demand was madeon Scindia that he should separate from the Rajah of Berar, and re-cross the Nerbuddah. To this demand an evasive reply was returned—and Eastern cunning was employed to obtain such delay as should permit the chieftains’ plans to be matured, and enable them to take the field in force. This shuffling policy was, however, quite apparent; and on the first information that his political agent had quitted Scindia’s camp, Wellesley suddenly broke up his cantonments, and marched directly on Ahmednuggur. This ancient town was defended in the Eastern fashion with a high wall, flanked at its bends and angles by a tower, and garrisoned by some of Scindia’s infantry and an auxiliary force of Arabs, while a body of the chieftain’s cavalry occupied the space between the pettah and the fort. Wellesley, without delay, assaulted the town, and carried it by escalade. On the 10th, the British cannon opened on the fort—the keeladar in command proposed terms, and the English general expressed a readiness to listen to his propositions, but the guns continued working. Indian diplomacy has no chance when batteries are open; and, on the 12th, a garrison of fourteen hundred marched out, and the place was delivered up. This fortress, from its locality, was valuable; it secured the communications with Poona, made a safe depôt for military stores, and was centrically placed in a district whose revenue was above 600,000 rupees. With a short delay, Wellesley moved on Aurungabad, and entered that splendid city on the 29th. The enemy moved in a south- easterly direction, threatening Hyderabad—while the British, marching by the left bank of the Godaverey, secured their convoys from Moodgul, and obliged Scindia to retire northwards. As yet the Mahratta chiefs were moving a cavalry force north, with but a few matchlock-men; but they were joined now by their whole artillery and sixteen battalions of infantry, officered chiefly by Frenchmen. On the 21st, at a conference at Budnapoor, General Wellesley and Colonel Stevenson arranged a combined attack for the 24th. They were to move east and west, pass the defiles on the same day,
- 67. and thus preventany movement of the enemy southward. A mistake, in distance, brought General Wellesley much sooner to his halting-place than had been calculated; and learning that the Mahratta army were already breaking up to retire, he sent orders to Colonel Stevenson to advance; and announcing his immediate march on Scindia, begged his colleague to hurry forward to his assistance. The cavalry consisted of the 19th Light Dragoons, and three native regiments, under the command of Colonel Maxwell, a bold and skilful officer. General Wellesley accompanied the horse—the infantry following in light marching order. After passing a league and half of ground, the advance reached an eminence; and on the right, and covering an immense extent of country, the Mahratta army appeared. In brilliant sunshine, nothing could be more picturesque than Scindia’s encampment. The varied colours of the tents, each disposed around its own chieftain’s banner without order or regularity, with “streets crossing and winding in every direction, displayed a variety of merchandise, as in a great fair. Jewellers, smiths, and mechanics were all attending as minutely to their occupations, and all as busily employed, as if they were at Poona, and in peace.” 16 In this enormous camp, fifty thousand men were collected—the river Kaitna running in their front—the Suah in their rear. These rivers united their waters at some distance beyond the left of the camp, forming a flat peninsula of considerable extent. The native infantry and all the guns were in position on the left, retired upon the Suah, and appuied on the village of Assaye—the cavalry were entirely on the right. The position was naturally strong; for the banks of the Kaitna are steep and broken, and the front very difficult to attack. As the British cavalry formed line on the heights, it presented a strange but glorious contrast to the countless multitude of Mahratta horsemen, who were seen in endless array below. The English brigade, scarcely numbering three thousand sabres, took its position
- 68. with all theboldness of a body having an equal force opposed. In number Scindia’s cavalry were fully ten to one; as it was ascertained that, with his allies, the horsemen actually on the field exceeded thirty thousand. Having made a careful reconnaissance, General Wellesley determined to attack—and, when the infantry came up, it was instantly executed. While examining the position, immense masses of Scindia’s cavalry moved forward, and threw out skirmishers, which were directly driven in. Wellesley having discovered a neglected ford, decided on crossing over, and, by attacking the infantry and guns, embarrass the immense cavalry force of Scindia, and oblige it to manœuvre to disadvantage, and act on the confined space the ill- selected ground afforded. The infantry had now come up, and, in column, they were directed on the river. A fire from the Mahratta guns immediately opened, but the range was far too distant to permit the cannonade to be effective, or check the forward movement of the columns. The whole were now across the river; the infantry formed into two brigades, and the cavalry in reserve behind them, ready to rush on any part of the battle-ground where advantage could be gained, or support should be required. The Mysore horse and the contingent of the Peishwah were merely left in observation of the enemy’s right. This flank attack obliged Scindia to change his front. He did so with less confusion than was expected; and by his new disposition rested his right upon the Kaitna, and his left upon the Suah and Assaye. His whole front bristled with cannon—and the ground immediately around the village seemed, from the number of guns, like one great battery. The fire from this powerful artillery was of course destructive; and the British guns were completely overpowered, and in a very few minutes silenced entirely. This was the crisis; and on the determination of a moment hung the fortune of a very doubtful day. Without hesitation Wellesley abandoned his guns, and advanced
- 69. with the bayonet.The charge was gallantly made, the enemy’s right forced back, and his guns captured. While this movement was being executed, the 74th and light infantry pickets in front of Assaye, were severely cut up by the fire from that place. Perceiving the murderous effect of the fusilade, a strong body of the Mahratta horse moved swiftly round the village, and made a furious onset on the 74th. Maxwell had watched the progress of the battle, and now was his moment of action. The word was given,—the British cavalry charged home—down went the Mahrattas in hundreds beneath the fiery assault of the brave 19th, and their gallant supporters the sepoys; while, unchecked by a tremendous storm of grape and musketry, Maxwell pressed his advantage, and cut through Scindia’s left. The 74th and the light infantry reformed, and, pushing boldly on, completed the disorder of the enemy, preventing any effective attempt to renew a battle, the doubtful result of which was thus in a few minutes decided by the promptitude of the general. Some of Scindia’s troops fought bravely—and the desperate obstinacy with which his gunners stood to the cannon, was almost incredible. They remained to the last—and were bayoneted around the guns, which they refused, even in certain defeat, to abandon. The British charge was, indeed, resistless; but in the enthusiasm of success, at times there is a lack of prudence. The sepoys rushed wildly on—their elated ardour was uncontrollable—while a mass of the Mahratta horse arrayed upon the hill, were ready to rush upon ranks disordered by their own success. But Wellesley foresaw, and guarded against the evil consequences that a too excited courage might produce. The 78th were kept in hand; and cool, steady, and with a perfect formation, they offered an imposing front, that the Mahratta cavalry perceived was unassailable. A strong column of the enemy, however, that had been only partially engaged, now rallied and renewed the battle, joined by a
- 70. number of Scindia’sgunners and infantry, who had flung themselves as dead upon the ground, and thus escaped the sabres of the British cavalry. Maxwell’s brigade, who had re-formed their ranks and breathed their horses, dashed into the still disordered ranks of these half-rallied troops—a desperate slaughter ensued, and the Mahrattas were totally routed; but the British lost their chivalrous leader—and in the moment of victory, Maxwell died in front of the battle, “and, fighting foremost, fell.” The last effort of the day was made by a part of the artillery who were in position near the village of Assaye—and in person Wellesley led on the 78th Highlanders and the 7th native cavalry. In the attack the general’s horse was killed under him; but the enemy declined the charge, broke, fled, and left a field cumbered with their dead, and crowded with cannon, bullocks, caissons, and all the matériel of an Eastern army, to the conquerors. The evening had fallen before the last struggle at Assaye was over—but the British victory was complete. Twelve hundred of Scindia’s dead were found upon the field; while, of his wounded, scarcely an estimate could be hazarded, for all the villages and adjacent country were crowded with his disabled soldiery. The British loss was of necessity severe, and it might be estimated that one- third of the entire army was rendered hors de combat. To call Assaye a brilliant victory, is only using a term simply descriptive of what it was. It was a magnificent display of skill, moral courage, and perfect discipline, against native bravery and an immense numerical superiority. But it was not a mass of men, rudely collected, ignorant of military tactics, and unused to combinations, that Wellesley overthrew. Scindia’s army was respectable in every arm, his cavalry excellent of their kind, and his artillery well served. His infantry were for a long time under the training of French officers; and the ease and precision with which he changed his front when the British crossed the Kaitna to assail his flank, shewed that the lessons of the French disciplinarians had not been given in vain.
- 71. The total dérouteof Assaye was followed by a tide of conquest. Fortress after fortress was reduced, and Scindia sought and obtained a truce. The British arms were next turned against the Rajah of Berar—General Wellesley marched against him—for the truce was ended suddenly, and Scindia joined his colleague with all his disposable force. On the plains of Argaum Wellesley found the confederated chiefs drawn up in order of battle. Scindia’s immense cavalry formed the right—on the left were the Berar infantry and guns, flanked by the Rajah’s cavalry—while a cloud of Pindaries were observed on the extreme right of the whole array. The British moved down and formed line, the infantry in front, and the cavalry in reserve. The battle was short and decisive. The Berar’s Persian infantry attacked the 74th and 78th regiments, and were literally annihilated; while Scindia’s cavalry charge failed totally, the 26th native regiment repulsing it most gloriously. The British now rushed forward—and the Mahrattas broke and fled in every direction, abandoning their entire park; 17 while the cavalry pursued by moonlight the scattered host, and captured an immense number of elephants and beasts of burden, the entire baggage, and stores and arms of every description. The fall of some places of strength, and the total defeat of their armies in the field, humbled Scindia and his ally, the Rajah, and obliged them to sue and obtain a peace. The brilliant career of General Wellesley had gained him a name in arms, which future victories were to immortalize. To commemorate the battle of Assaye, a monument was erected in Calcutta, a sword presented to the victor by the citizens, and a gold vase by the officers he commanded. He was also made a Knight Companion of the Bath, and honoured by the thanks of Parliament. Even from the inhabitants of Seringapatam he received an address, remarkable for its simplicity and affection, committing him to the care of “the God of all castes,” and invoking for him “health, glory, and happiness.” In 1805 he returned to his native land, “with war’s red honours on his
- 72. crest,” bearing withhim from the scene of his glory the high estimation and affectionate wishes of every caste and colour.
- 73. EGYPTIAN EXPEDITION. British armyemployed in useless expeditions.—Finally ordered to Egypt.—Voyage thither.—Arrival in the Bay of Aboukir.—Preparations for disembarkation.—Landing.— Attack and repulse of the French.—Sir Ralph Abercrombie advances—forces the French position—attempts the lines in front of Alexandria by a coup-de-main, and is repulsed. —Falls back, and takes up a position. Whether the employment of a British force in Egypt, under the circumstances Europe then presented, was a judicious disposal of it, is a question that would involve too large a political inquiry; “but certain it is that any positive object would have been preferable to the indeterminate counsels and feebly executed plans which wasted the soldiers’ health and spirits, compromised the honour of the army, and so materially prejudiced the interests of a country.” 18 In 1800, an attempt on Cadiz was planned and abandoned; and an army, the corps élite of Britain, was kept idly afloat in transports at an enormous expense, suffering from tempestuous weather, and losing their energies and discipline, while one scheme was proposed after another, only to be considered and rejected. By turns Italy and South America were named as countries where they might be successfully employed—but to both designs, on mature deliberation, strong objections were found; and on the 25th of October final orders were received from England, directing the fleet and army forthwith to rendezvous at Malta, and thence proceed to Egypt.
- 74. The troops onreaching the island were partially disembarked while the ships were refitting; and the fresh provisions and salubrious air of Valetta soon restored many who had suffered from long confinement and salt rations. Five hundred Maltese were enlisted to serve as pioneers. Water-casks were replenished, stores laid in, the troops re-embarked; and on the 20th of December, the first division got under weigh, followed by the second on the succeeding day. Instead of sailing direct for their destination, the fleet proceeded to the Bay of Macri. Finding that roadstead too open, the admiral shaped his course for the coast of Caramania. There he was overtaken by a gale of wind,—and though close to the magnificent harbour of Marmorrice, its existence appears to have been known, out of a fleet of two hundred vessels, only to the captain of a brig of war. As the fleet were caught in a heavy gale on a lee shore, the result might have been most disastrous to the transports, who could not carry sufficient canvas to work off the land. Fortunately, Marmorrice proved a haven of refuge; and the surprise and pleasure of the soldiers can scarcely be described, when they found themselves in smooth water, and surrounded by the grandest scenery imaginable, “though, the instant before, the fleet was labouring in a heavy gale, and rolling in a tremendous sea.” 19 Another landing of the troops took place, and no advantages resulted from it to compensate the loss of time which allowed the French to obtain strong reinforcements. Goat’s flesh was abundant, and poultry plentiful; but the Turks had probably been apprised beforehand of the munificence of the English, as every article was advanced on the arrival of the fleet four hundred per cent. in price. The remount of the cavalry formed an ostensible, almost an only reason, for the expedition visiting Asia Minor, and consuming time that might have been so successfully employed. The horses arrived, but from their wretched quality and condition they proved a sorry equivalent for the expense and trouble their acquisition cost. 20
- 75. While the expeditionwas in the harbour of Marmorrice, an awful tempest came suddenly on, and raged with unintermitting fury for two days. It thundered violently—hailstones fell as large as walnuts —deluges of water rushed from the mountains, sweeping every thing away. The horses broke loose—the ships drove from their anchors—the Swiftsure, a seventy-four, was struck with lightning— and many others lost masts, spars, and were otherwise disabled. Amid this elemental war, signal-guns fired from vessels in distress, and the howling of wolves and other wild animals in the woods, added to the uproar. After a protracted delay in waiting for the Turkish armament, which was expected to have been in perfect readiness, the expedition left the harbour without it on the 23rd of February. The sight, when the fleet got under weigh, was most imposing; the men- of-war, transports, and store-ships amounting to one hundred and seventy-five sail. The British army was composed of the whole or portions of twenty-seven regiments, exclusive of artillery and pioneers. 21 Its total strength in rank and file, including one thousand sick and five hundred Maltese, was fifteen thousand three hundred and thirty men. In this number all the attachés of the army were reckoned— and consequently the entire force that could have been combatant in the field would not exceed twelve thousand bayonets and sabres. This was certainly a small army with which to attack an enemy in possession of the country, holding fortified posts, with a powerful artillery, a numerous cavalry, and having a perfect acquaintance with the only places on the coast where it was practicable to disembark in safety. On the 1st of March the Arab’s tower was in sight,—and next morning the whole fleet entered Aboukir Bay. 22 On the following morning a French frigate was seen running into Alexandria, having entered the bay in company with the British fleet. 23
- 76. The weather wasunfavourable for attempting a landing of the troops. This was a serious disappointment, and an accidental occurrence added to the inconvenience it would have otherwise caused. Two engineer officers, engaged in reconnoitring the coast, advanced too far into the bay through an over-zealous anxiety to mark out a landing-place. They were seen and overtaken by a French gun-boat, who fired into the cutter, killing one of the engineers and making the other prisoner. The survivor was brought ashore, and forwarded to Cairo to General Menou; and thus, had the British descent been before doubtful, this unfortunate discovery would have confirmed the certainty of an intended landing, and allowed ample time for preparations being made to oppose it. The weather moderated in the morning of the 7th, and the signal was made by the flag-ship “to prepare for landing.” But the sea was still so much up that the attempt was postponed,—and with the exception of an affair between the boats of the Foudroyant and a party of the enemy, whom they drove from a block-house, that day passed quietly over. The 8th was more moderate—the swell had abated—and preparations for the landing commenced. At two o’clock the first division were in the boats, amounting to five thousand five hundred men, under General Coote; while the ships, on board of which the remainder of the army still remained, were anchored as near the shore as possible, to allow the landing brigades their immediate support. The right and left flanks of the boats were protected by launches and gun-brigs; three sloops of war, with springs upon their cables, had laid their broadsides towards the beach; and the Fury and Tartarus had taken a position to cover the troops with the fire of their mortars. The French were drawn up on a ridge of sandhills, with an elevated hillock in their centre, and twelve pieces of artillery in position along their line. The moment was one of absorbing interest —and many a heart beat fast as, in half-companies, the soldiers
- 77. stood under armsin the launches, impatiently waiting for the signal to advance. A gun was fired; off sprang the boats, while the men-of-war opened their batteries, and the bomb-vessels commenced throwing shells. The cannonade from the shipping was promptly returned by the French lines and Castle of Aboukir; while on swept the regiments towards the beach, under a furious discharge of shot and shells, and a torrent of grape and musketry, that ploughed the surface of the water, 24 or carried death into the dense masses of men crowded in the launches. But nothing could exceed the glorious rivalry displayed by both services in advancing: while shot was hailing on the water, the sailors, as the spray flashed from their oar-blades, nobly emulated each other in trying who should first beach his boat. Each cheered the other forward,—while the soldiers caught the enthusiastic spirit and answered them with loud huzzas. The beach was gained,—the 23rd and 40th jumped into the surf, reached the shore, formed as they cleared the water, and rushed boldly up the sandhills, never attempting to draw a trigger, but leaving all to be decided by the bayonet. The French regiments that confronted them were driven from the heights; while pressing on, the Nole hills in the rear, with three pieces of artillery, were captured. The 42nd were equally successful; they formed with beautiful regularity in the face of a French battalion protected by two guns— and after defeating a charge of two hundred cavalry, stormed and occupied the heights. While these brilliant attacks had been in progress, the Guards were charged by the French dragoons in the very act of landing, and a temporary disorder ensued. The 58th had formed on the right, and, by a well-directed fire, repulsed the cavalry with loss. The Guards corrected their line, and instantly showed front—while the French, unable to shake the formation of the British, retired behind the sandhills. The transport boats had been outstripped by those of the men- of-war—and consequently, the Royals and 54th only touched the
- 78. shore as thedragoons rode off. Their landing was, however, admirably timed; for a French column, under cover of the sandhills, was advancing with fixed bayonets on the left flank of the Guards. On perceiving these newly-landed regiments, its courage failed; it halted, delivered a volley, and then hastily retreated. The British had now possession of the heights; the brigade of Guards was formed and advancing, and the boats returning to the ships for the remainder of the army. Observing this, the enemy abandoned their position on the ridge, and, retiring behind the sandhills in the rear, for some time kept up a scattered fire. But on the British moving forward they deserted the ground entirely, leaving three hundred killed and wounded, eight pieces of cannon, and a number of horses to the victors. The remainder of the brigades were safely disembarked—Sir Ralph Abercrombie landed—and a position taken up, the right upon the sea, and the left on Lake Maadie. A landing in the face of an enemy, prepared and in position like the French, under a heavy cannonade, and effected on a dangerous beach, would naturally occasion a severe loss of life; and several promising officers, and nearly five hundred men, were killed, wounded, and missing. The only surprise is, that the casualties were not greater. The mode in which an army is debarked exposes it unavoidably to fire—and troops, packed by fifties in a launch, afford a striking mark for an artillerist. Guns, already in position on the shore, enable those who work them to obtain the range of an approaching object with great precision; and the effect of a well- directed shot upon a boat crowded with troops is necessarily most destructive. 25 After the army had been united, it advanced by slow marches, some trifling skirmishing daily occurring between the advanced posts. On the 12th, the British bivouac was at the town of Mandora, and on the 13th Sir Ralph moved forward to attack the enemy, who were posted on a ridge of heights. The French, reinforced by two half brigades of infantry, a regiment of cavalry from Cairo, and a corps from Rosetta, mustered
- 79. about five thousandfive hundred of that arm, with five hundred horse, and five-and-twenty pieces of artillery. Their position was well chosen, as it stood on a bold eminence having an extensive glacis in its front, which would allow full sweep for the fire of its numerous and well-appointed artillery. The English attack was directed against the right wing,—and in two lines, the brigades advanced in columns of regiments, the reserve covering the movements, and marching parallel with the first. Immediately on debouching from a date-wood, the enemy descended from the heights, and the 92nd—the leading regiment on the left—was attacked by a furious discharge of grape and musketry; while the French cavalry charged down the hill, and threw themselves upon the 90th, which led the right column. Though the charge was most gallantly made, Latour Maubourg leading the dragoons at a gallop, a close and shattering volley from the 90th obliged them to turn along the front of the regiment, and retreat with a heavy loss. A few of the leading files, however, had actually reached the line, and were bayoneted in a desperate effort to break it. The attempt failed—and in executing his duty gloriously, their gallant leader was desperately wounded. The British pushed the reserve into action on the right; the Guards, in the rear, to support the centre, and Doyle’s brigade, in column, behind the left. The French were on every point forced from their position—but, covered by the fire of their numerous guns and the fusilade of their voltigeurs, they retreated across the plain, and occupied their own lines on the heights of Alexandria. Dillon’s regiment, during this movement, made a brilliant bayonet charge, captured two guns, and turned them instantly on the enemy. Wishing to follow up this success, Sir Ralph attempted to carry the position by a coup de main; and advancing across the plain, he directed the brigades of Moore and Hutchinson to assault the flanks of the French position simultaneously. To attempt dislodging a force, posted as the enemy were, could only end in certain discomfiture. The troops could make no way 26 —a murderous
- 80. fire of artillerymowed them down—“the French, no longer in danger, had only to load and fire; aim was unnecessary, the bullets could not but do their office, and plunge into the lines.” For several hours the English remained, suffering this exterminating fire patiently; and at sunset, the order being given to fall back, the army retired and took up a position for the night. 27 The British loss, its strength considered, was immense. Eleven hundred men were killed and wounded,—while that of the enemy amounted barely to a third, with four field-pieces, which they were obliged to abandon. A strong position was now taken by Sir Ralph; the right reached the sea, resting on the ruins of a Roman palace, and projecting a quarter of a mile over heights in front. This promontory of sandhills and ruins was some three hundred yards across, sloping gradually to a valley, which divided it from the hills which formed the rest of the lines. The extreme left appuied on two batteries—and Lake Maadie protected the rear—and the whole, from sea to lake, extended about a mile. In front of the right, the ground was uneven; but that before the centre would admit cavalry to act. The whole space had once been a Roman colony—and, on its ruined site, a hard-fought day was now about to be decided.
- 81. BATTLE OF ALEXANDRIA. Frenchposition.—The English fortify their camp.— Occurrences.—Menou attacks the British lines.—Battle of the 21st.—The English commander wounded.—Casualties of both armies.—Remarks.—Death of Sir Ralph Abercrombie. The French position was still stronger than the English lines, as it stretched along a ridge of lofty hills, extending from the sea on one side to the canal of Alexandria on the other. A tongue of land in the advance of their right, ran nearly for a mile parallel with the canal, and had obliged the British posts to be thrown considerably back, and thus obliqued their line. In a classic and military view, nothing could be more imposing than the ground on which Menou’s army were encamped. In the centre stood Fort Cretin; on the left, Fort Caffarelli; Pompey’s Pillar showed boldly on the right; Cleopatra’s Needle on the left; while Alexandria appeared in the background, with its walls extending to the sea; and at the extremity of a long low neck of land, the ancient Pharos was visible. Wherever the eye ranged, objects of no common interest met it: some of the “wonders of the world” were contiguous; and “the very ruins under foot were sacred from their antiquity.” The British army had little leisure, and probably as little inclination, to indulge in classic recollections. The men were busily engaged in fortifying the position, bringing up guns for the batteries, and collecting ammunition and stores. The magazines were inconveniently situated; and to roll weighty spirit-casks through the deep sands was a most laborious task, and it principally devolved
- 82. upon the seamen.The fuel was particularly bad, the billets being obtained from the date-tree, which it is almost impossible to ignite, and whose smoke, when kindling, pains, by its pungency, the eyes of all within its influence. Water was abundant, but of indifferent quality; 28 and as Menou, with a most unjustifiable severity, inflicted death upon the Arabs who should be found bringing sheep to the camp, the price of fresh provisions was high, and the supply precarious. On the 10th, an affair took place between an enemy’s patrol and a detachment of British cavalry, under Colonel Archdale. It was a very gallant, but very imprudent encounter—a third of the men, and half the officers, being killed or taken. Another casualty occurred also, to the great regret of all. Colonel Brice, of the Guards, in going his rounds, was deceived by a mirage; and coming unexpectedly on an enemy’s post, received a wound of which he died the third day, a prisoner. Menou was reported to be advancing; and an Arab chief apprised Sir Sydney Smith, that the French intended an attack upon the British camp next morning. The information was discredited; but the result proved that it was authentic. On the 21st of March, the army, at three o’clock, as usual, stood to their arms—and for half an hour all was undisturbed. Suddenly, a solitary musket was fired, a cannon-shot succeeded it, and a spattering fusilade, broken momentarily with the heavier booming of a gun, announced that an attack was being made. The feebleness of the fire rendered it doubtful against what point the real effort of the French would be directed. All looked impatiently for daybreak, which, though faintly visible in the east, seemed to break more tardily the more its assistance was desired. On the right, a noise was heard; all listened in breathless expectation; shouts and a discharge of musketry succeeded; the roar increased; momentarily it became louder,—there indeed the enemy were in force—and there the British line was seriously assailed.
- 83. Favoured by brokenground, and covered by the haze of morning, the French had partially surprised the videts, attacked the pickets, and following them quickly, drove them back upon the line. One column advanced upon the ruin field by the 58th, their drums beating the pas de charge, and the officers cheering the men forward. Colonel Houston, who commanded the regiment, fearing lest his own pickets might have been retiring in front of the enemy’s column, reserved his fire, until the glazed hats of the French were distinguishable in the doubtful light. The 58th lined a wall partly dilapidated, but which in some places afforded them an excellent breastwork; and the twilight allowed the French column to be only distinctly seen when within thirty yards of the post. As the regiment occupied detached portions of the wall, where its greater ruin exposed it to attack, an irregular but well-sustained fusilade was kept up, until the enemy’s column, unable to bear the quick and well-directed musketry of the British, retired into a hollow for shelter. There they reformed, and wheeling to the right endeavoured to turn the left of the redoubt, while another column marched against the battery occupied by the 28th. On the front attack the regiment opened a heavy fire—but part of the enemy had gained the rear, and another body penetrated through the ruined wall. Thus assailed on every side, the 58th wheeled back two companies, who, after delivering three effective volleys, rushed forward with the bayonet. The 23rd now came to support the 58th—while the 42nd moved round the exterior of the ruins, cutting off the French retreat; and of the enemy, all who entered the redoubt were killed or taken. The situation of the 28th and 58th was, for a time, as extraordinary as it was dangerous—for at the same moment they were actually repelling three separate attacks, and were assailed simultaneously on their front, flanks, and rear. The 42nd, in relieving the 28th, was exposed to a serious charge of French cavalry. Nearly unperceived, the dragoons wheeled suddenly round the left of the redoubt, and though the ground was full of holes, rode furiously over tents and baggage, and, charging en masse, completely overthrew the Highlanders. In this desperate
- 84. emergency, the 42nd,with broken ranks, and in that unavoidable confusion which, when it occurs, renders cavalry so irresistible, fought furiously hand to hand, and opposed their bayonets fearlessly to the sabres of the French. The flank companies of the 40th, immediately beside them, dared not, for a time, deliver their fire, the combatants were so intermingled in the mêlée. At this moment General Stuart brought up the foreign brigade in beautiful order, and their heavy and well-sustained fusilade decided the fate of the day “Nothing could withstand it, and the enemy fled or perished.” During this charge of cavalry, Sir Ralph Abercrombie, who had ridden to the right on finding it seriously engaged, advanced to the ruins where the contest was raging, after having despatched his aide-de-camp 29 with orders to the more distant brigades. He was quite alone; and some French dragoons having penetrated to the spot, one, remarking that he was a superior officer, charged and overthrew the veteran commander. In an attempt to cut him down, the old man, nerved with a momentary strength, seized the uplifted sword, and wrested it from his assailant, while a Highland soldier transfixed the Frenchman with his bayonet. Unconscious that he was wounded in the thigh, Sir Ralph complained only of a pain in his breast, occasioned, as he supposed, by a blow from the pommel of the sword during his recent struggle with the dragoon. The first officer that came up was Sir Sydney Smith, who, having broken the blade of his sabre, received from Sir Ralph the weapon of which he had despoiled the French hussar. The cavalry being completely repulsed, Sir Ralph walked firmly to the redoubt on the right of the Guards, from which a commanding view of the entire battle-field could be obtained. The French, though driven from the camp, still maintained the battle on the right, and charging with their reserve cavalry, attacked the foreign brigade. Here, too, they were resolutely repulsed; and their infantry, finding their efforts everywhere unsuccessful, changed their formation and acted en tirailleur, with the exception of one battalion, which still
- 85. held a flèche 30 infront of the redoubt, on either flank of which the Republican colours were planted. At this time the ammunition of the British was totally exhausted; some regiments, particularly the reserve, had not a single cartridge; and in the battery the supply for the guns was reduced to a single round. In consequence, the British fire on the right had nearly ceased, but in the centre the engagement still continued. There the attack had commenced at daybreak; a column of grenadiers, supported by a heavy line of infantry, furiously assailing the Guards, and driving in the flankers which had been thrown out to check their advance. Observing the echelon 31 formation of the British, the French general instantly attempted to turn their left; but the officer commanding on that flank as promptly prevented it, by throwing some companies sharply back, while Coote’s brigade having come up, and opening its musketry, obliged the enemy to give way and retire. Finding the attack in column fail, the French broke into extended order and opened a scattered fusilade, while every gun that could be brought to bear by their artillery was turned on the English position. But all was vain; though suffering heavily from this murderous fire, the formation of the Guards was coolly corrected when disturbed by the cannonade—while the fine and imposing attitude of these regiments removed all hope that they could be shaken, and prevented any renewal of attack. The British left had never been seriously attempted, consequently its casualties were very few, and occasioned by a distant fire from the French guns, and a trifling interchange of musketry. While the British right was, from want of ammunition, nearly hors de combat, the French approached the redoubt once more. They, too, had expended their cartridges—and both the assailants and assailed actually pelted the other with stones, 32 of which missiles there was a very abundant supply upon the ground. A sergeant of the 28th had his skull beaten in by a blow, and died
- 86. upon the spot.The grenadiers of the 40th, however, not relishing this novel mode of attack and defence, moved out to end the business with the bayonet. Instantly the assailants ran—the sharpshooters abandoned the hollows—and the battalion, following their example, evacuated the flèche, leaving the battle-ground in front unoccupied by any save the dead and dying. Menou’s attempts had all been signally defeated. He perceived that the British lines had sustained no impression that would justify a continuation of the attack, and he determined to retreat. His brigades accordingly moved off under the heights of their position in excellent order; and though, for a considerable distance, they were forced to retire within an easy range of cannon-shot, the total want of ammunition obliged the English batteries to remain silent, and permit the French march to be effected with trifling molestation. The cannon on the British left, and the guns of some men-of-war cutters, which had anchored close in with the land upon the right, kept up a galling fire, their shots plunging frequently into the French ranks, and particularly into those of a corps of cavalry posted on a bridge over the canal of Alexandria, to observe any movement the British left might threaten. At ten o’clock the action had ended. Sir Ralph Abercrombie previously refused to quit the field, and remained exposed to the heavy cannonade directed on the battery where he stood, until perfectly assured that the French defeat had been decisive. From what proved a fatal wound he appeared at first to feel but little inconvenience, complaining only of the contusion on his breast. 33 When, however, the day was won, and exertion no longer necessary, nature yielded, and in an exhausted state he was carried in a hammock off the field, accompanied by the tears and blessings of the soldiery. In the evening he was removed, for better care, on board the flag-ship, where he continued until his death. Immediate attention was bestowed upon the wounded, who, from the confined nature of the ground on which the grand struggles of the day had occurred, were lying in fearful numbers all around.
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