DAVIS, Calif.--Prof. James S. Jackson says the overwhelming propensity among researchers to view data on health disparities among African Americans through the lens of race is highly misleading, and masks deeper truths about how blacks and others cope with societal stressors.
“We know that race matters,” Jackson said to scientists attending the Resource Centers for Minority Aging Research conference in April at the University of California, Davis. But the color of one’s skin is genetically irrelevant to understanding racial and ethnic disparities in health, he explained.
Jackson is the co-director of the Michigan Center for Urban African American Aging Research [http://mcuaaar.wayne.edu/about.php], at the University of Michigan and Wayne State University. During his keynote address at the national research conference, he described findings that challenge the very basis of racial categories in research on health disparities.
Over 30 Years of Research
Extensive research by Jackson and his colleagues over three decades shows that persistent health disparities between African Americans and non-Hispanic whites result both from structural racism in the United States and how people respond differently to pervasive stress.
Their studies--both sociological and biochemical--have found that as they age, blacks, unlike other ethnic or racial groups, engage in “bad behaviors,” such as excessive smoking, overeating and substance abuse, that enable them to cope emotionally with their situations while also undermining their physical health.
Between African Americans and whites, Jackson said, aging matters: “You find very little disparity early in the life course. They tend to accelerate over the life course.”
Jackson, who also directs the University of Michigan’s Institute for Social Research, sharply criticized the research community for perpetuating the false notion that genetic differences can account for underlying health disparities.
“I think it’s very important to dispel the notion that the biology of blacks and whites is different,” Jackson stated.
Because race is such a slippery concept, he explained, it fails to serve as a reliable scientific variable that can be singled out to help researchers better understand the root causes of widespread problems, such as a group’s apparently self-defeating behavioral choices.
People’s Lived Experience
Race, Jackson said, “has to do with people’s lived experience,” not genetics. He asserted that too much research on health disparities divides findings according to racial groups without recognizing the complexity of race, which reflects “a wide set of experiences that are difficult to array along a simple dimension of black and white, or Asian, or whatever kind of group you might mean.”
Health studies that segment research racially, rather than by social and cultural factors, too often lead researchers to assume that black people escape their tensions by engaging in hedonistic behaviors leading to poor health outcomes.
Jackson stressed that racial framing of health disparities has generally led researchers to conclude that African Americans merely need to stop smoking, drinking and “doing all these bad things--and everything is going to be all right.”
By failing to dig more deeply, such shallow framing both reinforces racial stereotypes and misses important social and behavioral factors that can account for African Americans’ poor health outcomes across most disease categories, such as diabetes, stroke—and overall life expectancy.
Jackson is one of 15 leading academic experts in aging and longevity who comprise the prestigious MacArthur Foundation Research Network on an Aging Society. Among the panel’s 2012 findings that Jackson called “startling” is that four in 10 black males with low educational levels, who initially live to age 25, die before they reach 65. That compares with one in 10 in all other groups.
The news was also bad for women across ethnic or racial groups who have low versus high educational attainment. Under-educated white women live a whopping 10.4 years less than their more schooled cousins. African American women schooled 12 years or under live 6.5 years less than well-educated lack women. The gap for Latinas is 2.9 years of life expectancy.
Jackson emphasized, “This is not a story about individual interventions to try to deal with individual people. These are problems of bad environments. People try to cope with those bad environments and have negative outcomes as a function of that.”
He and his research staff found that when they “threw away the designation of race” in analyzing large national health surveys, people clustered together in integrated groups, not by race, but by their propensity to engage in healthier or less healthy behaviors.
More informed research, he said, would examine issues though the lenses of behavioral propensities, class, gender, immigration and other conditions of life as they age. “The notion of homogeneity in the research on ethnic and racial populations is not tenable,” he declared.
Jackson emphasized that although color differences are literally skin-deep, “it’s not about racelessness,” or false notions of a post-racial society.
He told researchers at the conference “You have to understand that being in a particular racial categorization makes you vulnerable from attacks from the environment, whether that is other people or circumstances that happen to you. That’s what race does.”
Race, when it is misapplied as a research variable, obscures deeper issues that can help explain underlying social and behavioral factors and lead to potential solutions, he said.
Although Jackson’s research discounts the role of innate genetic variations by race, his studies have shown surprising biological differences between how whites and others respond to negative circumstances and how African Americans do.
White and Black Women
Overall, whites and others who slide into self-destructive behaviors decline in both their physical and mental health. For instance, Jackson’s research team is also trying to understand why white women with low educational levels constitute the only demographic group in the United States that has lost years of life expectancy in the past quarter century
Not only do they “have the worst combination of really bad behaviors in the face of stressors,” such as rising levels of obesity plus other destructive habits, but mental health problems tend to accompany their poor physical health. Not so, African American women.
Biochemical studies at Jackson’s center have shown while whites and others with a propensity for poor behaviors usually experience a cascade of hormones that set off high levels of depression and anxiety, blacks commonly have a response that goes in the opposite direction.
Jackson explained his program’s 30 years of data reveal that 80 percent of African Americans who live under high stress without delving into unhealthy behaviors are the ones who develop major depression. But those who do indulge fare much better emotionally with lower prevalence rates of emotional disorders at almost any age. Why?
He continued, “Our argument is that under many conditions, these behaviors are not hedonic at all. Instead, they reflect adaptive coping strategies that people use to deal with the stressors in their lives. And we need to understand that.”
For example, he said, “African American women have the highest probability at any point across the life course of being obese.” Past age 60, nearly 80 percent are significantly overweight--“just a phenomenal number.” Although black women tend to choose comfort food, at any age they also have the lowest probability of any demographic group of sinking into smoking, substance abuse or similar behaviors, according to Jackson.
Alternatively, he noted, African American males have the lowest probability of being obese at any age, but high rates of other poor health behaviors. He asked, if race were an inherent genetic factor, “shouldn’t we observe similar kinds of effects” for both black women and men?
Blame Circumstances, Not People
“When people are suffering they will actually do something about it, but they may not do what’s right,” Jackson said. People don’t passively fall into self-defeating behaviors, he said, but “will try to engage their environment in important ways, to do something about the circumstance that they see.”
Among blacks, Jackson went on, the same psychological stressors that can cause mental health problems for many, “actually may motivate people to action” that may protect them in some ways.
He urged the researcher community to adopt a theoretical approach that does not “blame people for their circumstances or blame their behaviors for their circumstances.”
Jackson continued, “People are only trying to act in response to the stimulus in their environments in terms of these chronic stressors of life. But what causes these things are having to live in the kinds of neighborhoods a lot of people have to live in, the poor housing people have, awful jobs, other kinds of circumstances they have.”
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