What Is a “Racial Health Disparity”? Five Analytic Traditions

Abstract

Abstract What exactly is a “racial health disparity”? This article explores five lenses that have been used to answer that question. It contends that racial health disparities have been presented—by both academic researchers and those outside of it—as problems of five varieties: of biology, of behavior, of place, of stress, of policy. It also argues that a sixth tradition exploring class—and its connection to race, racism, and health—has been underdeveloped. I examine each of these conceptions of racial disparities in turn. Baked into each interpretive prism is a set of assumptions about the mechanisms that produce disparities: a story, in other words, about where racial health disparities come from. Discursive boundaries set the parameters for policy debate, determining what is and is not included in proposed solutions. How one sees a racial health disparity, then, determines the strategies a society advocates—or ignores—for their elimination. I end by briefly discussing problems in the larger research ecosystem that dictates how racial health disparities are studied.