Immigrant Health Inequities: Exposing Diversions and White Supremacy

Abstract

Diversions occur when research disregards the inequality-generating actions of advantaged groups and instead focuses attention on the actions and behaviors of disadvantaged groups. We incorporate important insights from COVID-19 to illustrate historical and contemporary examples of diversions. This paper highlights US immigrant health inequities—a burgeoning subfield within the broader health inequalities canon—to explore: (1) if and how diversions appear in immigrant health studies; (2) how often white supremacy and intersectionality are explicitly named in grants, publicly available datasets, and published research. The data derive from: NIH R01 grants (17), publicly available datasets that focus on immigrant health (7), and research published in three health journals (14). Using a qualitative content analysis approach, we analyzed these data as evidence concerning the knowledge production cycle, and investigate whether: (a) the role of advantaged groups in generating inequalities is explicitly mentioned; (b) disadvantaged groups are asked about discriminatory actions perpetuated by advantaged groups; (c) health inequalities are placed on the conditions of disadvantaged groups; (d) if white supremacy and intersectionality are explicitly mentioned in grants, publicly available datasets, and research articles. The findings demonstrate the prevalence of diversions in immigrant health research, given an overemphasis on health behaviors and cultural explanations towards explaining immigrant health inequities. There was no mention of white supremacy across the knowledge production cycle. Intersectionality was mentioned once in a research article. We argue that understanding white supremacy’s role in the knowledge production cycle illuminates how diversions occur and prevail. We provide suggestions on moving away from diversionary research, toward adopting an intersectional approach of the study of immigrant health inequities.