Introduction to the Special Issue
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Introduction to the Special Issue Sarah Gehlert • Darrell L. Hudson
Published online: 26 April 2013 Ó Springer Science+Business Media New York 2013
In the late 1970s, Stephen Jay Gould (1978) reviewed the notes used by Samuel George Morton to support his 1839 classification of races (1839) and found what he considered to be serious methodological flaws. Morton had concluded that Caucasians had larger brains, and therefore higher intellectual capacity, based on the measurement of the cranial capacities of skulls that Gould considered to be biased. Heated debates about the meaning of race, specifically whether it is a biological reality or socially constructed, continue to this day (Bamshad et al. 2004; Braun and Hammonds 2008; Gravelee 2009). Needless to say, whether race is biological has major implications for how it is used to understand the nature and extent of the group differences in health seen in the United States. Further, although we have made some progress in our understanding of how race, social factors, and biology might interact to affect health in the United States, our understanding remains imperfect. There is general agreement that the causes of group differences in health, variously referred to as health disparities, health inequities, and health inequalities, are multifactorial, with contributions from the societal to the cellular levels that interact in ways not yet fully understood (Gehlert and Colditz 2011). A conceptual framework developed by Warnecke et al. (2008) includes three primary levels of determinants, namely distal, intermediate, S. Gehlert (&) E. Desmond Lee Professor of Racial and Ethnic Diversity, George Warren Brown School of Social Work, Washington University in St. Louis, St. Louis, MO, USA e-mail: [email protected] D. L. Hudson George Warren Brown School of Social Work, Washington University in St. Louis, St. Louis, MO, USA
and proximal. Distal determinants include determinants whose roots are embedded in shared social norms about health or social practices and social disadvantage. Intermediate determinants include the social and physical contexts in which the distal determinants are experienced. They are the links through which the environment affects individual demographic factors and the biological responses that make up proximal determinants. The latter includes individual behaviors and biological and genetic factors such as ancestry. Most would agree that improving population health relies on critically evaluating determinants at each of these levels and the complex ways in which they interact with one another (Gehlert 2013). Decades of research focused primarily on the level of individual health behavior (i.e., proximal factors) without considering how behavior influences and is influenced by neighborhood, community, and societal factors. The articles in this special issue of the Journal of Race and Social Problems contribute to our understanding of race and health in three basic ways by: (1) critically examining constructs such as race and socioeconomic status in heal
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