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CONCEPTUALIZING RACIAL DISPARITIES IN HEALTH: Advancement of a Socio-Psychobiological Approach

  • David H. Chae (a1), Amani M. Nuru-Jeter (a2), Karen D. Lincoln (a3) and Darlene D. Francis (a2)
Abstract

Although racial disparities in health have been documented both historically and in more contemporary contexts, the frameworks used to explain these patterns have varied, ranging from earlier theories regarding innate racial differences in biological vulnerability, to more recent theories focusing on the impact of social inequalities. However, despite increasing evidence for the lack of a genetic definition of race, biological explanations for the association between race and health continue in public health and medical discourse. Indeed, there is considerable debate between those adopting a “social determinants” perspective of race and health and those focusing on more individual-level psychological, behavioral, and biologic risk factors. While there are a number of scientifically plausible and evolving reasons for the association between race and health, ranging from broader social forces to factors at the cellular level, in this essay we argue for the need for more transdisciplinary approaches that specify determinants at multiple ecological levels of analysis. We posit that contrasting ways of examining race and health are not necessarily incompatible, and that more productive discussions should explicitly differentiate between determinants of individual health from those of population health; and between inquiries addressing racial patterns in health from those seeking to explain racial disparities in health. Specifically, we advance a socio-psychobiological framework, which is both historically grounded and evidence-based. This model asserts that psychological and biological factors, while playing a central role in determining individual risk for poor health, are relatively less consequential for understanding racial disparities in health at the population level. Such a framework emphasizes the etiologic role of social inequities in generating and perpetuating racial disparities in health and highlights their impact on psychological, behavioral, and biological disease processes.

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Corresponding author
David H. Chae, Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Room 512, Atlanta, Georgia 30322. E-mail: david.chae@emory.edu
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