Locating diversity: race, nativity and place in health disparities research

Abstract

Nancy Krieger has been one of the leading voices in documenting how social 'axes of difference', including race, ethnicity and class make people vulnerable to poor health and limit their access to effective health care. We discuss the importance of 'locating' diversity in health inequalities research. This includes critically dissecting racial and ethnic axes into more nuanced social categories that incorporate differences based on immigration and other factors. It also involves considering how diverse population groups vary in their perception and use of space for healthrelated activities and exposures. Examples relating to immigrant populations' health and access to health care are discussed.

Do Mexican immigrants “import” social gradients in health to the US?

“…Much of the research on social disparities in health has categorized populations into broad racial and ethnic groups but has ignored ethnic subgroups, generational effects, and migration-related social capital (McLafferty & Chakrabarti, 2009). Recent studies that do pay careful attention to these moderators have yielded complex and nuanced findings.…”

Health disparities between immigrant and Danish cleaners

“…Since immigrants generally have a low socioeconomic status, some ethnic inequalities may therefore be related to socioeconomic differences (Stronks and Kunst 2009). The observed contradictory findings regarding immigrant health may therefore be caused by varied control for socioeconomic status (McLafferty and Chakrabarti 2009).…”

The Impact of Binational Barriers to Medical Care on the Care-Seeking Practices of Mexican Immigrants

“…Research into health disparities has sought to locate the “axes of difference” that determine health outcomes and interrogate the ways in which the lived experiences of social categories such as race, socio-economics, and education levels become embodied in differential health outcomes (Krieger, 2009). In recent years, there has been a call to action to complicate our understanding of such differences and recognize the “diversity within diversity,” that gets lost when population health is analyzed without regard to place, nativity, and immigration (Buttenheim et al, 2010; Krieger, 2010; McLafferty & Chakrabarti, 2009). According to postcolonial health theorists, the lack of documented health history among previously colonized peoples blurs our ability to clearly identify and address the diverse sources of health inequities in these populations (Anderson et al, 2009; Browne et al, 2011; Horrill et al, 2018).…”