Race-based Health Disparities and the Politics of Difference: What Rates of HIV Among Latinos Tell Us

The 10th anniversary of National Latino AIDS Awareness Day reminds us how far we still have to go to address race-based health disparities. But we must keep our efforts trained on the real causes of these statistics: social and economic conditions.

Monday, October 15th, was the tenth anniversary of National Latino AIDS Awareness Day, an initiative that seeks to bring attention to the rates of HIV and AIDs among Latinos in the United States and the unique needs of the community for education, outreach, and services.

Latinos in the United States experience higher rates of HIV infections than their white counterparts. Latino men are three times as likely to contract HIV as white men, and Latina women are four times as likely to contract HIV as white women.

These community-based, race- and ethnicity-specific campaigns are crucial to both bring light to race-based health disparities and also help us to tailor prevention and treatment efforts to specific communities. The barriers to HIV testing, for example, maybe different in the Latino community than in the African-American community. Cultural norms, socioeconomic factors, and issues of health care access can all have an impact on shaping the needs of a particular community.

But we must be very careful when addressing race-based health disparities to make clear the distinction between disparities and differences.

On that Monday, I heard Professor Dorothy Roberts, faculty at the University of Pennsylvania with appointments in both the law school and the sociology department, give a lecture at Barnard College called “Race, Gender and the New Biocitizen.” Based on her most recent book, Fatal Invention: How Science, Politics and Big Business are Re-creating Race in the 21st century she makes a compelling argument that race is a purely political category with no biological or genetic basis.

This argument is well supported by genetic research outlined by Professor Roberts painstakingly in her book. She also takes to task much recent scientific research that purports to draw genetic conclusions based on race, pulling apart the hypotheses and revealing shoddy methodology.

The fact remains that race, while a highly influential social and political category, has no genetic definition. Translation: there is very little genetic similarity within the races. In fact, Roberts explains there is actually more commonality genetically between the races than within them.

When taken logically, this actually makes a lot of sense. Think about the Latino/Hispanic community in the US. While a group that has been brought together for political solidarity, largely because of socioeconomic and cultural similarities, in reality it’s an extremely diverse group across all measures. Skin color differences abound, with those categorized as Latino or Hispanic going from the lightest skinned to the darkest and everywhere in between. The ethnic makeup of this group is actually incredibly diverse. Similar things can be said for other groups we define as races—African Americans, Asians, Native Americans.

I bring this up now because while I wholeheartedly support and promote efforts to highlight race-based health disparities, and believe we should be putting a lot of our focus on these challenges, I also want to emphasize that I believe, as does Roberts, that these differences come purely from the social, economic and environmental impacts of the social and political category of race on people.

Which is to say Latinos do not experience higher rates of HIV and AIDS because of any unique genetic propensity or susceptibility toward the disease, but instead because of the social and economic reality faced by Latinos that lead to higher rates of HIV infections and AIDS-related illnesses. Things like lack of access to health care, homophobia, lower rates of condom use, and language barriers among other causes.

To some it may seem absurd to think that anyone would argue that race-based health disparities are a result of genetic or biological differences among racial groups, but the fact is this argument is on the rise, and it isn’t new. Studies with these kinds of claims grace the front page of the New York Times science section on a regular basis. Rather than acknowledge disparities, some want to highlight the concept of difference—meaning that racial groups have biological differences that account for these statistics, rather than blaming the conditions of racism that shape our lives and our health.

This distinction feels as important to highlight as the problem of race-based health disparities themselves, particularly in an era where the FDA can approve a race-specific drug (BiDil, a drug for congestive heart failure) with little scientific evidence backing the claim that it successfully targets African Americans over other groups. 

Our work to address health disparities needs to be based outside of the laboratory or pharmaceutical industry, and instead placed in the broader social context that is likely to blame for these disparities in the first place.