On Nothing and Everything

The Relationship between Ethnicity and Health
  • Pamela M. Kato
Part of the The Plenum Series in Culture and Health book series (PSCH)


The use of ethnicity as a grouping variable in health research is disturbing to scientists. It is poorly defined, is not objectively measured, and cannot be studied in a true experiment. Thus, scientific conclusions about the causal relationship between ethnicity and health are difficult to make. To a large extent, ethnic categories are problematic because they are socioculturally constructed categories. Depending on the culture, definitions and criteria for ethnic categories vary. Even within cultures, such as the United States, criteria for membership differs from one context to another. However, ethnicity as a grouping variable should not be discarded because it is not scientific. It deserves careful study because it is associated with important health outcomes. It is well known that ethnic groups differ dramatically on many measures of health outcomes (e.g., U.S. Department of Health and Human Services, 1985).


Breast Cancer Ethnic Group White Woman Ethnic Difference White Female 
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  1. Adler, N. E., Boyce, T., Chesney, M. A., Cohen, S., Folkman, S., Khan, R. L., & Syme, S. L. (1994). Socioeconomic status and health: The challenge of the gradient. American Psychologist, 49 15–24.PubMedCrossRefGoogle Scholar
  2. Bassett, M. T., & Krieger, N. (1986). Social class and black-white differences in breast cancer survival. American Journal of Public Health, 76, 1400–1403.PubMedGoogle Scholar
  3. Bondy, M. L., Spitz, M. R., Halabi, S., Fueger, J. J., & Vogel, V. G. (1992). Low incidence of familial breast cancer among Hispanic women. Cancer Causes Control 3, 377–382.PubMedCrossRefGoogle Scholar
  4. Boyd, W. C. (1950). Genetics and the races of man. Boston: Little, Brown.Google Scholar
  5. Castro, F. G., Coe, K., Gutierres, S., & Saenz, D. (1996). Designing health promotion programs for Latinos. In P. M. Kato & T. Mann (Eds.), Handbook of diversity issues in health psychology (pp. 319–345). New York: Plenum Press.Google Scholar
  6. Cavalli-Sforza, L. L., Menozzi, P., & Piazza, A. (1994). The history and geography of human genes. Princeton, NJ: Princeton University Press.Google Scholar
  7. Chun, C., Enomoto, K., & Sue, S. (1996). Health care issues among Asian Americans: Implications of somatization. In P. M. Kato & T. Mann (Eds.), Handbook of diversity issues in health psychology (pp. 347–365). New York: Plenum Press.Google Scholar
  8. Claus, E. B., Risen, N., & Thompson, W. (1991). Genetic analysis of breast cancer in the cancer and steriod hormone study. American Journal of Human Genetics, 48, 232–242.PubMedGoogle Scholar
  9. Coon, C. S., Garn, S. M., & Birdsell, J. B. (1950). Races. Springfield, IL: Thomas.Google Scholar
  10. D’Andrade, R. G. (1984). Cultural meaning systems. In R. A. Schweder & R. A. Levine (Eds.), Culture theory: Essays on mind, self, and emotion (pp. 88–119). Cambridge, UK: Cambridge University Press.Google Scholar
  11. Diehr, P., Yergan, J., Chu, J., Feigl, P., Glaefke, G., Moe, R., Bergner, M., & Rodenbaugh, J. (1989). Treatment modality and quality differences for black and white breast-cancer patients treated in community hospitals. Medical Care, 27, 942–958.PubMedCrossRefGoogle Scholar
  12. Dobzhansky, T. (1962). Mankind evolving. New Haven, CT: Yale University Press.Google Scholar
  13. Dutton, D., & Levine, S. (1989). Overview, methodological critique, and reformulation. In J. P. Bunker, D. S. Gomby, & B. H. Kehrer (Eds.), Pathways to health (pp. 29–69). Menlo Park, CA: The Henry J. Kaiser Family Foundation.Google Scholar
  14. FitzGerald, M. G., MacDonald, D. J., Krainer, M., et al. (1996). Germ-line BRCA1 mutations in Jewish and non-Jewish women with early-onset breast cancer. The New England Journal of Medicine, 334, 143–149.PubMedCrossRefGoogle Scholar
  15. Garn, S. M. (1971). Human races (3rd ed.). Springfield, IL: Charles C Thomas.Google Scholar
  16. Gottesman, I.I. (1968). Biogenetics of race and class (pp. 1–51). New York: Holt, Rinehart and Winston, Inc.Google Scholar
  17. Grembowski, D., Patrick, D., Diehr, P., & Durham, M. (1993). Self-efficacy and health behavior among older adults. Journal of Health & Social Behavior, 34, 89–104.CrossRefGoogle Scholar
  18. Jackson, J. S., & Sellers, S. L. (1996). African-American health over the life-course: A multidimensional framework. In P. M. Kato & T. Mann (Eds.), Handbook of diversity issues in health psychology (pp. 301–317). New York: Plenum Press.Google Scholar
  19. Johnson, S. D. (1990). Toward clarifying culture, race, and ethnicity in the context of multicultural counseling. Journal of Multicultural Counseling and Development, 18, 41–51.Google Scholar
  20. Jones, B. A., Kasl, S. V., Curnen, M. G. M., Owens, P. H., & Dubrow, R. (1995). Can mammography screening explain the race difference in stage at diagnosis of breast cancer? Cancer (Philadelphia), 75, 2103–2113.CrossRefGoogle Scholar
  21. Kleinman, A. (1980). Patients and healers in the context of culture: An exploration of the borderland between anthropology, medicine, and psychiatry. Berkeley, CA: University of California Press.Google Scholar
  22. Kleinman, J. (1990). Infant mortality among racial/ethnic minority groups, 1983–1984. Morbidity and Mortality Weekly Report, 39, 31–39.Google Scholar
  23. Latter, B. (1980). Genetic differences within and between populations of the major human subgroups. The American Naturalist, 116, 220–237.CrossRefGoogle Scholar
  24. Liff, J. M., Sung, J. F. C., Chow, W. H., Greenberg, R. S., & Flanders, W. D. (1991). Does increased detection account for the rising incidence of breast cancer? American Journal of Public Health, 81, 462–465.PubMedGoogle Scholar
  25. Marmot, M., Ryff, C., Bumpass, L., Shipley, M., & Marks, N. (1995). Social inequalities in health: A major public health problem. London: University College London Medical School.Google Scholar
  26. Miller, A. B. (1980). Nutrition and cancer. Preventive Medicine, 9, 189–195.PubMedCrossRefGoogle Scholar
  27. Murphy, G., & Medin, D. (1985). The role of theories in conceptual coherence. Psychological Review, 92, 289–315.PubMedCrossRefGoogle Scholar
  28. Musey, V. C., Collins, D. C., Musey, I. P., Martino-Saltzman, D., & Preedy, J. R. K. (1987). Long-term effect of a first pregnancy on the secretion of prolactin. New England Journal of Medicine, 316, 229–234.PubMedCrossRefGoogle Scholar
  29. National Center for Health Statistics. (1991). Health: United States, 1990. Hyattsville, MD: Public Health Service.Google Scholar
  30. Poussaint, A. F. (1984). Benefits of being interracial (Vol. 15). New York: Council on Interracial Books for Children.Google Scholar
  31. Schinke, S. (1996). Behavioral approaches to illness prevention for Native Americans. In P. M. Kato & T. Mann (Eds.), Handbook of diversity issues in health psychology (pp. 367–387). New York: Plenum Press.Google Scholar
  32. Smith, M., & Lin, K. (1996). A biological, environmental, and cultural basis for ethnic differences in treatment. In P. M. Kato & T. Mann (Eds.), Handbook of diversity issues in health psychology (pp. 389–406). New York: Plenum Press.Google Scholar
  33. Trent, K. (1994). Family context and adolescents’ expectations about marriage, fertility, and nonmarital childbearing. Social Science Quarterly, 75, 319–339.Google Scholar
  34. U.S. Department of Health and Human Services. (1985). Report of the secretary’s task force on black and minority health. Washington, DC: U.S. Government Printing Office.Google Scholar
  35. Wells, B. L., & Horm, J. W. (1992). Stage at diagnosis in breast cancer: Race and socio-economic factors. American Journal of Public Health, 82, 1383–1385.PubMedCrossRefGoogle Scholar
  36. Williams, D. R., & Rucker, T. (1996). Socioeconomic status and the health of racial minority populations. In P. M. Kato & T. Mann (Eds.), Handbook of diversity issues in health psychology (pp. 407–424). New York: Plenum Press.Google Scholar
  37. Zang, E. A., Barrett, N. O., & Cohen, L. A. (1994). Differences in nutritional risk factors for breast cancer among New York City white, Hispanic, and black college students. Ethnicity & Disease, 4, 28–40.Google Scholar
  38. Zuckerman, M. (1990). Some dubious premises in research and theory on racial differences. American Psychologist, 45, 1297–1303.PubMedCrossRefGoogle Scholar

Copyright information

© Plenum Press, New York 1996

Authors and Affiliations

  • Pamela M. Kato
    • 1
  1. 1.Department of Psychiatry and Behavioral SciencesStanford University School of MedicineStanford

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