Race and Health in the United States

Race has a central place in the social imagination of the United States, and its defining features continue to shape the country’s culture and politics. Biological conceptions of race, and the implication that there are inherent differences between people of different races, dominated throughout the nineteenth and early twentieth centuries. However, recent research has demonstrated that the concept of race is a social construct and not based on any biological characteristics. This has implications for how data is collected and reported on, including how health risk and outcome patterns are stratified by racial categories.

During the 19th century, race was largely defined by physical traits like skin color and nose shape. Biological anthropologists, led by Blumenbach and Franz Boas, gave the race concept scientific validity. Despite this, they emphasized that race was a socially constructed category rather than a fact about human biology and evolution.

At the time, two main ideas competed for supremacy in describing human races: monogenesis and polygenesis. Monogenesis adhered to the Biblical creation story, asserting that all humans had a single common ancestor, possibly Adam of the Book of Genesis; polygenesis argued that different human groups descended from distinct ancestral roots.

In the 1890s, Louis Agassiz introduced a new interpretation of biological race that sought to reconcile monogenist and polygenist ideas. He emphasized the importance of genetic similarity and physical traits as the basis for a scientific concept of race, but he also conceded that cultural factors could produce the same appearance and behaviors and thus create a racial distinction.

While the apogee of biological race was reached around 1900, the idea began to fade as a consequence of increasing anthropological research. In particular, the work of Franz Boas challenged one of the core fundaments of racial typology, the idea that cranium size is a fixed characteristic that distinguishes a person from others within a group.

The racial categories included in the Census questionnaire are socially defined and not based on biological or anthropological criteria. They reflect the racial categories recognized in this country, as well as those required by Office of Management and Budget (OMB). Individuals may report more than one race, and the racial groups are not mutually exclusive. OMB requires the following five minimum categories: White, Black or African American, Hispanic or Latino, American Indian or Alaska Native, and Asian.