The fecundity of the race discourse in public health and epidemiology: understanding the limits of explaining health disparities using race categories in Brazil

Abstract

This paper problematizes the use of race categories in epidemiological and health surveys in Brazil. The (re)production of epidemiological data using racial categories is common practice in epidemiology and public health. Often presented as a means of explaining the persistence of gaps in health status across diverse groups, racial categories have enjoyed an uncritical advantage. The rationale of using racial categories in surveys by its proponents is that such categories facilitate the development of policies that address structural inequalities in health access, and foregrounding reasons why disparities in health outcomes for minoritized and racialized groups and how broader social determinants of health (SDOH) must be addressed. Justified by the persistence of poorer health outcomes for minoritized groups in pluralistic societies, health researchers often argue for the necessity to collect data using racial categories. Utilizing the Foucauldian inspired Critical Discourse Analytic (CDA) method, this paper comments on the data quality issues related to the use of racial categories and the methodological dilemma such a practice poses for public health researchers and epidemiologists. The paper further cautions that an uncritical use of racial categories in public health surveys, reinforce and perpetuate a sense that the measures are real, their meaning uncomplicated, and their properties substantial.