Ethnicity/race, ethics, and epidemiology.

Ethnicity/race is a much-studied variable in epidemiology. There has been little consensus about what self-reported ethnicity/race represents, but it is a measure of some combination of genetic, socioeconomic, and cultural factors. The present article will attempt to: 1.) Elucidate the limitations of contemporary discourse on ethnicity/race that emphasizes the genetic and socioeconomic dimensions as competing explanatory frameworks; 2.) Demonstrate how considerable attention to the cultural dimension facilitates understanding of race differences in health-related outcomes; and 3.) Discuss interpretations of disparities in health status of African Americans versus European Americans from an ethical perspective. A major challenge to the discourse on ethnicity/race and health being limited to socioeconomic and genetic considerations is the lack of attention to the third alternative of a cultural perspective. The combined cultural ideologies of individualism and racism undermine the utility of epidemiologic research in health promotion and disease prevention campaigns aimed at reducing the racial gaps in health status. An ethical analysis supplements the cultural perspective. Ethics converge with culture on the notion of values influencing the study of ethnicity/race in epidemiology. A cultural approach to the use of ethnicity/race in epidemiologic research addresses methodological limitations, public health traditions, and ethical imperatives.