Ellison G T, de Wet T
Institute of Urban Primary Health Care, Alexandra Health Centre and University Clinic, Johannesburg.
S Afr Med J. 1997 Dec;87(12):1671-9.
In the light of growing concern about the clinical, social and political impact of 'racial' categorisation in health research, this survey aimed to re-evaluate the current use of 'racial' categories in articles published by the South African Medical Journal. SURVEY DESIGN: Any categories that might have been used or interpreted as measures of genetically determined 'racial' differences (including 'racial', ethnic and sociopolitical 'population group' categories) were included in this survey of 668 articles describing South African health research published during the past 5 years. By classifying the research contained in each of these articles it was possible to assess the importance of 'racial' categorisation in study design. The explanations given for any 'racial' differences in health were then used to evaluate the impact of 'racial' categorisation on the perception that innate characteristics were responsible.
Three hundred and seventeen (47.5%) articles mentioned one or more 'racial' categories, 292 (43.7%) of which used 'racial' categories to describe the subjects they studied. The commonest generic labels used for these categories were "race" and "population group", while the commonest descriptive labels referred to traditional 'racial' characteristics such as phenotype, nationality and geographical origin. Only 15 (5.1%) articles fully defined the categories and labels they used, and many more used different generic and descriptive labels interchangeably. The use of 'racial' categories was highest among genetic (73.9%), descriptive (55.3%) and quasi-experimental studies (38.2%), although most used these categories simply to describe the subjects they examined. Of those 162 (24.3%) articles that discussed 'racial' differences in health, only 120 (18.0%) contained an explanation, and 60 of these suggested that inherent genetic or behavioural factors were responsible. Nine articles contained derogatory statements that could be interpreted as prejudiced or racist.
The use of 'racial' categorisation remains widespread in South African health research. By using generic and descriptive labels from traditional 'racial' taxonomies, many of these articles reinforce the perception that distinct human 'races' exist. Although most of the articles failed to explain any of the 'racial' differences in health they observed, it is likely that these will be interpreted as evidence of innate genetic or behavioural differences, like those suggested by the few articles that offered explanations. The continued use of 'racial' categorisation in health research might be inevitable, particularly for examining the impact of social forces, such as apartheid and other forms of racism, that use 'racial' categories to create unequal access to health and health care. However, any studies that use 'racial' categories should be careful to avoid legitimising the biological concept of 'race', misidentifying the causes of 'racial' disparities in health and reinforcing 'racial' prejudice.
鉴于人们日益关注健康研究中“种族”分类的临床、社会和政治影响，本次调查旨在重新评估《南非医学杂志》发表文章中当前对“种族”类别的使用情况。
本次对过去5年发表的668篇描述南非健康研究的文章进行的调查，纳入了任何可能被用作或解释为基因决定的“种族”差异衡量标准的类别（包括“种族”、族裔和社会政治“人群组”类别）。通过对每篇文章中所含研究进行分类，能够评估“种族”分类在研究设计中的重要性。然后，对所给出的关于健康方面任何“种族”差异的解释进行分析，以评估“种族”分类对认为先天特征起作用这一观念的影响。
317篇（47.5%）文章提及了一个或多个“种族”类别，其中292篇（43.7%）使用“种族”类别来描述所研究的对象。用于这些类别的最常见通用标签是“种族”和“人群组”，而最常见的描述性标签则涉及传统的“种族”特征，如表型、国籍和地理起源。只有15篇（5.1%）文章对所使用的类别和标签进行了完整定义，更多文章则互换使用不同的通用和描述性标签。在遗传学研究（73.9%）、描述性研究（55.3%）和准实验研究（38.2%）中，“种族”类别的使用最为频繁，不过大多数只是用这些类别简单描述所研究的对象。在那些讨论了健康方面“种族”差异的162篇（24.3%）文章中，只有120篇（18.0%）给出了解释，其中60篇认为内在的遗传或行为因素是原因。9篇文章包含了可被解释为有偏见或种族主义的贬损性陈述。
“种族”分类在南非健康研究中仍然广泛使用。通过使用传统“种族”分类法中的通用和描述性标签，许多此类文章强化了不同人类“种族”存在的观念。尽管大多数文章没有对所观察到的健康方面的任何“种族”差异做出解释，但这些差异很可能会被解释为先天遗传或行为差异的证据，就像少数给出解释的文章所暗示的那样。在健康研究中继续使用“种族”分类可能不可避免，特别是在研究诸如种族隔离和其他形式的种族主义等社会力量的影响时，这些社会力量利用“种族”类别造成获得健康和医疗保健机会的不平等。然而，任何使用“种族”类别的研究都应谨慎，避免使“种族”的生物学概念合法化、错误识别健康方面“种族”差异的原因以及强化“种族”偏见。
