What is your race or ethnicity? Most of us at one point in our lives have had to check a box to answer this question, whether you took a standardized test, applied to college, filled out a health care form or completed a U.S. Census. Some would argue that we shouldn’t have to label ourselves into specific categories. However, our background significantly influences who we are as individuals, it shapes the way we think and see the world, how we interact with others, and often how we are treated.
The concepts of race and ethnicity, while considered by some to be the same, are in fact different. Blakemore (2019) emphasizes race as a “category of humankind that shares certain distinctive physical traits” and ethnicity as “large groups of people classed according to common racial, national, tribal, religious, linguistic, or cultural origin or background.” Race is typically associated with physical traits such as skin color or hair texture and is typically broken down into the five distinct categories (U.S. Census Bureau, 2022):
- White – an individual whose ancestors originated in Europe, the Middle East, or North Africa
- Black or African American – an individual whose ancestors originated in any of the Black racial groups of Africa
- Asian – an individual whose ancestors originated in the Far East, Southeast Asia, or the Indian subcontinent
- American Indian or Alaska Native – an individual whose ancestors originated in North, Central and South America and who maintains tribal affiliation or community attachment
- Native Hawaiian or Pacific Islander – an individual whose ancestors originated in Hawaii, Guam, Samoa, or other Pacific Islands
Ethnicity classifies people based on their cultural expression, identification, and place of origin. For example, my husband is “white” and states his ethnicity as English, German, and Slovak based on the origins of his great grandparents. I am “Asian,” and my ethnicity is Filipino. My parents were both born in the Philippines, they spoke their native language Tagalog at home, we ate traditional Filipino food, and celebrated several Filipino customs around the holidays. Our two sons both identify as “mixed” race, white and Asian. While my sons and I can easily hide our Filipino ethnic association, we cannot disguise our race or physical attributes such as skin color or eye shape.
With respect to U.S. Census Bureau (2022), race is based on self-identification and as of 2000, individuals were allowed to “check” more than one race on the form. The Census utilizes a social definition of race and does not define race biologically or genetically. People who identify their origin as Hispanic, Latino, or Spanish may be of any race. Given the hundreds of possible ethnicities to choose from, the Census simplifies this into two categories: Hispanic/Latino and non-Hispanic/Latino. Both race and ethnicity are important data points used to make policy decisions, ensure civil rights, promote equal employment opportunities, and to assess racial disparities in health and environmental risks (U.S. Census Bureau, 2022).
As health care providers, it’s our job to provide the highest level of patient care regardless of cultural background yet race and ethnicity cannot be ignored entirely. In clinical practice, these factors are often used to determine a patient’s socioeconomic status, risk factors, and potential for genetic-related diseases (Moscou & Baker, 2018). Conditions such as Sickle Cell, Tay-Sachs, Cystic Fibrosis, Thalassemia, and many others, have been associated with certain ethnicities, therefore, knowing and understanding a patient’s background is relevant and essential. Conversely, when we use race and ethnicity solely to shape health care decisions, we may be subject to
implicit biases leading to false assumptions, inappropriate screenings, misdiagnosis, and delays in treatment. Good clinical practice requires a wholistic approach, a thorough health history, and assessment of
social determinants of health.
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