Conceptualizing “Race” and Racism in Health Disparities Discourse: A Critical Discourse Analysis

Abstract

Critically analyzing how language and discourse influence health policy agendas to eliminate racial and ethnic health disparities (REHD) supports social work’s commitment to address oppression and marginalization. Various institutions construct health policy agendas regarding REHD without explicitly conceptualizing terms such as “race,” “racism,” “African American/Black,” “Latino/a,” “Asian,” and “White”, and their relationship to racialized health outcomes. However, there is limited research examining the inherent ideologies and meaning related to racial concepts, which rely heavily on conveying historical influences through discourse over time. The purpose of the current qualitative study is to explore how policy initiatives to address REHD conceptualized “race” and racism. By employing grounded theory (GT) and critical discourse analysis (CDA), the study examined the discourse underpinning city, state, and national policy agendas to eliminate REHD. The study’s findings highlighted how terminology, assigned meanings, and ideology are replicated over time to reproduce a non-critical analysis of “race” and racism. The resulting implications suggest that conceptualizing “race” void of understanding differential racial health outcomes as racism omits the structural, historical, and ethical characteristics of racial concepts. Within health disparities discourse, the meanings assigned to “race” and racism ultimately influence which interventions are identified to address REHD.