Race and Ethnicity: How to We Describe People?

I would appreciate hearing my colleagues' thoughts on the race and ethnicity issue and how best to describe people. We obviously do not use terms like red or yellow and there has been some discussion about whether black is acceptable. Along the same lines, there has been discussion as to whether white is or should be any more acceptable than the others. The CBE Manual states that the term Caucasian, like Mongoloid and Negroid, are "based on an outmoded theory of racial distinction and are no longer used." The AMA states that Caucasian "is technically specific to people from the Caucasus region and thus should be avoided." Unfortunately, neither offers any alternatives to the term white.

I would appreciate hearing how other journals approach this sensitive issue.

Thanks
Virginia St-Denis
Managing Editor, Gestionnaire de rédaction

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Because we are a journal specializing in minority health, we are asked this frequently. At first thought we were going to standardize the terms we used when referring to ethnic groups and races. However, we encountered problems. One example can be found with the term African American. Not all blacks are African American. Some are Caribbean, some are African and not American at all, some aren't even "black." There are many terms to describe different races and ethnic groups. Upon closer examination we have decided to let the terms that each group of authors chose stand. This more accurately portrays what occurs in real life in this day and age—many terms to describe the same or similar bodies of people. So we leave black black, African American African American, negros negros, Africans Africans, and colored people colored people—just one example. The only thing we do keep in mind is to be sure that no one is offended by terminology chosen by the authors. The only case that has ever come up was the use of the word ghetto to describe a minority nieghborhood. The editor-in-chief instructed the authors not to use that word because some might find it offensive or as Virginia quoted, "outmoded theory of racial distinction and are no longer used." We are based in the US and I am sure global editors handle this in different ways.

Kimberly Taylor
Publications Director, Journal of the National Medical Association

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From the AP Style book:
African-American: The preferred term is black. Use African-American only in quotations or the names of organizations or if individuals describe themselves so.

Black: Preferred usage for those of the Negroid or black race. (Use Negro only in names of organizations or in quotations.) Do not use colored as a synonym. See the colored entry.

Colored: In some societies, including the United States, the word is considered derogatory and should not be used. In some countries of Africa, it is used to denote individuals of mixed racial ancestry. Whenever the word is used, place it in quotation marks and provide an explanation of its meaning.

Race: Identification by race is pertinent:

• In biographical and announcement stories, particularly when they involve a feat or appointment that has not routinely been associated with members of a particular race.
• When it provides the reader with a substantial insight into conflicting emotions known or likely to be involved in a demonstration or similar event.

In some stories that involve a conflict, it is equally important to specify that an issue cuts across racial lines. If, for example, a demonstration by supporters of bussing to achieve racial balance in schools includes a substantial number of whites, that fact should be noted.

Do not use racially derogatory terms unless they are part of a quotation that is essential to the story.

Jeanette Mangels
Director of Communications
Managing Editor, The Journal
South Carolina Medical Association

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I think that race was a significant epidemiologic tool insofar as it can be used to explain differences in frequency of some diseases. The term helps put point to the environment where this race lived and the impact of the environment on this race.

However, race has lost the epidemiologic importance, and currently in the same country, several races cohabit together. For example, Japanese individuals living in Japan have a greater frequency of gastric cancer than Japanese living in the USA.

Thus, race does not have the same importance as before; geographic area has become a more precise decriptor for prevalence and frequency differences.

Hnid K

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I have seen a strategy in which people were described as being, for example, primarily of European, African, or Asian descent. Skin color (in the racial sense, as opposed to the pigmentation sense) is perhaps not a medically useful variable, but the genetic heritage is, in that people of African ancestry are more at risk for sickle-cell anemia.

Tom
Tom Lang Communications and Training

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Interestingly though, if the "continental" description is used (ie, African, European, and Asian) , then we may have to also use Australian or American, and here it becomes murky, because for the American, if used in the "African sense" it refers to the native American. Who then is the Australian? There must be some group just as there must be some American group.

I see our discussion as interesting as it raises issues that are difficult and sometimes painful to acknowledge. Of course last time I was meeting someone for the first time, I told him that probably I would be the only African at that place at that time, and it did WORK!

Adamson Muula
Malawi Medical Journal

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I usually write for journals that use APA standard. I find this a very difficult issue both in collecting data and writing it up.

It also seems to me that the context it is being used in makes a difference. When I am describing my sample for demographic purposes, I will tend to use the strategy described by Tom. I will not usually make finer distinctions between different people on the basis of ethnic heritage or ethnic identification unless it is important in understanding characteristics of the population. For example, in a recent paper comparing Chilean, Filipino, and US adolescents, we described the US sample broadly (European-, African-, Latino-, and Asian-American), then specified that the Latino sample was primarily Cuban-American. Interestingly, data on ethnicity is rarely collected in Chile (which is relatively ethnically homogeneous and has a strong identity that this is so) and would be extremely sensitive to collect in the Philippines (we were told we could not collect it when we were in the schools there). I am told this is also true in France and I know it was true when we collected data in Japan.

I have often had to qualify those descriptions. When we collect data, for example, we specifically ask adolescents to identify the ethnic group with which they most strongly identify (and usually allow them to identify more than one if applicable and add a category for multiethnic and an "other" category where they can write in their own term). Collecting data, we use multiple terms: Black/African American, White/European-American/Caucasian, Latino/Hispanic/Chicano, etc. We will ask about multiple different ethnic origins with categories of Latino or Asian-American. Thus, this assesses not race (whatever that is) or skin pigmentation. It does, however, get at important culturally defined categories that are markers of how people are treated and think about themselves within the United States.

Collecting and reporting data on ethnicity can be very difficult. For example, when I work or publish in Chile, we can't use the word 'español' to describe the language because there are, of course, several Spanish languages and we are privileging Castillian. Recent South American immigrants to the US tend to be very sensitive to the Spanish colonial heritage of South America and are uncomfortable with the term Hispanic and more comfortable with Latino. But other people have the opposite reaction. And even using the phrase South America is very sensitive because Chileans refer to what in the US is referred to as 2 continents (North and South) as one.

Respect and sensitivity are, as the APA manual suggests, paramount. It strikes me that genetic heritage is key for medical research. Cultural identification is more important for what I do. And when I'm focusing specifically on questions of ethnicity, we actually measure a whole battery of things from self to other identification, to strength of identification, to language use and culturally normative beliefs and customs.

Nancy Darling

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