Individualism, in both its political and attitudinal senses, reinforces societal and institutional racism in the United States. Because of individualism's dominant focus on self-interest and self-reliance, any application of “participatory democracy” in community-based biomedical and behavioral research is fraught with dilemmas similar to those that Gunnar Myrdal observed between American racism and democracy. The research establishment is overwhelmed by well-meaning non-minorities who recognize racism and its consequences on health, but only greater representation of people-of-color in the health establishment can ameliorate the inherent contradictions of “participatory democracy” which is so fundamental to the process of community-based participatory research.
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References
1.
GeigerH. J., Race and Health Care—An American Dilemma? (Editorial), New England Journal of Medicine, 335: 11, pp. 815–816, 1996.
2.
HognessJ. R.McLaughlinC. J.OsterweisM. (eds.), The University in the Urban Community: Responsibilities for Public Health, Association of Academic Health Centers, Washington, D.C., 1995.
3.
BeauchampD., What is Public about Public Health, Health Affairs, 2: 4, pp. 76–87, 1983.
4.
GishO., Values in Health Care, Social Science and Medicine, 19: 4, pp. 333–339, 1984.
5.
SidelV. W.SilverG. A., Social Medicine: A 1990's Perspective for the United States, Scandinavian Journal of Social Medicine, 23, pp. 145–149, 1995.
6.
IsraelB. A.SchulzA. J.ParkerE. A.BeckerA. B., Review of Community-Based Research: Assessing Partnership Approaches to Improve Public Health, Annual Review of Public Health, 19, pp. 173–202, 1998.
7.
CharterOttawa, The Ottawa Charter for Health Promotion, 1986.
8.
SasaoT.SueS., Towards a Culturally Anchored Ecological Framework of Research in Ethnic-Cultural Communities, American Journal of Community Psychology, 21: 6, pp. 705–727, 1993.
9.
SmallS., Collaborative, Community-Based Research on Adolescents: Using Research for Community Change, Journal of Research on Adolescence, 6: 1, pp. 9–22, 1996.
10.
Diaz-VeizadesJ.ChangE. T., Building Cross-Cultural Coalitions: A Case of the Black-Korean Alliance and the Latino-Black Roundtable, Ethnic and Racial Studies, 19: 3, pp. 680–700, 1996.
11.
KimE. M., “At Least You're Not Black”: Asian Americans in U.S. Race Relations, Social Justice, 25: 3, pp. 3–12, 1998.
12.
Okazawa-ReyM.WongM., Organizing in Communities of Color: Addressing Interethnic Conflicts, Social Justice, 24: 1, pp. 24–39, 1997.
13.
McIntoshP., White Privilege: Unpacking the Invisible Knapsack, Peace and Freedom, pp. 10–12, 1989.
14.
KaplanG.PamukE.LynchJ.CohenR.BalfourJ., Inequality in Income and Mortality in the United States: Analysis of Mortality and Potential Pathways, British Medical Journal, pp. 999–1003, 1996.
15.
KriegerN., Shades of Difference: Theoretical Underpinnings of the Medical Controversy on Black/White Differences in the United States, 1830–1870, International Journal of Health Services, 17: 2, pp. 259–278, 1987.
16.
KriegerN.SidneyS., Racial Discrimination and Block Pressure: The CARDIA Study of Young Black and White Adults, American Journal of Public Health, 86: 10, pp. 1370–1378, 1996.
17.
WilliamsD.Lavizzo-MoureyR.WarrenR. C., The Concept of Race and Health Status in America, Public Health Reports, 109: 1, pp. 26–41, 1994.
18.
WilkinsonD.KingG., Conceptual and Methodological Issues in the Use of Race as a Variable: Policy Implications, The Milbank Quarterly, 1, pp. 47–61, 1987.
19.
SharletJ., Ayn Rand has Finally Caught the Attention of Scholars, Chronicle of Higher Education, 45: 31, pp. A17–A18, 1999.
20.
SkinnerB. F., Beyond Freedom & Dignity, Bantam/Vintage Books, New York, 1980.
21.
FriedmanM.FriedmanR., Free to Choose: A Personal Statement, Avon, New York, 1980.
22.
OmiandM.WinantH., Racial Formation in the United States: From the 1960s to the 1980s, Routledge & Kegan Paul, New York, 1986. (Critical social thought).
23.
SaleebeyD., The Strengths Perspective in Social Work Practice: Extensions and Cautions, Social Work, 41: 3, pp. 296–305, 1996.
24.
HofstadterR., Social Darwinism in American Thought, Beacon Press, Boston, 1992.
25.
GansH. J., The War Against the Poor: The Underclass and Antipoverty Policy, Basic Books, New York, 1995.
26.
LeacockE. B., The Culture of Poverty: A Critique, Simon and Schuster, New York, 1971.
27.
SpignerC., Race, Class, and Violence: Research and Policy Implications, International Journal of Health Education, 28: 2, pp. 349–372, 1998.
28.
WilsonW. J., The Ghetto Underclass and the Social Transformation of the Inner City, The Black Scholar, pp. 10–17, May/June 1988.
29.
KozolJ., Amazing Grace: The Lives of Children and the Conscience of a Nation, Crown, New York, 1995.
30.
GitlinT., The Twilight of Common Dreams: Why America is Wracked by Culture Wars, Metropolitan Books, New York, 1995.
31.
SteinbergS., The Liberal Retreat from Race During the Post-Civil Rights Era, in The House That Race Built,LubianoW. (ed.), Pantheon Books, New York, pp. 13–47, 1997.
32.
MillerS. M., Race in America, in The Nation's Health (4th Edition),LeeP. R.EstesC. L. (eds.), Jones and Bartlett Publishers, Boston, Massachusetts, 1994.
33.
KernerJ. F.DusenburyL.MandelblattJ. S., Poverty and Cultural Diversity: Challenges for Health Promotion among the Medically Underserved, Annual Review of Public Health, 14, pp. 355–377, 1993.
34.
RappaportJ., Terms of Empowerment/Examples of Prevention: Towards a Theory of Community Psychology, American Journal of Community Psychology, 15, pp. 121–148, 1987.
35.
TurnerJ. H., The Structure of Sociological Theory (Rev. Edition), Dorsey Press, Homewood, Illinois, 1976.
36.
StevensonL. F., Seven Theories of Human Nature, Oxford University Press, New York, 1975.
37.
CoxT. H.LobelS. A.McLeodP. L., Effects of Group Cultural Differences on Cooperative and Competitive Behavior on a Group Task, Academy of Management Journal, 34: 4, pp. 827–847, 1991.
38.
HofstedeG. H., Culture's Consequences, International Differences in Work-Related Values, Sage Publications, Beverly Hills, 1980.
39.
InkelesA., The American Character, The Center Magazine, 6, pp. 25–39, 1983.
40.
HsuF. L. K. (ed.), American and Chinese: Passage to Difference (3rd Edition), University of Hawaii Press, Hawaii, 1981.
41.
AbramsR. D., African Worlds, Pantheon Books, New York, 1983.
42.
KwasiW., Philosophy and African Culture, Cambridge University Press, London, 1980.
43.
KaganS., Social Motives and Behaviors of Mexican-Americans and Anglo Children, in Chicano Psychology,MartinesJ. L. (ed.), Academic, New York, pp. 45–86, 1977.
44.
MarinandG.TriandisH. C., Allocentric as an Important Characteristic of the Behavior of Latin Americans and Hispanics, in Cross-Cultural and National Studies in Social Psychology,Diaz-GuerreroR. (ed.), North-Holland, Amsterdam, pp. 69–80, 1985.
45.
TriandisH. C.MarinG.HuiC. H.LisanskyJ.OttatiV., Role Perceptions of Hispanic Young Adults, Journal of Cross-Cultural Psychology, 15, pp. 297–320, 1984.
46.
TriandisH. C., Cross Cultural Studies in Individualism-Collectivism, in Nebraska Symposium on Motivation: Cross Cultural Perspectives, 37,BermanJ. J. (ed.), University of Nebraska Press, Lincoln, pp. 41–113, 1989.
47.
TriandisH. C.McCuskerC.HuiC. H., Multi-Method Probes of Individualism-Collectivism, Journal of Personality and Social Psychology, 59, pp. 1006–1020, 1990.
48.
FoemanA.PressleyG., Ethnic Culture and Corporate Culture: Using Black Styles in Organizations, Community Quarterly, 35, pp. 293–307, 1987.
49.
KochmanT., Black and White Styles in Conflict, University of Chicago Press, Chicago, 1981.
50.
DurkheimE., Durkheim: Essays on Morals and Education, PickeringW. S. F. (ed.), SutcliffH. L. (trans.), Routledge, London, p. 12, 1979.
51.
KennedyB. P.KawachiI.LochnerK.JonesC.Prothrow-StithD., (Dis)respect and Black Mortality, Ethnicity and Disease, 7, pp. 207–214, 1997.
52.
BellD. A., Faces at the Bottom of the Well: The Permanence of Racism, Basic Books, New York, 1992.
53.
CoseE., The Rage of a Privileged Class, Harper Collins, New York, 1993.
JewkesR.MurcottA., Community Representatives: Representing the “community”?, Social Science and Medicine, 46: 7, pp. 843–858, 1998.
56.
LongresJ. F., Human Behavior in the Social Environment, F. E. Peacock Publishers, Itasca, Illinois, 1990.
57.
LelandP. J., Exploring Challenges to Nonprofit Status: Issues of Definition and Access in Community-Based Research, American Behavioral Scientist, 39: 5, pp. 587–601, 1996.
58.
OreiroD. W., A Community-Based Public Health Initiative Integrating a Traditional War Canoe Culture within Today's Contemporary Lifestyles: The ‘C.E.D.A.R’ Project, Patient Education and Counseling, 26: 1–3, pp. 177–181, 1995.
59.
Santiago-RiveraA. L.MorseG. S.HuntA.LickersH., Building a Community-Based Research Partnership: Lessons from the Mohawk Nation of Akwasasne, Journal of Community Psychology, 26: 2, pp. 163–174, 1998.
60.
ScloveR., Research by the People, For the People, Futures, 29: 6, pp. 541–549, 1997.
61.
ReedW., Suffer the Children: Some Effects of Racism on the Health of Black Infants, in Sociology of Health and Illness,ConradP.KernR. (eds.), St. Martin's Press, New York, pp. 272–280, 1986.
62.
LaVeistT. A., The Political Empowerment Health Status of African Americans: Mapping a New Territory, American Journal of Sociology, 97, pp. 1080–1095, 1992.
63.
LeClereF. B.RogersR. G.PetersK., Neighborhood Social Context and Racial Differences in Women's Heart Disease Mortality, Journal of Health and Social Behavior, 39: 2, pp. 91–107, 1998.
64.
PolednakA. P., Black-White Mortality in Infant Mortality in 38 Standard Metropolitan Statistical Areas, American Journal of Public Health, 81, pp. 1480–1482, 1991.
65.
HogueC. J. R.HargravesM. A., Class, Race, and Infant Mortality in the United States, American Journal of Public Health, 83, pp. 9–12, 1993.
66.
McCordC.FreemanH., Excess Deaths in Harlem, New England Journal of Medicine, 322: 3, pp. 173–177, 1990.
67.
MorrisonR. S.WallensteinS.NataleD. K.SenzelR. S.HuangL. L., “We Don't Carry That”—Failure of Pharmacies in Predominantly Nonwhite Neighborhoods to Stock Opioid Analgesics, New England Journal of Medicine, 342: 14, pp. 1023–1026, 2000.
68.
PerkinsD. D.ZimmermanM. A., Empowerment Theory, Research, and Application, American Journal of Community Psychology, 23: 5, pp. 569–579, 1995.
69.
HimmelsteinD. U.WoolhandlerS., Care Denied: U.S. Residents Who are Unable to Obtain Needed Medical Services, American Journal of Public Health, 85: 3, pp. 341–344, 1995.
70.
Statistical Abstract of the United States, 1998, Washington, D.C.: U.S. Department of Commerce, Economics and Statistics Administration, Bureau of the Census, p. 418, Table 764, “Families Below the Poverty 125 Percent of Poverty Level: 1960 to 1966,” 1998.
71.
Statistical Abstract of the United States, 1998, Washington, D.C.: U.S. Department of Commerce, p. 48, Table 765, “Families Below the Poverty Level by Selected Characteristics: 1996”, 1998.
72.
Statistical Abstract of the United States, 1998, Washington, D.C.: U.S. Department of Commerce, p. 198, Table 181, “Health Insurance Coverage Status by Selected Characteristics: 1990–1996,” 1998.
73.
SchoendorfK. C.HogueC. J.KleinmanJ. C.RowleyD., Mortality among Infants of Black as Compared with White College-Educated Parents, New England Journal of Medicine, 326: 23, pp. 1522–1526, 1992.
74.
MolnarS., Human Variation: Races, Types, and Ethnic Groups, Prentice-Hall, Englewood Cliffs, New Jersey, 1992.
75.
WitzigR., The Medicalization of Race: Scientific Legitimization of a Flawed Social Construct, Annals of Internal Medicine, 125: 8, pp. 675–679, 1996.
76.
GambleV. N., Under the Shadow of Tuskegee: African Americans and Health Care, American Journal of Public Health, 87: 11, pp. 1173–1778, 1997.
77.
OsborneN. G.FeitM. D., The Use of Race in Medical Research, Journal of the American Medical Association, 267: 2, pp. 275–279, 1992.
78.
ClarkR.AndersonN. B.ClarkV. R.WilliamsD. R., Racism as a Stressor for African Americans: A Biopsychosocial Model, American Psychologist, 54: 10, pp. 805–816, 1999.
79.
National Research Council, Commission on Behavioral and Social Sciences and Education, Committee on the Status of Black Americans, in A Common Destiny: Blacks and American Society,JaynesG. D.WilliamsR. M.Jr. (eds.), National Academy Press, Washington, D.C., 1989.
80.
United States Department of Health and Human Services, Task Force on Black and Minority Health, Margaret M. Heckler, Secretary, Report of the Secretary's Task Force on Black & Minority Health, U.S. Department of Health and Human Services, Washington, D.C., 1985.
81.
Whites Retain Negative View of Minorities a Survey Finds, New York Times, p. B10, 1991.
82.
ThomsonG., Discrimination in Health Care, Annals of Internal Medicine, 126: 11, pp. 910–912, 1997.
83.
SchulmanK. A.BerlinJ. A.HarlessW.KernerJ. F.SistrunkS.GershB. J.DubeR.TaleghaniC. K.BurkeJ. E.WilliamsS.EisenbergJ. M.EscarceJ. J., The Effect of Race and Sex on Physicians' Recommendations for Cardiac Catheterization, New England Journal of Medicine, 340: 8, pp. 618–626, 1999.
84.
FreemanH. P.PayneR., Racial Injustice in Health Care (Editorial), New England Journal of Medicine, 342: 14, pp. 1045–1047, 2000.
85.
ShortellS. M., The Contribution and Relevance of Sociology to Health Services Research, in Social Science Approaches to Health Services Research,ChioJ.GreenbergJ. N. (eds.), Health Administration Press, Ann Arbor, Michigan, pp. 21–53, 1982.
86.
FreidsonE., Professional Dominance: The Social Structure of Medical Care, Atherton Press, New York, 1970.
87.
O'BrienL. J., Bad Medicine: How the American Medical Establishment is Ruining Our Healthcare System, Prometheus Books, Amherst, New York, 1999.
88.
JonesJ. H., Bad Blood: The Tuskegee Syphilis Experiment, Free Press, New York, 1993.
89.
ThomasS. B.QuinnS. C., The Tuskegee Syphilis Study, 1932 to 1972: Implications for HIV Education and AIDS Risk Education Programs in the Black Community, American Journal of Public Health, 81: 11, pp. 1498–1505, 1991.
90.
WhiteR. M., Unraveling the Tuskegee Study of Untreated Syphilis, Archives of Internal Medicine, 160: 5, pp. 585–598, 2000.
91.
HobermanJ. M., Darwin's Athletes: How Sport Has Damaged Black America and Preserved the Myth of Race, Mariner Books, Boston, 1997.
92.
AlperJ. S., Ethnical and Social Implications, in Sociobiology and Human Nature, Jossey-Bass, San Francisco, pp. 195–221, 1978.
93.
HorneG., Race Backwards: Genes, Violence, Race, and Genocide, Covert Action, pp. 29–35, 1992–1993.
94.
DusterT., Backdoor to Eugenics, Routledge, New York, 1990.
95.
MarkelH., The Stigma of Disease: Implications of Genetic Screening, American Journal of Medicine, 93: 2, pp. 209–215, 1992.
96.
GibbsW. T., Seeking the Criminal Element, Scientific American, pp. 101–107, 1995.
97.
TolnayS. E., The Bottom Rung: African American Family Life on Southern Farms, University of Illinois Press, Urbana, 1999.
98.
AshmoreH. S., Hearts and Minds: A Personal Chronicle of Race in America, Seven Locks Press, Cabin John, Maryland, 1988.
99.
College Enrollment by Racial and Ethnic Group, Selected Years, Chronicle of Higher Education Almanac, 46: 1, p. 24, 1999.
100.
Employees in Colleges and Universities by Racial and Ethnic Group, Fall 1995, Chronicle of Higher Education Almanac, 46: 1, p. 38, 1999.
101.
Number of Full-time Faculty Members by Sex, Rank, and Racial and Ethnic Group, Fall 1995, Chronicle of Higher Education Almanac, 46: 1, p. 38, 1999.
102.
Institutionalised Racism in Health Care, Lancet, 353: 9155, p. 765, 1999.
103.
SindlerA. P., Bakke, DeFunis, and Minority Admissions: The Quest for Equal Opportunity, Longman, New York, 1978.
104.
HerrnsteinR. J.MurrayC., The Bell Curve: Intelligence and Class Structure in American Life, Free Press, New York, 1994.
105.
LemannN., The Big Test: The Secret History of the American Meritocracy, Farrar, Straus, and Giroux, New York, 1999.
106.
GreveM. S., The Demise of Race-Based Admission Policies, Chronicle of Higher Education, p. B6–B7, 1999.
107.
CantorJ. C.MilesE. L.BarkerD. C., Physician Service to the Underserved: Implications for Affirmative Action in Medical Education, Inquiry, 33: 2, pp. 167–180, 1996.
108.
KeithS. N.BellR. M.SwansonA. G.WilliamsA. P., Effects of Affirmative Action in Medical School: A Study of the Class of 1975, New England Journal of Medicine, 313: 24, pp. 1519–1525, 1985.
109.
OrfieldG., Affirmative Action Works—But Judges and Policy Makers Need to Hear that Verdict, Chronicle of Higher Education, 46: 16, pp. B7–B8, 1999.
110.
BowenW. G.BokD., The Shape of the River: Long Term Consequences of Considering Race in College and University Admissions, Princeton University Press, Princeton, New Jersey, 1998.
111.
SchneiderA., Affirmative Action's Impact on Academe has been Minimal, A New Book Argues, Chronicle of Higher Education, 46: 29, p. A20, 2000.
112.
BanduraA., Social Learning Theory, Prentice Hall, Englewood Cliffs, New Jersey, 1977.
113.
AndersenR., A Behavioral Model of Families' Use of Health Services (Chicago): Center for Health Administration Studies, University of Chicago (Research series, 25) University of Chicago, Center for Health Administration Studies, 1968.
114.
AdayL. A.AndersonR., A Framework for the Study of Access to Medical Care, Health Services Research, 9, pp. 208–220, 1974.
115.
AdayL. A.AndersonR.FlemingG. V., Health Care in the U.S.: Equitable for Whom?Sage Publications, Beverly Hills, 1980.
116.
GreenL. W., Health Promotion Planning: An Educational and Environmental Approach (2nd Edition), Mayfield Publishing Company, Mountain View, California, 1991.
117.
LaVeistT. A.KeithV. M.GutierrezM. L., Black/White Differences in Prenatal Care Utilization: An Assessment of Predisposing and Enabling Factors, HSR: Health Services Research, 30, pp. 43–58, 1995.
118.
WilliamsS. J.TorrensP. R., Introduction to Health Services (3rd Edition), Delmar Publishers, Inc., Albany, New York, 1988.
119.
WeedD., Epidemiology, The Humanities, and Public Health, American Journal of Public Health, 86: 7, pp. 914–918, 1995.
120.
EngD.SalmonM. E.MullanF., Community Empowerment: A Critical Base for Primary Health Care, Family and Community Health, 15: 1, pp. 1–12, 1992.
121.
KanterR. M., The Change Masters: Innovation for Productivity in the American Corporation, Simon and Schuster, New York, 1983.
122.
GrahamL., Our Kind of People: Inside America's Black Upper Class, HarperCollins, New York, 1999.
