Using community participatory action research (CPAR) in immigrant community health promotion: Ideas for chronic disease and mental health prevention

The routine (re)production of epidemiological data on racial health disparities is common practice in public health research.  Often presented as a means of explaining the persistence  of gaps in health status across racialized groups, the “race” concept has enjoyed an uncritical advantage in public health discourse.  The rationale of using “race” is that in producing such knowledge enables public polocies that intervene to address the determinants of health inequalities. The persistence of poorer health outcomes for diverse groups raises the spectre of the usual suspects in the discourse: that is, a disproportion­ate preference to poor health, a lack of truly equal access to healthcare, and a breakdown in effective interactions between racialized groups and the health care system; all indicate the need for positioning “race” as a health culprit in public health research. This paper examines the use of “race” in two case studies of Canada and Brazil. I argue that an uncritical use of “race” in public health research reinforces a sense that the measures are real, the properties of the category meaningful, and their meaning unproblematic. This paper discusses in detail the data quality issues related to the measurement of “race” and methodological dilemmas in measurement, conceptualization of the findings, and application in public health praxis. Through a critical discourse analytic method, this paper demonstrates that when “race” is narrowly conceptualized, differences in values regarding health behaviours of individuals and groups are often ignored and silenced. The technology of epidemiological enumeration and the knowledge it produces is shaped by all kinds of narratives, positions, and assumptions that must be highlighted to refine the research process.  Thus, in practice quantitative public health discourse(s) of “race” normalize classification systems of “race” in particular ways for specific purposes, pointing to the construction, and regurgitation of a discourse in the research process.