Race and ethnicity in health services research

Race and ethnicity (race/ethnicity) are routine demographic variables in health services research. Researchers use racial/ethnic identifiers to document health disparities, describe populations, denote risk markers for disease, and policy development.;How researchers conceptualize and operationalize race/ethnicity, determine their explanations for health disparities. These explanations might inadvertently reinforce racial/ethnic stereotypes, lead to medical over/under treatment of racial/ethnic groups, and guide health policies that minimize the larger social implications of racial/ethnic disparities.;Given the dearth of empirical research about how researchers' conceptualize, operationalize, and analyze racial/ethnic data, the role that funders and journal editors might play in this practice, and the usefulness of racial/ethnic variables to explain health disparities, this dissertation was guided by these open-ended questions: (1) How do researchers conceptualize and operationalize race/ethnicity and collect and analyze racial/ethnic data? (2) Do funding agency administrators and journal editors play a role in collecting and reporting racial/ethnic data? (3) Are racial/ethnic variables helpful in explaining health disparities?;The theoretical frameworks guiding this dissertation were sociology of knowledge (SoK) and critical race theory (CRT). SoK informed the contemporary understandings of race/ethnicity in research and the influences leading to collecting racial/ethnic data. CRT provided insights into the racial/ethnic metaphors used to explain health disparities.;Data were derived from interviews with 46 study participants (33 researchers affiliated with academic health centers in the northeast, southern, and western US, six funding agency administrators, and seven journal editors). Non-probabilistic sampling strategies were used to ensure variation among researchers.;Overwhelmingly, respondents' conceptualization and operationalization of race/ethnicity was framed within the dominant scientific paradigm (empirical knowledge) using the dominant methodology (quantitative tools). This form of knowledge maintained a priori beliefs and presuppositions about race/ethnicity, thus reinforcing the necessity of these variables in research. Furthermore, binary constructions of racial/ethnicity overlooked the broader social meanings of disparities and often emphasized the racialization of differences.;The policy recommendation calls for a paradigmatic shift in thinking about how racial/ethnic variables are used in health services research.