Racial ideology and explanations for health inequalities among middle-class whites

Middle-class whites' explanations for racial inequalities in health can hav e a profound impact on the type of questions addressed in epidemiology and public health research. These explanations also constitute a subset of whit e racial ideology (i.e., racism) that in itself powerfully affects the heal th of non-whites. This study begins to examine the nature of attributions f or racial inequalities in health among university students who by definitio n are likely to be involved in the research, policy, and service profession s (the upper middle class), Investigation of the degree to which middle-cla ss whites attribute racial inequalities in cardiovascular health (between t hemselves and African Americans, American Indians, or Asian Americans) to b iological, social, or lifestyle factors reveals that whites tend to attribu te their own health to lifestyle choice and to biology rather than to socia l factors. These results suggest that contemporary middle-class whites' "se lf-serving" explanations for racial inequalities in health are comprised of two beliefs: implicit biologism (race is an attribute of organisms rather than a social relation) and liberal belief in self-determination, choice, a nd individual responsibility-some of the core lay beliefs of the worldview that sustains neoliberal capitalism. Contemporary white middle-class explan ations for racial inequalities in health appear to include assumptions that justify class inequality. Liberal approaches to racism in public health ar e bound to miss a key component of racial ideology that is currently used t o justify racial and class inequalities.