Immigrant Health InequitiesĪmong immigrant health inequalities research, there is significant interest in documenting the health of undocumented populations. Therefore, we incorporate the pandemic to exemplify our concept of diversions, to identify if, and whether, diversions are prevalent in immigrant health studies, and if terms such as white supremacy and intersectionality are explicitly named in immigrant health research. COVID-19 has brought to the fore the historically and systemic rooted inequities that continue to wreak havoc, and further exacerbates the already existing health inequities. The quote hints at the desperate need for explicitly addressing health inequities by describing what is left out, what is emphasized as the culprit for health inequalities, and whether the inequality-generating actions of those in power are considered in health inequalities research. Navarro ( 2009), referring to the WHO Commission on the Social Determinants of Health report, acknowledges and applauds many of its recommendations, but faults it for ignoring the power relations that shape the social determinants of health. Policy agendas, such as reparations, and other income and wealth redistribution policies, might better address the fundamental causes of health, getting us closer to a more just and equitable society. Medicalizing inequality ultimately reinforces medical, behavioral, and neoliberal approaches, by allowing politicians and policy makers to hide behind an “equity” agenda, instead of addressing the redistribution of income and wealth ( Lynch 2017 Navarro 2009). Framing health inequalities as deriving from social inequalities leads to medicalizing inequality, and, as Lynch ( 2017) argues, makes politicians and policy makers able to promote an “equity” agenda, without confronting the fundamental causes of health needed to truly address and eradicate both health and social inequities.
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For example, the World Health Organization Commission on the Social Determinants of Health (CSDH) invokes social inequalities as drivers of health inequalities ( World Health Organization 2008). Health inequalities have been linked with social inequalities. We provide suggestions on moving away from diversionary research, toward adopting an intersectional approach of the study of immigrant health inequities. We argue that understanding white supremacy’s role in the knowledge production cycle illuminates how diversions occur and prevail. Intersectionality was mentioned once in a research article. There was no mention of white supremacy across the knowledge production cycle. The findings demonstrate the prevalence of diversions in immigrant health research, given an overemphasis on health behaviors and cultural explanations towards explaining immigrant health inequities.
Using a qualitative content analysis approach, we analyzed these data as evidence concerning the knowledge production cycle, and investigate whether: (a) the role of advantaged groups in generating inequalities is explicitly mentioned (b) disadvantaged groups are asked about discriminatory actions perpetuated by advantaged groups (c) health inequalities are placed on the conditions of disadvantaged groups (d) if white supremacy and intersectionality are explicitly mentioned in grants, publicly available datasets, and research articles. The data derive from: NIH R01 grants (17), publicly available datasets that focus on immigrant health (7), and research published in three health journals (14).
This paper highlights US immigrant health inequities-a burgeoning subfield within the broader health inequalities canon-to explore: (1) if and how diversions appear in immigrant health studies (2) how often white supremacy and intersectionality are explicitly named in grants, publicly available datasets, and published research. We incorporate important insights from COVID-19 to illustrate historical and contemporary examples of diversions. Diversions occur when research disregards the inequality-generating actions of advantaged groups and instead focuses attention on the actions and behaviors of disadvantaged groups.