Health in Black and White: Debates on Racial and Ethnic Health Disparities in Brazil

Posted in Anthropology, Brazil, Caribbean/Latin America, Dissertations, Health/Medicine/Genetics, Media Archive, Politics/Public Policy, United States on 2012-01-10 22:56Z by Steven

Health in Black and White: Debates on Racial and Ethnic Health Disparities in Brazil

University of California, San Diego
2011
320 pages
Publication Number: AAT 3458492
ISBN: 9781124703657

Anna Pagano

A dissertation submitted in partial satisfaction of the requirements for the degree Doctor of Philosophy in Anthropology

In 2006, the Brazilian Health Council approved a National Health Policy for the Black Population. The Policy is striking because it promotes the image of a biologically and culturally discrete black population in a nation where racial classification has historically been relatively fluid and ambiguous. It transforms established patterns of racialization by collapsing “brown” (pardo) and “black” (preto) Brazilian Census categories into a single “black population” (população negra) to be considered a special-needs group by the public health apparatus. This construction resembles the United States’ dominant mode of racialization based on hypodescent and represents a significant departure from hegemonic portrayals of Brazil as a racially mixed nation. Furthermore, the Policy challenges national ideologies of racial and cultural unity by affirming the existence of an essential black body with specific health concerns, as well as an essential Afro-Brazilian culture that materializes in recommendations for culturally competent health care. As such, the Policy constitutes an important site for new negotiations of racial and cultural identity in Brazil.

In this dissertation, I explore the political and social implications of treating racial and ethnic groups differently within Brazilian health care. I examine how the re-definition and medicalization of racial and cultural identities unfolds in public clinics, temples of Afro-Brazilian religion, and social movements based in São Luís and São Paulo, Brazil. Through an analysis of ethnographic data that I collected over twenty-four months, I assess the impact of recent developments in race-conscious health policy on Brazilians’ lived experiences of race, ethnicity, and health disparities.

I argue that the new Policy, and its associated health programs, signals the emergence of a new biopolitical paradigm in which the Brazilian state formalizes citizens’ racial and ethnic differences in order to address inequalities among them. I also show that many aspects of these programs, which incorporate global discourses and concepts related to health equity, fail to resonate with Brazilian citizens’ notions about race and health. Consequently, patients and healthcare providers often resist the new measures. The result is a disjuncture between policy and practice that ultimately hinders Brazil’s efforts to reduce health inequalities among its citizens.

TABLE OF CONTENTS

  • Signature Page
  • Table of Contents
  • List of Figures
  • List of Tables
  • Acknowledgements
  • Vita
  • Abstract of the Dissertation
  • PART I: RACE, MEDICINE, AND BIOPOLITICS IN BRAZIL
    • Chapter 1: Introduction
      • Race and Ethnicity
      • Biologization and the Re-Biologization of Race
      • Medicalization
      • Medicalization of Race
      • Biopower and Biopolitics
      • Applying a Biopolitical Framework to the Medicalization of Race
      • Race and National Identity in Brazil
      • Black Movement Activism
      • Public Health in Brazil
      • Ethnographic Field Sites
    • Chapter 2: Everyday Narratives on Race, Racism, and Health
      • Patients’ Narratives on Race and Health
      • Health Care Professionals’ Narratives on Race and Health
      • Patients and Providers: A Counter-Biopolitics
  • PART II: THE BLACK HEALTH AGENDA
    • Chapter 3: The Birth of the Black Health Agenda in Brazil
      • Black Health Activism in Brazil
      • The Black Health Agenda in São Paulo
      • The Black Health Agenda in São Luís
    • Chapter 4: The Black Health Epistemic Community in Brazil
      • The Politics of Categorization
      • The Imperative of Self-Declaration
      • Etiological Claims
      • Medicalizing Racism
      • Discourses of Difference
      • Implications for Citizenship
      • Conclusion
  • Part III: AFRO-BRAZILIAN RELIGIONS AND HEALTH
    • Chapter 5: Health and Healing in Afro-Brazilian Religions
      • Afro-Brazilian Religions: A Brief Background
      • Mãe Letícia
      • Pai Cesar
      • Healing in Afro-Brazilian Religions
    • Chapter 6: Afro-Brazilian Religions and the State
      • Partnerships between Terreiros and SUS: Rehabilitating History
      • Razor Blades and Comic Strips
      • Other Sources of Conflict
      • Cultural Competence and the Terreiro
      • De-Sacralizing the Terreiro
      • Conclusion
    • Chapter 7: Afro-Brazilian Religions and Ethnic Identity Politics in the Brazilian
      • Public Health Arena
      • Terreiro Health Activists’ Identity Politics
      • Conclusion
    • Chapter 8: Health in Black and White
  • Bibliography

LIST OF FIGURES

  • Figure 1. Household Income, 2000
  • Figure 2. Distribution of Race/Color (Pretos and Pardos), 2000
  • Figure 3. Public Health Facilities and Distribution of Population by Color in São Paulo, 2000
  • Figure 4. Population Density of São Paulo, 2000

LIST OF TABLES

  • Table 1. Characteristics of Sample Population
  • Table 2. Self-Identified Race or Color
  • Table 3. Beliefs Regarding Health Outcomes between Blacks and Whites

Purchase the dissertation here.

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