Any policy, research, and action on the part of individuals or institutions that promote (intentionally or unintentionally) the believed superiority of one group, profession, or set of ideals over another can be considered ethnocentric. The Oxford English Dictionary (OED) defines ethnocentrism as "regarding one's own race or ethnic group as of supreme importance" (1989, p. 424). The dictionary records the first use of the term to be in 1900 when W. G. McGee, in the Annals and Reports of American Ethnology, referred to ethnocentrism as a characteristic of primitive cultures. McGee couldn't imagine his own European culture as having ethnocentric biases. Ethnocentrism, as it is understood in the twenty-first century, was first defined in 1951. Noted anthropologist E. E. Evans-Pritchard, in the publication Social Anthropology, saw ethnocentrism as claiming or believing that one group has superiority over others and urged that "this ethnocentric attitude has to be abandoned if we are to appreciate the rich variety of human culture and social life" (OED 1989, p. 424). It is apparent that a broader use of the term has entered common usage.
Success in the field of public health requires cultural and social sensitivity. Recognizing the limiting effects of ethnocentrism and heeding the call of Evans-Pritchard is essential. Public health workers and the programs they design must recognize the distinctive features and characteristics of the populations they serve. S. Van der Geest notes that ethnocentrism encourages narrowmindedness. It prevents one from entertaining different worldviews, and one becomes less inclined to challenge or question how different groups of people learn or to understand what they are interested in learning. The appreciation of different forms of knowledge and values are at the core of ethical practice, policy, and research in public health.
Understanding ethnocentrism and its relation to race in public health research is particularly important in the United States because of its history of using race in classifying and judging different groups. M. T. Fullilove notes that race is an arbitrary system of visual classification that has no scientific relevance in public health research. R. Bhopal and L. Donaldson suggest the use of nonracialized terms in public health research and caution that the use of racial categories in scientific research can be interpreted as an endorsement of racial determinism. The historical use of racial categorization was founded on the ethnocentric belief that the so-called white race was superior to the so-called black, red, and yellow races and promoted an attitude that there was no need for equality in entitlement to public goods and services. The most often cited example of racist and ethnocentric conduct in U.S. public health history is the forty-year Tuskegee syphilis study, where African-American men with syphilis
In twenty-first-century America, there is concern over persistent disparities in health status between those of European or Caucasian descent and other groups—a distinction often based on racial or minority status. The disparity has persisted in part because of ethnocentric attitudes and beliefs on the part of health care providers, researchers, and health-policymakers over the most effective methods for addressing health promotion and disease prevention on the one hand, and for providing the most efficient health care services on the other. Effectiveness and efficiency are dependent on social and cultural characteristics and skills. It has been demonstrated that ethnic and cultural values and beliefs influence the way individuals and groups view health and disease and determine what practices are followed when illness occurs. Ethnocentric points of view can prevent attempts to acknowledge ethnic differences and cultural values in making health decisions that better address the health concerns of U.S. minorities. To challenge ethnocentrism is to recognize and value differences and qualities that exist in diverse groups. Such differences can include eating practices, spiritual values, body shape and size, and preventive and curative beliefs, to name but a few.
Public health often focuses too much on risk factors and not enough on protective cultural and cognitive factors in the same individuals. Public health does focus on these in attempting to promote positive health practices, attitudes, beliefs, values, and living conditions. All groups have both risk (negative) and protective (positive) factors that can determine health-related behavior and skills. The positive aspects of a group's beliefs and practices as they relate to health need to be recognized and promoted. When negative aspects of a minority group's beliefs and values must be changed, it does not follow that the strategy and approach for such change needs to conform with the strategy and approach for changing negative beliefs and values in the majority group. Failure to understand differences in the way various groups address their preventive and curative health needs often leads to ethnocentrism in public health. To eliminate the disparity in the health status of ethnic minorities in the United States, public health professionals must encourage diversity in approaches to health promotion and disease prevention and eliminate ethnocentrism in public health.
COLLINS O. AIRHIHENBUWA
(SEE ALSO: African Americans; Anthropology in Public Health; Asian Americans; Assimilation; Biculturalism; Cultural Identity; Cultural Appropriateness; Ethnicity and Health; Immigrants, Immigration; Minority Rights; Values in Health Education)
Airhihenbuwa, C. O. (1999). "Of Culture and Multiverse: Renouncing the 'Universal Truth' in Health." Journal of Health Education 30:267–273.
Bhopal, R., and Donaldson, L. (1998). "White, European, Western, Caucasian, or What? Inappropriate Labeling in Research on Race, Ethnicity, and Health." American Journal of Public Health 88(9):1303–1307.
Fullilove, M. T. (1998). "Comment: Abandoning 'Race' as a Variable in Public Health Research—An Idea whose Time Has Come." American Journal of Public Health 88(9):1297–1298.
Jones, J. H. (1995). Bad Blood: The Tuskegee Syphilis Experiment. New York: Free Press.
Judd, C. M.; Park, B.; Ryan, C. S.; Brauer, M.; and Kraus, S. (1995). "Stereotypes and Ethnocentrism: Diverging Interethnic Perceptions of African American and White American Youth." Journal of Personal and Social Psychology 69(3):460–481.
Oxford English Dictionary, 2nd edition (1989). Oxford, England: Clarendon Press.
Van der Geest, S. (1995). "Overcoming Ethnocentrism: How Social Science and Medicine Relate and Should Relate to One Another." Social Science and Medicine 40(7):869–872.