Thread by @AnushaVable

I’ll try to live tweet ⁦@zinzinator⁩’s talk!

@zinzinator In epi, we should try to conceptualize more meaningful counterfactuals when thinking about race.

@zinzinator it's more than just social determinants of health -- we need to think about role of race, racism, and racialization in thinking through health and health disparities outcomes

@zinzinator Critical Race Theory (CRT) grew out of legal scholar's recognition of the centrality of racism.

Challenged the claim that the law is "race neutral"

Noted that fundamental systemic inequalities are driving by structural institutional racism that distorts social hierarchies

How is racialization relevant to the problem?

How is racialization relevant to the production of knowledge, methods we use, and the questions we can answer?

Race is driven by social, political and historical contexts -- when we put race in a model, what does it really mean? is it racism? Is it something else?

distinctions between "races" and the importance of 'genetic' or phenotypic traits or are driven by cultural, historical, ideological, geographical, and legal influence, and are inherently hierarchal

racialization is normative - not aberrant - in society and permeates all aspects of life.

different groups have been racialized over time, e.g. Arab Americans we racialized after 9/11 in a way they weren't previously

what is asked when we put race in the model as an exposure: what would happen to black ppl if they were white?

not such an interesting counterfactual!

more interested in what is the expected difference in health in the Black populations had the current social conditions that create and maintain racial hierarchies been dismantled during an earlier time period?

Social conditions are mutable and not innate!

Changing social conditions is a different counterfactual than the variable race in a model.

Social structures that are created can be dismantled

you guys, I'm doing an extremely mediocre job of live tweeting.

the questions we ask should not be dictated by the methods available -- methods should work for us, not us for them.

racialization is imbedded in our social & scientific fabric.

the push toward "specificity" of hypothetical experiments biases us towards not attributing responsibility to the structures that perpetuate structural racism

this leads to an *individual-focused* "social" epidemiology rather focusing on the possibility of addressing structural racism

We need to focus on different counterfactuals!

Rather than put the "exposure" race in a model and / or focus on things close to the individual, we need to ask questions that address structural racism to dismantle the social structures that create racial disparities

I hope I didn't put too much of my own spin / interpretation on Zinzi's talk ...

Interested in learning more?

Come the #SER2020 symposia @zinzinator, @JuliaRaifman & I are organizing "Plausible Counterfactuals in the Study of Structural Racism and Population Health"

We have great speakers lined up: @WhitneyEpi, @atheendar, & Alyssa Mooney!

Date & time: TBD