:What? Inappropriate Labeling in Research

Contemporary European and American research on race, ethnicity, and health uses poorly defined labels to describe study populations. The search for accurate terminology remais controversial, for scientific and social reasons,1-16 as ilustrated by discussions of the terms Hispanic34 and Asian5 and the changing meaning of ethnicity and race in the United Kingdom" and the United States.2"2 Researchers should describe the study populations, define the terms used, and avoid lumping together heterogeneous populations.3'57 The controversy2 and scholarly and political debate'2'6 have largely bypassed the label White. Words such as White and Caucasian have been accepted as selfevidently suitable. While, for example, the labels Hispanic and South Asian are indexed in key textbooks,'0"' White is not. White is institutionalized in the censuses of the United States and the United Kingdom and is used freely in compiling statistics,'4 in epidemiology,' " and in clinical medicine. Racial and ethnic nomenclature in the United States is dominated by the classification of the Office of Management and Budget, which was devised by a subcommittee of the Federal Interagency Committee on Education.'6 It was adopted in 1977 and has been reviewed.'5 Its purpose was to collect data on groups that are discrimnated against, primarily for monitoring civil rights.'6 The recent review drew httle attention to the category White, although there were requests to include European-American, GermanAmerican, and Arab-American categories.'6 The US census has 10 subcategories for Asians and Pacific Islanders but none for Whites, who accounted for 80% ofthe population in 1990. The British census is similar. White is effectively a category for everyone left out of specific racial and ethnic groups. Researchers tend to rely on these classifications because of cost and convenience, even though they were devised for a different purpose other than research. As health and social research is an important by-product of statistics on population, this debate is relevant to future discussions on the census. Gimenez3 noted the problem of lumping together heterogeneous minority groups under one label but did not consider White groups. Williams et al.'8 also pointed to cultural and health variations within categories (e.g., Afncan Amencans, Asian Americans) but not within White populations. Hahn and Stroup'3 criticized the Atlas ofUS CancerAmong NonWhites: 1950-1980 for combining data for all non-Whites but not for combining Whites into one group. The British Medical Journal's guidance emphasizes the need to describe the populations studied and to avoid shorthand ethnic and racial labels. Examples are given for minority groups, but not for the majority population. Critical appraisal of the term White and similar labels is overdue.