mensions of demographic differences—than may be commonly assumed. The second purpose of this chapter is to offer an alternative concept of cultural processes that affords a more relevant base from which to understand sociocultural diversity and its implications for health communication. Our recommendations from this chapter stem from the perspective that understanding differences in health status or health behavior requires an examination of sociocultural processes and life experiences. Underlying this perspective is a radical reframing of cultural groupings because current categories are often misused in attempts to explain differences within and across groups. This new perspective suggests a fundamental reorientation in the research agenda.

In the discussion of culture and diversity in this chapter, a number of specific issues are raised, and suggestions are made to address those issues. The issues include:

  • Despite a lack of biological evidence for racial groupings, “race” as a social construct continues to be a reality that is reflected in discriminatory social relationships and actions (racism, discrimination, oppression). For this reason, the construct of “race” matters in our society.

  • Because these key social constructs of “race/ethnicity” (e.g. African-Americans and whites) are correlated, however imperfectly, with socioeconomic indicators, they are useful as rough indicators of health disparities. It is when we want to go beyond rough assessments of the health impacts of socially mediated macro forces that these constructs have little explanatory power, because of intragroup variation and other sociocultural and political factors that may have more important influences on behavior.

  • The identification of health disparities through the use of racial and ethnic categories has also led some to equate diversity with disparity and to contribute to a view that ethnic groups are homogeneous. Neither of these is necessarily the case. In fact, the use of racial/ethnic labels reifies the groups and conveys the sense that these group labels reflect some “cultural reality” in some meaningful way. This implies that the solution lies in dealing with



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