Racism: A (Social) Infectious Disease?
The classic definition of an infectious disease occurs when microscopic organisms get pass the body’s natural defense system and create symptoms. Causal agents include bacteria, viruses, fungi and parasites. Infections can affect the entire body (measles, malaria, HIV and yellow fever) while others can be limited to a system or organ. Tuberculosis and the common cold are examples of local infections. Virulence, immune response, and health of the host influence the outcome of infection. As evidenced by recent pandemics (e.g. SARS, COVID), infectious diseases present an ongoing public health issue.
Infectious disease causal models have been applied to chronic diseases such as obesity. The social contagion process of obesity does not rely on the spread of microorganisms by direct social contact found in infectious disease research. Instead, researchers have posited that obesity prevalence depends on belief decisions. The key for Huang and colleagues was the adoption of the framework of Dempster-Shafer theory of evidence (DST) that “people are influenced by their prior beliefs and expectations when evaluating new information.” They conclude, the “social contagion of obesity can be contained and even eradicated through the competing spread of physical activity belief and physical inactivity belief.” The rate of weight gain can signal “hints” to peers about physical activity or inactivity. Targeting physical inactivity beliefs serves as a basis for public health intervention.
Corollaries with racism are clear. Racial beliefs can be used in conjunction with infectious disease models. These beliefs can include:
belief in supporting policies or program that have racial disparate impact, a surprisingly common practice regardless of racial/ethnic background
belief in diminishing capacity of minority groups to limit their effective participation in policy development or program planning
belief in inaction, minimal disruption, or maintaining the status quo (“conservatism”) pertaining to racial divides,
belief in limiting education and discussion to exclude tools of liberation
belief in racial superiority
belief in false narratives that there are no or few solutions to an issue of racial health inequity
belief in lack of liberation (or opposition) for perpetuation of racist policy or program
belief in threat to dominant position of power whether individual (within a social system) or group
These beliefs can be measured and used in models to understand changes in racial violence over time. Rather than obesity as the outcome, we can study how these beliefs perpetuate structural racism. We can apply agent-modeling that assumes that certain agents with disproportionate sources of authority or influence within the system (e.g. hiring and team managers, director, deans, elected officials, CEOs, community leaders) can contribute more substantially to structural racism.
These approaches are desperately needed in public health. If we endeavor to accelerate racial health equity, a core value of Public Health Liberation, then we must innovate in the area of racial science.
