A Duboisian Dogma Appropriate for Addressing Social Context and Global Health: The Case of Cardiovascular Disease

W.E.B. Dubois (1906) was the first Sociologist to show “social context” was a major mechanism driving racial differences in morbidity and mortality.  The problems identified in Dubois’ empirical studies “The Philadelphia Negro” and “The Health and Physique of the Negro American” have continued relevance for understanding the underlying factors driving race/ethnic disparities in health presently.  Using two of his seminal projects as frameworks, this paper uses empirical evidence from 3 secondary datasets to investigate the role of “social context” in cardiovascular disease, measured by hypertension prevalence, for race/ethnic groups in the United States, Canada and South Africa.  Findings suggest African American hypertension rates remain higher than whites (OR=1.48; CI= 1.47,1.48)  that are explained by education, smoking, drinking, age, sex.  For South Africa, Coloureds (OR=1.44; CI=1.44, 1.44) and Asians (OR=1.43; CI= 1.43, 1.44) had higher hypertension rates compared to Whites, that were explained by heavy drinking and smoking. In Canada, “visual minority” groups had higher hypertension rates (OR=1.11; CI=1.02, 1.21) compared to whites that were explained by education, health behaviors and age.  This paper proves the factors implicated in high mortality rates for African Americans identified by Dubois, continue to be the same factors driving health disparities for Blacks, marginalized race groups and “visual minorities” presently.  Conclusions challenge scholars, researchers and public health professionals to think critically about how to address race/ethnicity and racial subjugation in global health policy in order to move forward to improve population health in varying geographic spaces, particularly in countries with socialized medicine.