An Interview with Merlin Chowkwanyun

This interview has been edited for length and clarity.

Ian McKay: Professor Merlin Chowkwanyun is the Donald H. Gemson Assistant Professor in Sociomedical Sciences at Columbia University, New York. Dr. Chowkwanyun has just brought out a book, All Health Politics is Local: Community Battles for Medical Care and Environmental Health, with University of North Carolina Press. In a close examination of health politics in New York City, Central Appalachia, Los Angeles and Cleveland in the 1960s and 1970s, Dr. Chowkwanyun argues that bird’s-eye views of health politics in the US, often reliant on “large aggregate, nationally representative data sets,” tend to lose sight of fundamentally important local phenomena and edit out all the local activists and local experiences that “challenged the paradigms of more powerful actors working on the national level.”[1] Dr. Chowkwanyun is currently at work on another book about political unrest at medical schools and neighborhood health activism. He was also the principal investigator on a research grant for ToxicDocs, where one can find millions of pages from once-secret documents pertaining to industrial toxins.

With Adolph L. Reed, Jr., he recently published in the New England Journal of Medicine an article cautioning against the subtle re-emergence of myths of racial biology, racial stereotypes and the stigmatizing of entire territories in seemingly objective statistics that help to frame Covid-19 as “largely a problem of minorities.”[2] Welcome to Syndemic, Professor Chowkwanyun.

Merlin Chowkwanyun: Thanks for having me….It’s actually kind of rare to have long-form conversations about these kinds of topics and especially around health. We’re very used to very short news blasts these days about Covid, but not really sustained kinds of exchanges….

McKay: We’re so glad you’re joining us. I’d first like to start out with the meta-question about the methodological and disciplinary challenges that relate to your stance as an historian of public health. In 2011, you brought out a really interesting paper on the “Strange Disappearance of History from Racial Health Disparities Research” – about how history has completely dropped out of many public health discussions.[3] Ironically, historians had played a central role in discussions of public health beforehand.

Here you noted that, although the field of racial disparities research in public health is booming, “what is missing…is a deeper understanding of how and why these social determinants of racial health matter so much, the long-term process through which they came into being, and how they might have been avoided” (254).

To put this less diplomatically: it seems to me a lot of contemporary discussion of the politics of public health drowns the reader in wave upon wave of descriptive statistics that don’t really give us any idea of the context. Citing Robert Aronowitz, you suggest that many mainstream investigations privilege the quantifiable and the “properties of the free-standing individual”(259), in order to squeeze data into pre-established equations, thereby neglecting fundamental forces and processes that can better be grasped holistically and historically.

So, here’s a three-part question. (1) In the 10+ years since you published this critique, have you noticed anything shifting in what we might call this pattern of simplistic positivism? (2) Are there indications that the chasm between critical historical intelligence and model-driven medical science is closing? (3) Do you find some sympathetic audiences for your call for the recognition of history as a “fundamental policy science”?

Chowkwanyun:  That’s an excellent … set of related questions…. In broad general terms,… I don’t think much has changed.  So, my critique, I think, still stands.

And I’m not surprised by that.  Anybody who has studied organizational inertia and how science is produced knows that those big dominant funding agencies, the ones that give out the most influential kinds of grants that really shape research agendas and how universities operate – they’re very, very, very slow to change (impervious to change, sometimes). They are often dominated by people who are embedded in the same tight social networks and who often think the same way. So it’s not surprising to me that, even if I do see the occasional currents suggesting we have to be more expansive about how we think about this, it’s very slow for the funding agencies themselves, who are some of the most important stakeholders in all this, to change… Often, studies have to be proposed to them in a kind of “A is on this side and B is on that side” format – with an independent and dependent variables kind of framework….

I’ll give you an example of this … Lead poisoning continues to be a scourge in the United States in some communities (and I assume in Canada as well). You are much more likely to be funded, if you can count the number of people who have been exposed to lead poisoning and the adverse health effects that they’ve [experienced]. That’s an important thing to continue cataloguing, of course – I’m not saying it is not – but, ultimately, we are dealing with what some would refer to as ‘downstream’ effects.

And I think what was often missing in that research (despite a lot of rhetoric saying we need more of this) is the ‘upstream.’ How did the lead get there in the first place?  And why is it still there – even though remediation, in the grand scheme of things, is not that expensive an undertaking relative to other things we spend lots of money on?

So, I think that kind of outcomes framework, whether it’s qualitative or quantitative, is still there, but I do see some signs of change.  There are people who don’t derive their funding from the big science world – medical anthropologists, sociologists, historians like myself. They are  advancing some really provocative questions on much lower budgets.

But the thing that worries me is,  essentially, we have two kind of discourses going on. There’s the one that’s produced by those more traditional quantitative researchers. And then there’s the scholarship produced by those who study institutions, legal regimes, historical processes and so forth.

I do sense some restlessness with… just saying the same general story over and over again about racial health disparities and not much beyond that. I especially see it with students of colour.  They say a lot of this research is actually bothersome to them because the only depiction that comes forth from it is that they’re a bunch of damaged people. That’s all that’s presented to them.  They actually want a story that tells them more about the kinds of the power dynamics and political arrangements that create this damage – not just a damage story itself. So, I do see a lot of energy from the student perspective.

But, you know, it’s hard for those old paradigms to fall…

Here’s an example of how some of the funding agencies, especially after the tumultuous events of the past few years, are operating. They signal, “OK, we have to expand our agenda, a little bit.” It’s also an example, at the same time, that shows that that instinct has some limits.

After the summer of 2020, the National Institutes of Health (NIH) issued a call for proposals for research on “structural racism” and health. Now, whatever you think about this term, I think that was pretty eye-opening to a lot of people. NIH (at least in the United States) tends to stay away from terms that have kind of a sort of normative critique embedded in them. And “structural racism” is, I think, such a term.  Some people were heartened that the NIH was interested in studying things in this way, was interested in structures and institutions….

Still, they [the NIH] listed the sorts of projects that are not eligible, in bullet-point form. Here’s one of the bullet-points: projects that are exclusively qualitative or that only use individual-level data. The second I could understand, but just to dismiss exclusively qualitative projects just because of the data type – that seems very, very questionable to me.

And the second [bullet-point] that really stuck out to me: “projects that do not examine the impact of structural racism and disparities on health-related outcomes.” There’s that obsession with, or fixation on, outcomes. They’re important, but they’re not the only thing you can study.

The arc of how society affects health is a long one. Measuring outcomes is an important part of it. The stuff that gets you to the outcome is also important. I think this is an example of how I do see signs of change but institutional strictures are very tough.

I see, from the younger generations of students, a lot of foment, and I’m very optimistic about that.

McKay: It’s really interesting you’re starting to see pushback from students of colour against some of this portrayal of them as damaged people living in damaged communities….

My second question relates to that theme. In 2012, with Adolph Reed, you published “Race, Class, Crisis: The Discourse of Racial Disparity and its Analytical Discontents.”[4] This is a very strongly-worded piece. Here you indict as “interpretive pathologies” many analyses of disparity made in the wake of the 2008 financial crisis, arising from a “distinctive, pro forma narrative structure”:  “Quantitative data, usually culled from large aggregate data sets, [are] parsed to generate accounts of the many facets of apparent disparity along racial lines with respect to barometers of inequality such as wealth, income and economic security, incarceration, employment, access to medical care, and health and educational outcomes” (150). “Among those pathologies are a schematic juxtaposition of race and class that frequently devolves into unproductive either-or debates; the dilution of class into a cultural and behavioural category or a static (usually quantitative) index of economic attainment that fails to capture power relations; sweeping characterizations of white Americans’ racial animus and collective psyche; ahistorical declarations that posit a long and unbroken arc of American racism and that sidestep careful dissection of how racism and, for that matter, race have evolved and transformed; and a tendency to shoehorn the United States’ racial history into a rhetorically powerful but analytically crude story of ‘two societies’, monolithic and monochromatic” (150).

Along with such scholars as Adolph Reed, Touré Reed, Barbara Fields, Karen Fields, Michele Mitchell, Kenneth Warren, and Joanna Wuest, you raise profound questions about how one ought to navigate a very complicated situation. In our time,   the scientific reputation of “race” as a useful category of biological analysis has all but collapsed… Yet, in much of the everyday world, “race” has never been more pervasively invoked. The paradox is that even though the scientific credibility of race as a concept has collapsed, in much of the world race has never been more prominent as a category of analysis. You hear of it every day.

For the Fields, for instance, placing so much weight on “race” as a master-category can  be likened to stubbornly insisting that crop failures are the result of spells cast by witches – a holdover from the Victorian “race science” that offered so much ideological cover to Jim Crow in your country and equivalent policies with respect to Indigenous peoples in ours. For Wuest, “even when older schemes of racial classification are seen as outdated and false, the proposed solutions wind up retaining the logic of racial aggregation.”[5] Do you see your work as a contribution to this school?

Chowkwanyun: Generally, yes. I use the qualifier “generally” because I’m always cautious about terms like “schools.” You and I know, as historians, that there are intellectual schools that are very tightly bound and they try to hold the line. The head of the school tries to get the mentees to propound a given thesis.

[In this case], I don’t think there’s a line or anything. In fact, among all those people that you mentioned, many of whom are colleagues, teachers, friends of mine, there are probably some subtle differences among us (and maybe some not-so-subtle differences).

To the extent we have something in common, it’s… the conviction that we should not make race and racism static, reified categories that are timeless and contextless  and always the same, no matter where you are on earth and what time period you’re in.

So, unlike a lot of academics, including some historians, I’m pretty averse to any kind of generalized statement about how race works and how important racism is or isn’t to larger patterns of inequality. Those are empirical questions, ultimately, to be investigated.  And the answer to that investigation varies a lot just depending on the phenomenon that you’re looking at – whether it’s health or housing or something contextual, such as the time and the place you’re in.

You know, our students use social media a lot (for better or worse) and not just to share pictures of themselves at concerts or whatever, but, increasingly, to learn about politics. One of the things I’ve never really liked about this (although I can see some benefits to it) is the diffusion of aphoristic statements on little squares…So, you know, one statement might be: “Racism is the fundamental force United States has been built on and always will be [built on].” It’s true enough, but also vague and general enough that it doesn’t really actually explain things like what vectors the racism is running through, where it came from, does it ever change, how does it cut across other axes of inequality – and so on. 

I generally just don’t like statements like that. Even if they seem self evident and true (at least initially), I’d rather be very contextually specific.  I think that’s what probably unites those scholars that you mentioned.

…Race is part of a genus of a larger set of ascriptive categories and labels that people have fixed to each other.  In the United States, that label happens to correlate very closely with phenotypical characteristics. In other societies, it might correlate with language, religion, the town or village you grew up in, tribal affiliations, whatever.

So, I view it as an item on the menu of many different categories. The interesting puzzle to is to figure out why some items on the menu seem to be more salient in some societies or in some eras than in others.

There’s a book that actually influenced me a lot on this, Charles Tilly’s Durable Inequality.[6] He was trying to figure out the reasons why inequality forms and why does it seem to really stick. And what are the mechanisms that make it so that people fall on one side or the other in a society?

Now he could have written this book, and focused it on just race alone, but he intentionally doesn’t do that. And he instead uses a huge litany of examples from around the world and different time periods…. The one thing in common with all of these examples, heterogeneous as they are, is that basically in societies, lines (i.e. categories) form. And you’re either on one side of line or the other.

It can be a gender line, a racial line, a professional/non-professional line (“You’re  in this tribe, not that tribe,” etc). He calls this process “categorical inequality.”

That’s always how I prefer to think about racial inequality, ultimately:  a manifestation of a broader process underneath called categorical inequality.  The onus is on us to figure out exactly why that version of categorical inequality arose….

McKay: You write that, “at its most simplistic,” a bird’s-eye quantitative analysis of race can leave the reader with “figure after figure illustrating disparity and not much else, or only slightly better, a series of plausible just-so stories that attempt to fill in the explanatory black holes post hoc. Simplistic use of race as the key analytic category,… suggests intra-racial class uniformity and encourages thinking in monochromatic dyads. Much of the problem rests with the almost exclusive reliance on quantitative data sets, which usually limits researchers to pre-defined administrative and demographic variables while ignoring consideration of forces not captured by that data”(152). Further, you argue,  there can be a neoliberal agenda active in such formulations, as signalled by such expressions as “equal opportunity” or “American Dream” or “level playing field”: “These red flags confirm that the agenda at work here stems from a concern to create competitive individual minority agents who might stand a better fighting chance in the neoliberal rat race rather than a positive alternative vision of a society that eliminates the need to fight constantly against disruptive market whims in the first place”(166). And you are emphatically critical of the “constantly expanding panoply of neologisms–‘institutional racism’, ‘systemic racism’, ‘structural racism’, ‘colour-blind racism’, ‘post-racial racism’, etc.  –intended to graft more complex social dynamics onto a simplistic and frequently psychologistic racism/anti-racism political ontology”(167). Here are some more phrases from this piece: “analytical sloth”, a “stifling, ready-made narrative,” “superficial,” “self-righteous,” “lazy-minded.”  One might fairly say, it does not want for fighting words.

Some will fight back, saying your current of anti-racist thought, if we agree it is a coherent current, disregards the grievous injuries of racism. Does it?

Chowkwanyun:   I don’t think it does. In fact, quite frankly, I think it does the opposite. I’ll explain why.

Sometimes, criticisms of that sort are based on the point that we just don’t put up in neon lights…a very general polemical slogan about how racism explains X and Y:  X and Y are “racist outcomes” explainable with reference to “racism.” That’s kind of tautological. I think you have to drill a little deeper than that.  

What we were trying to do in that article is take a term like “race,” often used as a kind of static variable, and disaggregate it [down] to its component parts. And, most important, to get to the underlying processes underlying it, whether those processes are tied to the labour market, the housing market, finance, land use, or whatever else…We want to know what chain of institutions and laws and public policies and collective actions resulted in that.

[Some critics] criticize prior generations of researchers for not labeling this racism.  There are a number of papers that have come out in health policy journals in the past couple years saying that racism needs to be a word that is explicitly used in these articles.

For me, I actually find this not particularly satisfying and a little besides the point:  because declaring those outcomes “racism” doesn’t actually elucidate the various specific forces through which that racism operates and of which it is a by-product.  So, I would argue for placing more emphasis on the processes that constitute what you call racism.

I think that is the opposite of disregarding it. It’s actually trying to probe more concretely what it is, beyond just using what is actually a pretty elastic construct of racism.

For a similar reason, I’m also a little averse to constructions like “structural racism,” which has seen an uptick in social science and health literature.

This is actually an interesting term…. It’s traceable to the 1960s, late 1960s, when more and more activists and academics started realizing that racism often (not always, but often) was more than just the psychological hearts-and-minds problem of individual prejudice.  Even if you changed many hearts and minds, why are racially disparate outcomes still intact? The answer was that many institutions or societal structures… sometimes even without nefarious people in them, could still perpetuate aggregate outcomes that were racially disparate.

That’s a very interesting idea. And I think that is indeed how a lot of society works to produce those kinds of outcomes. But, I also think not all racism works that way. Sometimes it is very much just the results of prejudicial beliefs or, more commonly, the consequence of many individuals collectively holding those prejudicial beliefs, and then acting on them. I think the task for us as researchers is to figure out exactly what flavour of racism we are dealing with. But having that “structural” adjective in front of it nudges you in that one direction…

You don’t want to actually take your constructs and stuff your theses into them. The constructs are supposed to serve (in my view) as heuristics that help guide the inquiry – not answer the inquiry before it starts.

McKay: Does your emphasis on the local case study and the problem-solving engaged in by elites as they wrestle with public health questions preclude looking at global, transnational patterns? For some scholars – here one thinks of Loïc Wacquant – one of the major deficiencies of much US work on race and racialization is that it narrows our understanding of the phenomenon, transforming the outlying American case, with its “one-blood rule,” into the measure of all of humanity, in a perverse form of American exceptionalism.

A less parochial approach is one that suggests, for example, the analytical possibilities offered by comparisons of various kinds of racism in various places. Some are drawn to the seemingly very different, yet also oddly comparable, stories of US racism, with its foundations in chattel slavery and Jim Crow, and the caste systems of India, based on age-old Hindu cosmologies – yet strikingly similar in its consequences for subalterns, at least as perceived by such organic intellectuals as Martin Luther King. Do you consider this ‘transnational turn’ a promising one for students of racism?

Chowkwanyun: I’m not a transnational scholar. I’m very much bound, for better for worse, to a nation-state framework. I’m very humbled, often, reading this very ambitious transnational scholarship.

My general inclination is to say, absolutely. But, you know, I guess the qualifier would be, I don’t fetishize scale for its own sake. Transnational history was a very hot thing when I was starting graduate school in 2005. It’s since become a little less hot….

You can do transnational history really well; you can also do it really sloppily and badly. For example,… taking categories of analysis, particularly around race in the United States, and imposing them elsewhere. You can also do it from a brass tacks perspective – really superficial stuff with surface-level landings in a lot of places….

But, that said, from the best of that work, I have learned a tremendous amount. The Latin American work,…offers us so many counter-examples to the “one drop-ism” of the United States. Again, it shows you that race in many cases is a lot more fungible and anchored fundamentally in particular places with unique histories. You get that with [well-conducted] transnational analyses.

I’ve also been interested in the circulation of racial ideas. One of the insights from comparative analysis is that, actually, the race idea in the US looks nothing like other categorical regime in some other place or nation state. That’s one big insight from that comparative work. Yet, that stands in some tension with transnational work that looks at the circulation of racial ideas. I am very interested to see whether or not the American idea of race, which seems so exceptional and parochial in many ways, was in fact transported and exported to many other places….

Now, my case for the local is actually grounded a lot more in the field of public health. Among public health researchers, research has been very top-down. It’s still dominated by the language of statistical aggregation.  It seems somewhat disconnected to me from the block level, the neighbourhood level – which, wherever you are in the world, is where, ultimately, public health policy is implemented and enacted. So, I wanted to restore that….

The major political project of our time, right now, is to speak to people on the ground in the context of their real day-to day-lives, while also realizing that their real day-to-day lives, even if they don’t necessarily see it, are very much structured by huge processes at all levels of society. I’m not saying that the local is the only optic we should all be switching to. Keep your eye on every single level.

McKay: And the paradox surely in the American case is that some people even dispute whether there is a national public health system. There’s so many local actors, disputing jurisdictions, chaos and confusion. Yet, at the same time, we’re given all these statistics that made the pandemic appear very uniform and understandable bird’s-eye view of the process – with elegant looking waves and endless pseudo-scientific measurements of them. There is a kind of illusion to it all….

Through the pandemic, one almost had the sense that “Someone is in charge” – if not the Centers for Disease Control, then somebody else behind the Wizard of Oz’s curtain. But, I’m not sure there is anybody there.

Chowkwanyun: That’s something that’s particularly difficult, I think, with the United States versus some of the other OECD nations or nations in general.  Our governance system is federated, especially, especially in sharp contrast to… countries in which there’s a more centralized function.

You’re absolutely right that a kind of fracturing is built into the system. It’s been especially difficult, over the past two years, not to have that kind of central coordinating system.  

McKay: Turning now to the pandemic, your piece with Adolph Reed in the New England Journal of Medicine argues that, although disparity data can be useful, “Disparity figures without explanatory context can perpetuate harmful myths and understandings that actually undermine the goal of eliminating health inequities.” Can you offer examples of this pattern from the Covid-19 years?

Chowkwanyun: I have a couple. One is something that people are more familiar with and one is maybe something people are a little less familiar with.

We’re all familiar with data visualizations of curves and models and things like that. Another one of those things is, of course, the “dashboard.” Every municipality and state has a dashboard. The country at large has a dashboard.

And on this dashboard you can usually disaggregate the figures by race and you can see the rate at which white people versus non-white people have gotten Covid-19 or died from Covid-19.

The Atlantic magazine also had what I thought was a pretty admirable project called the “Covid Tracking Project.”[7] It was an attempt to scrape all the data sets from a bunch of different municipalities and levels of government together in one convenient place.

But they also had something that I thought was a little less admirable: the “Covid Racial Data Tracker,”  which let’s you take those data and disaggregate them by racial demographic variables.

What’s the problem with doing that? If I show you those racial charts, without any kind of explanatory context and facts next to them, people can just start making up “just so stories” to explain them…. Often there is no evidentiary basis [to those stories]. They also often stigmatize the various populations that these graphs show are on the short end of the stick.

…I know you had said earlier that the biological notion of race is discredited. More so in academia. Less so with the person on the street. If I go to the person on the street and ask, “What makes me Asian?,” I think we would find many people who would just start spouting off stuff like blood and genes and stuff like that.  “You’ve got Asian genes” or “You’ve got Chinese genes” or whatever. It’s very ingrained at the folk level, if not at the academic level.

So, people tend to pivot when they see these figures without any context, and imagine, “Oh, there must be something just intrinsically, biologically defective about those people that makes them weaker and unable to fight off Covid.”

And the second [default narrative] is also very powerful….it’s the notion that there’s a racially specific culture, and that there are certain populations that just don’t follow rules and hygiene practices. So, the reason why they have Covid-19 more is because they haven’t been following public health directives, and so on and so forth. Again, it often takes the form of a “just-so story.”  

Lots of numbers… without any context for them. I think it is very dangerous. I’ve seen a lot of that during Covid.

Another, more obscure example of how these narrow post hoc narratives can often substitute for explanation: in the first year of the pandemic, when black Americans were experiencing higher rates of Covid, at large, there was this strange narrative going around about Vitamin D. The claim was that black Americans, because of complexion, don’t have enough Vitamin D.  Therefore, this is the reason why their immune systems can’t fend off Covid. Again, there are all kinds of holes in this analysis, including not a lot of unambiguous evidence about why Vitamin D was related to Covid to begin with. In these kinds of narratives… you just put out stuff without actually giving some explanatory context to them….

McKay: What kind of response did your New England Journal of Medicine article generate?

Chowkwanyun:  We have been surprised…. My strong sense is that… people have been frustrated with just seeing a bunch of tables that tell us sad (sometimes depressing, sometimes outrageous) stories, and then leave them hanging with nothing more. Not only is that analytically unsatisfactory but it’s actually potentially dangerous….Our article seemed to resonate. Both Reed and I have been giving a number of presentations about this paper, including to medical students and residents.

It hit in some unexpected ways… One of the things I always encourage historians who want to see more history in the public health arena: you’ve got to infiltrate those [specialized] publications. We could have presented this critique in some science and technology studies journal but far fewer people would have read it. Putting it in a venue like the New England Journal of Medicine means a more challenging audience, in many ways – and a more skeptical audience… but it is ultimately more consequential…

McKay: With respect to Covid-19, there were all these attempts to say that elevated Black levels in the US were related to non-workplace-related customs, such as funerals, weddings, church services. There was far less attention to the workplace conditions that were, in all likelihood and in most places, of far more causal significance.

Chowkwanyun: In our article, we suggested a variety of explanatory contexts, but the one we didn’t stress was occupation. I have no idea why, in retrospect. We didn’t do that… and that’s still what I think is really missing from this conversation about Covid and inequality: the workplace…. The labour movement, and interest in labour, especially in the public health world, has really declined in the past 20 or 30 years. It’s actually been hard to find a lot of scholarship on occupation and Covid risk, even though I believe it was the most important factor, other than age.

McKay: Some people might say, given how much the race talk has been abused throughout the Covid-19 period: wouldn’t it be a good idea to abandon the term “race” altogether? It’s become such a loaded, complicated, and in many ways toxic term, used, often in the most damaging ways, to oppress people. Might it not be a good idea, as I think the Fields argue in Racecraft,  to just set this politically-charged, damaging word aside? Yet, remembering an earlier point in our conversation: “race” may have collapsed as a scientific category for much of biology,… but it still seems to be going strong in public discourse.

By attaching ourselves to this old term, do we not, in a sense, elevate it? Do you see a way out of this trap?

Chowkwanyun: If we embargo the term (or make it so that every time you use “race,” you have to have like a long qualifier about how it’s just the label for a construct or an idea people invoke for various purposes), your writing starts to just get kind of cumbersome.  On a practical level, we’re probably stuck with the term.

But, I do think we can enhance the ways we use it. One is to, again, teach people that race is a label, one of many different labels. Sometimes it’s the most salient label in society and the most consequential. Other times, it may not be. And at other times, it may work in tandem with other kinds of labels and other kinds of mechanisms for marginalizing, stigmatizing, and separating people.

If you understand that race isn’t just this static thing, but actually a kind of technology that is used and applied to sort people, I think that that’s the way to go about it.

It’s definitely a social artifact that’s there. One thing to worry about if it’s simply dropped is that you play into the hands of people with certain political persuasions who want to make a problem disappear by disappearing the ways we can measure it. That’s not what I think should be done at all….

…It is a term doing category work…. Thinking about it that way has helped me, in some ways, de-provincialize and de-exceptionalize the term and see it as one of the many categories Charles Tilly was talking about…. The Latin American scholar Mara Loveman also argued for this categorical approach to race. [8] … Not race as this kind of exceptional category, even though it often seems that way in the United States – but as one of many categories….

McKay: A scepticism of identity politics characterizes many of the works I would associate with your current. In Adolph Reed’s words, “identitarians” seem convinced “that the basic units of a radical politics “should be groups formed around ascriptive identities that relate to one another on a principle of recognizing and preserving the integrity of their various differences.” From this perspective, the lengthy exposés of one’s positionality one associates with intersectionality solidifies division between people by “reading coherent group perspective unproblematically from common identity,” by “giving them an elaborate theoretical foundation.”[9] For you, the rigorous exploration of distinct localities as subalterns wrestle with the legacies of capitalist deindustrialization and pollution offers progressives something much more valuable than pre-defined and often simplistically dualist notions of racial politics in the US. Where would you align yourself with respect to intersectionality?

Chowkwanyun:  …I have a pretty high bar for concepts in general, and the coinage of new terms, and I’m quite conservative on this. There’s a basket of terms and, for the most part, I’m not sure we actually need to be inventing more of them…

An issue with intersectionality is that the definition of it has morphed so much, so that you actually don’t often know what exactly people are talking about when they invoke it. It refers to everything from having multiple ascriptive identities that reinforce oppression in some people to [an approach that refers to the ways] everything just kind of operates simultaneously. We have to look at every kind of variable you can think of, not just race, gender, but also sexuality, class, etc. There’s such elasticity to the term that I wonder about how useful it actually is.

That said: if one of the key claims of the term is that we should be examining the life chances and power from as many axes as possible, my answer is: “Absolutely, yes.” But I’m not sure the term is really needed to do that…. People were doing this before the term arrived.

…The original version of intersectionality as it was elaborated was a pretty interesting… legal thought experiment examining how anti-discrimination law is supposed to work, when you could potentially file an anti-discrimination claim around either racial discrimination or around gender discrimination (because, in American courts, it’s often very hard to make the case for both). A very interesting thought-experiment.

I have noticed that in some of the definitions of intersectionality, class is either missing or is thought to be this minimal thing that actually inadequately addresses social position. My issue with that [approach] is that class fundamentally operates in a different way than those ascriptive labels.  If intersectionality means to be more holistic, I’d like to see more class analysis in our understanding of categorical differences….

What do I mean by class analysis? Three things, and it’s worthwhile describing each of them.

Many of my colleagues, especially in the quantitative social sciences, tend to define class in a way that is most measurable and most operationalizable, but perhaps is less analytically fruitful. That’s the SES approach. This approach is to measure one’s education level or the amount of money someone has either stored or that’s coming in a flow as an income. Sometimes, occupational status. So there’s the SES approach, focused on quantitative measures of stratification.  I do think that it provides a lot of insight. But, I don’t think that is all that class is.

So I think a second approach is based on your relationship to the labour market, including not being in the labour market. Are you a boss? A petty owner of a small proprietorship? A worker?…  

A third approach looks at class as a process, particularly a process whereby a number of goods in society, especially essential goods, get commodified. Access to them is determined by ability to pay for the price of the commodified good….

I would like to see these three aspects of class enter the racial disparity discussion in the United States.  I don’t view these as mutually exclusive juxtapositions to race and other kinds of ascriptive difference. I view them as often working in tandem…

I find race-versus-class kind of debates, especially in a quantified form, to be incredibly frustrating. I think both of these processes are working at the same time and in different ways. They’re not things you should butt against one another…

McKay: Can you tell me a bit more about the distinction between ascriptive and other differences?

Chowkwanyun: …One is ultimately a sticker and a label that gets put on to you. And then that label and sticker generates meanings.  And those meanings result in different kinds of life chances and the way people treat you and even policies that dictate that if you’ve got that label you get this, if you have that label, you get that….

Whereas classes entail a set of economic processes having again to do with those things that I mentioned – the relationship to the labor market, and the commodification of social goods…

If you start from those considerations, you can very quickly get to all kinds of other things like immigration and flows of people around the world and justifications using labels of coercive labour systems – which is how race arose, at least in the US, where it was used to justify bondage and slavery and say: “You’ve got this label on you. This is why you are an enslaved person.”

…Sometimes categories are not anchored to the economic system as well. You can get into a kind of “Robo-automatic Marxism” thing, whereby you think absolutely every single kind of label is anchored to the capitalist system. Often it is, but sometimes it is not.

Perry Anderson, in an interview many years ago, remarked, à propos of Frankfurt School analyses of capitalism and anti-semitism: sometimes anti-semitism is just anti-semitism. Sometimes racial animus is not really anchored in labour and economics, even though we do realize it often has been….Often I find people treat class like an “ascriptive” category like race, especially if you just flatten class to “what did you make on your most recent pay-check.”

McKay: That reminds me of a point you raised earlier, when we were discussing  the treatment of the peculiar, outlying concept of race in the US as a generalization about the world. Might not the same point also apply to class? It’s far easier to talk about class in other contexts in the world…– in some, it’s not all that controversial. In France, once speaks quite readily of the bourgeois, the workers. Obviously, this can come with risks of oversimplification. Yet, generally, people grasp that class is so much more than income and “status” level…. In American discussions, though, class is almost always quantified and treated in terms of social status. Sometimes, as in discussions of the opioid epidemic, people treat having an education as a proxy for class. That doesn’t seem adequate to me at all.

Chowkwanyun:  I moonlight as an historian of McCarthyism and have written a few pieces on its legacy, particularly with respect to the American medical system….

The scars of McCarthyism are still with us. Even though you had versions of red scares all around the world, I think it was most pronounced in the United States, especially on social science. Different ways of thinking about class, particularly on the left, got sidelined…. Social science in the United States became highly quantitative in the 1950s and 1960s. This pattern started to reach its zenith in the Cold War period. There’s a reason for that…

Of course, there are places where you have the resident ‘house Marxist’ or something like that. But, generally speaking, it’s very, very off-limits. I think this is very much traceable to the red scares in the United States.

There’s a very interesting book called The Second Red Scare… by Landon R.Y. Storrs.[10] She identifies a number of people in a number of professional spheres, especially people who worked in government who, after they touched the Red Scare, started to thin out their views and move away from leftist ones. It really had a lot of career consequences and chilling effects. I think they’re still kind of here, today….

McKay: In the wake of the 2008 financial crisis, and now as we grapple with Covid-19, aren’t we experiencing a moment when economic structures and social structures are just so glaringly important that those who downplayed of both (coming for instance from postmodern or poststructuralist positions influential since the 1970s, with their characteristic emphasis on the ambiguities of experiences and subjectivities) have been fundamentally challenged? Recalling your point about individualism in the medical literature: it’s hard to see how either crisis could be understood without a robust concept of structure. And both are unreadable, I would say, without an understanding of class.

Chowkwanyun:  I agree. I mean the one thing I would say, from an organizing perspective, is that one has to work with what is presented before them. And so, you know, I understand why that [individualistic] kind of discourse is appealing to people.  It’s often your first way of making sense of your life. I think you can hold the two in your head at the same time….

McKay: One of the most striking aspects of the pandemic recently in North America was the muted way we recently observed the passing of a significant milestone in the US: a million deaths (far more than that, when you look at the world). When we got to 100,000, there was a commotion. 500,000 – quite a flutter. A million? Not so much.  

For me, it seemed to say a lot about the subaltern, disrespected lives of those who passed away. What would have been unimaginable before the pandemic – the deaths of a million human beings, many of them preventable by governments less myopically focused on the needs of business and more on ensuring the survival of their citizens – was crowded out by other events and stories, as though these million lives have been erased from our memory, much like those lost in the first great Influenza Epidemic.

We’re starting to see the first drafts of history coming out. And isn’t it also telling how zealously defenders of a neoliberal order, including so many model-builders and quantifiers, are rushing to bring out accounts of Covid-19 that seek to show they were right all along? Do you sense that, as it passes from memory to history, Covid-19 is going to challenge their seemingly still very buoyant positivism – their utter faith in ‘the numbers’ rather than in the close and rigorous examination of historical processes?

Chowkwanyun:  That’s a terrific question… Which model-builders?

McKay: I follow the British debates, and there we find quite a few model-builders defending their models and predictions.[11] Often the tone of the discussion is very defensive: “We were right all along! I didn’t cause 50,000 deaths! It’s not my fault!” I imagine the first historical takes on Covid-19 around the world will have that super-polemical quality. “Don’t blame me!”…

My question is, once this moment passes, will we really be able to remember this event accurately? And within the requisite time-frame?  Many critical scholars say we’re confronting  an era in which pandemics have been made far more probable by the ongoing capitalist assault on the planet. We don’t have decades to polish on our interpretation. But the results of the current and pervasive comic-book-level of discourse can be quite dangerous…

Chowkwanyun:  …Covid-19 has shown how many things in the society were broken. You wonder if people are going to shove the broken pieces under the carpet and pretend they’re not there. There are so many things, ranging from the credibility of experts and eggheads to (still) a lack of occupational health protections and quality ventilation for people who are at most risk for Covid.

…I’ve always been curious about which large-scale tragedies society chooses to remember and which it choses to forget. Why are some genocides remembered and commemorated every year, while there are others nobody knows about? It will be interesting to see which side Covid lands on.

When my students ask, ‘What the heck is the point of studying history?,’ …I recall a powerful quotation from Eric Hobsbawm. “The job of the historian is to remember what society prefers to forget.”[12]

…Sometimes forgetfulness just happens. Sometimes it’s very premeditated and intentional. I do suspect that Covid will come to be characterized as a kind of fluky, exogenous, horrible, acute event. A lot of the things we have seen in the past 20 years that are really social crises are treated that way. For example, the 2008 financial crisis. It did not lead to a fundamental rethinking of how the economy works and how it is regulated, in the way many of us thought it would….

Or the BP oil spill in the Gulf [of Mexico]. Not on the radar of most Americans right now, even though it was one of the most catastrophic environmental disasters in recent world history.

Or the Coal Ash disaster at that time also in Tennessee.[13] It is still causing all kinds of damaging health effects for people potentially who live in that area. But these events are all treated as acute episodes, and not as a result of longstanding processes…. We need actually to find the underlying processes and not just surface manifestations that we try to treat away….

…I am encouraged – and this is sort of a generational thing – by some of the younger epidemiologists and model builders, who are trying to think through ways of doing their work in a much less unidimensional way, that takes into account the influence of social structures on who gets harmed and who doesn’t in pandemics like this.

There’s a brilliant epidemiologist at the University of Michigan named Jon Zelner. He, other authors and I brought out an article recently (he was definitely in the driver’s seat and I was just along for the ride) about the kinds of pandemic modelling of Covid-19 that we’ve all become very familiar with.[14] Our argument was that the metrics from many models are helpful for planning for disease burden, hospital capacity, and to inform non-pharmaceutical interventions, but they have systematically failed to account for the structural factors that lead to socioeconomic, racial, and geographic health disparities.

The various metrics coming from those models, that tell you the average spread in the neighbourhood, that there are more cases today than yesterday, the famous R0  all the numbers we became very familiar with – they can be aggregations that mask the uneven impact of something like Covid. Future models need not to try to mask that aggregation but to make it central. I see a lot of people … who are really interested in this. So, I am kind of hopeful on that front.

I do think a younger generation is asking tough questions and challenging paradigms. But, as we both know,  paradigms and big science agencies are powerful. They don’t like change. Will a huge event like Covid rattle them?  We’ll see.

McKay: I noted that, paradoxically, in the first year of the pandemic, there seemed to be many more people saying, “Everything has to change. We must cross this threshold and enter a new world of future possibilities. We can do things differently.” Those voices quietened down over the course of the pandemic. People became less hopeful and more fatigued. These possibilities seem more and more distant. What one might call the ‘critical utopian energy’ of the first year dissipated. Can we somehow retrieve it? Do you think that’s possible?

Chowkwanyun:  I remember something like that with the financial crisis, too. The first year, some major changes were proposed, but over time, [the changes] were fundamentally just around the edges. 

…I was taken by an article by an historian named Howard Markel in The Atlantic recently.[15] He’s an historian of epidemics…. He made a lot of historians mad…But I thought he actually had an interesting point, which is he was not going to use the 1918 flu pandemic anymore to talk about Covid (which is what many historians, including myself, would do). He said the reason he won’t is because he actually sees Covid-19 as, in some ways, largely unprecedented in terms of the scale and the people it affects and the deadliness of the virus and how contagious it is and other intrinsic properties associated with it. And he noted one thing that kind of stuck out for me:  that none of the mitigation measures in the 1918 pandemic (including some of the most aggressive ones) lasted quite as long as the ones that have been imposed today. I think what he was implying is that there’s a human psychology to this, a kind of a frontier…

McKay: I think we would both hope that Covid-19 leads to some profound challenges to the existing social system. And yet, I can’t see who’s going to mount those challenges… I just can’t see the social force right now that’s going to say, “This has to stop. This has to change.”

Chowkwanyun:  …It takes time to recover from, you know, these kinds of events.  After a recovery period, hopefully, we can all think together how to move from this without sinking into fatalism. That is the worst thing right now.

McKay: Thank you very much, Merlin.

Merlin Chowkwanyun visited with Syndemic on 19 May 2022.

[1] Merlin Chowkwanyun, All Health Politics is Local: Community Battles for Medical Care and Environmental Health (Chapel Hill: University of North Carolina Press, 2022).

[2] Merlin Chowkwanyun and Adolph L. Reed, Jr., “Racial Health Disparities and Covid-19—Caution and Context,” New England Journal of Medicine 383, 3 (16 July 2020), 201-203, Link to source.

[3] Merlin Chowkwanyun, “The Strange Disappearance of History from Racial Disparities Research,” Du Bois Review 8, 1 (2011), 253-270.

[4] Adolph Reed, Jr., and Merlin Chowkwanyun, “Race, Class, Crisis: The Discourse of Racial Disparity and its Analytical Discontents,” Socialist Register, 2012, 149-175, Link to source.

[5] Joanna Wuest, “The Racial Disparity Politics of Biomedical Research: Disaggregating Categories into New Essentialisms,” Nonsite, 29 December 2019, Link to source.

[6] Charles Tilly, Durable Inequality (Berkeley: University of California Press, 1998).

[7] Link to source.

[8] Mara Loveman, “Is “Race” Essential?,” American Sociological Review 64, no. 6 (December 1999), 891-898.

[9] Adolph Reed, Jr., Class Notes, Posing as Politics, and Other Thoughts on the American Scene (New York: New Press, 2000), xiv.

[10] Landon R.Y. Storrs, The Second Red Scare and the Unmaking of the New Deal Left (Princeton and Oxford: Princeton University Press, 2012).

[11] For an overview: David Spiegelhalter and Anthony Masters, Covid by Numbers: Making Sense of the Pandemic with Data (London: Pelican Books, 2021).

[12] See Richard Evans, Eric Hobsbawm: A Life in History (Oxford: Oxford University Press, 2019).

[13] On 22 December 2008, a dike at the Kingston Fossil Plant in Roane County, Tennessee, managed by the Tennessee Valley Authority, failed, releasing 4.2 billion cubic metres of coal fly ash slurry into nearby waters, in one of the largest industrial spills in American history. 

[14] Jon Zelner, Link to source (a final version here).

[15] Howard Markel, “History Won’t Help Us Now: We have no historical precedent for this moment,” The Atlantic, 19 August 2021; Link to source.