The 'Asian BMI' and Logics of Difference in Biomedicine

• In Event: Trans/national Politics of Race, Racism, and Anti-Racism

Abstract

In 2004, the World Health Organization (WHO) released a report that recommended lowering current body mass index (BMI) guidelines for Asian populations specifically, as previous research demonstrated that Asian populations had higher rates of cardiovascular disease and type 2 diabetes at a lower BMI than other populations (WHO 2004). Following this, in 2015, the American Diabetic Association (ADA) revised their type 2 diabetes screening guidelines for Asian Americans, lowering the screening threshold from a BMI of 25 to 23. However, translating the WHO’s guidelines into clinical practice within the United States is a conceptually muddy process that requires making racial categories commensurate with biomedical categories. Drawing on interviews with doctor-researchers and textual analysis of research documents and policy reports, this paper investigates why biomedical researchers used both racial categories and BMI as the main tools with which to implement new public health policies, despite extant research that demonstrates the biomedical limits of both such measures. I argue that the invisibility of Asian health problems more broadly led to Asian American researchers strategically using the ADA in order to render visible Asian health, through the objective veneer of numerical measures. Although doctor-researchers recognized that the revised guidelines were not scientifically accurate per se, they saw it as a practical intervention that would simultaneously address a pressing health issue and highlight Asian health disparities. This paper further points to the ways in which scientific accuracy and clinical practicality more generally are not always aligned, and the challenges of translating research into practice.

Author

• Mallory Fallin, Northwestern University