Bio-power and racial, class, and gender formation in biomedical knowledge production

The inclusion of race/ethnicity, socioeconomic status, and sex/gender in biomedical and epidemiologic research often constitutes routine and taken-for-granted practices that are based on particular notions of bodily “differences” and their roles in health and illness. Such practices legitimate constructions of race, class, and gender as attributes of atomistic individuals—rather than as intersectional dimensions that structure social relationships—and render invisible how relations of power contribute to the stratification of well-being and disease. This paper offers applications of two theoretical perspectives to illuminate these arguments. Firstly, epidemiologic research exemplifies in many ways Foucauldian notions of biopower and Panopticism. It individualizes bodies and bodily differences; at the same time, it disindividualizes power, embedding it within the diffuse and pervasive acts of biomedical knowledge production and subsequent imperatives of self-judgment and surveillance. Secondly, epidemiologic research embodies processes of racial, class, and gender formation, and constitutes a kind of racial, class, and gender project. Such projects mediate between the discursive definitions of bodily differences and the institutional forms in which those definitions are routinized and standardized. As such, biomedical knowledge production is an active participant in the construction and institutionalization of social meanings of “difference”. However, my contention is not that we should abandon the epidemiologic use of racial, class, and gender categories. Instead, race, class, and gender must be reconceptualized as social relations of power that are located not just in the biological bodies of individuals but in the social spaces between them, producing and stratifying the distribution of health and illness.