Time to Phase Out "Caucasian"

Words matter and play an important role in shaping our worldview. Precision in language is a critical aspect of communicating what we really mean, which is even more true as we navigate the murky waters of race and racial classification in the United States. As we move toward antiracist action in our department and in our lives, we need to be clear about racial terminology and the history behind it.

Racial classifications are ill-defined and have changed over time. They are essentially biologically meaningless, except as markers of systemic oppression and the effects of racism on the body. Racial classifications provide value in understanding the historical stratified allocation of resources and power and the experience of being coded in society as one race or another based on external characteristics. And they are based on the logic that there is a meaningful difference between peoples with different external characteristics and that sharply defined classifications can provide some valuable insight, which they cannot. Continuing to use outdated or imprecise terminology in our research, education, or clinical practice has real and tangible negative effects by perpetuating racism.

The term "Caucasian" elicits different interpretations, depending on perspective and context, which further muddies the waters. Literally speaking, "Caucasian" refers to people from the Caucasus mountain region, which includes Georgia, Armenia, Azerbaijan, parts of north Iran, and central southern Russia. This is a geographical ancestry term, which could have implications for genetics if used precisely. However, "Caucasian" today typically refers broadly to people coded as White by society, the majority of whom are actually not from the area of the Caucasus mountains. Additionally, classifying those coded as White by society as "Caucasian" is a throwback to the racist classification system defined by German anatomist Johann Blumenbach in the late 1700s. Blumenbach differentiated five human races, which he also stratified by perceived beauty (and thus value): Caucasian, Mongolian, Malayan, American, and Ethiopian. Eugenicists in the 1920s further divided the "Caucasian" group into subraces: Nordic, Alpine, Mediterranean, and Semitic. In this framing, "Caucasian" is inherently imprecise and inaccurate, as it encompasses a huge breadth of possible genetic ancestry and cultural influences.

Carol Mukhopadhyay's paper "Getting Rid of the Word Caucasian" from 2008 is an excellent summary of the problematic implications of continuing to use "Caucasian" when we mean White or European-American or whatever we actually mean. Additionally, in 1998, the American Journal of Public Health published this article, "White, European, Western, Caucasian, or What? Inappropriate Labeling in Research on Race, Ethnicity, and Health," discussing why we need to be more specific when we are using these terms in research.

Using a blanket term like Caucasian when you are actually referring to people of Scandinavian descent or Euro-Americans, for example, is not helpful either in the context of genetic or ancestral research. However, if we are discussing something like the impacts of racism, geographic origin and genetic ancestry are not particularly relevant. Here the term "White" is most appropriate, since the differential allocation of resources to people coded as White in society is similar regardless of their geographic or genetic background.

This brings me to my next point, the other, more insidious, problem with continuing to use "Caucasian" when we actually mean "White": prioritizing comfort of White people. This article by Susana Rinderle, "6 Reasons to Not Say 'Caucasian,'" discusses part of why we have a hard time letting go of the word "Caucasian." To be frank, White people are uncomfortable with naming themselves as White. It is uncomfortable to consider that an entire group of people can be referred to in a general way, and that is a topic or an idea that is more completely fleshed out in other articles, books, podcasts, and scholarship, so I won't elaborate on it here.

I also want to be clear: If one uses the word Caucasian, that does not say anything about who they are as a person, and it does not make them inherently a racist or a white supremacist. This is not a value judgment. That being said, there is an opportunity for every one of us to commit to antiracist action. It is important to consider the implications and effects of the language we use, and the word Caucasian used indiscriminately when not rooted in historical context or impact does further racist assumptions and obstructs antiracist discourse.

Finally, I want to introduce the concept of "white supremacy" as one that needs to be confronted in medicine in particular and in society as a whole. This definition of "white supremacy culture" from Showing Up for Racial Justice expresses that white supremacy doesn't just refer to believing that White ideas, ideals, culture and values are superior to those of people of color, but also that these values, ideas, culture, and ideals are the "standard" or the "norm." While these themes are often amplified in people racialized as White, "whiteness" and "white supremacy" are part of American history and persist in society today, affecting everyone. Showing Up for Racial Justice states, "Culture is powerful precisely because it is so present and at the same time so very difficult to name or identify. The characteristics listed below are damaging because they are used as norms and standards without being proactively named or chosen by the group. They are damaging because they promote white supremacy thinking. They are damaging to both people of color and to White people." Please read this excellent summary of some prominent themes and elements of "white supremacy" culture, here curated in a document by Tema Okun on www.dismantlingracism.org.

Reflecting on the ways that a culture of white supremacy affects our relationships to ourselves, each other, communities, society at large, evidence and research, etc. is an important step to making a more inclusive and integrated culture and climate in which to live, learn, work, and thrive.