Academic studies coauthored by Michigan Democratic Senate candidate Abdul El-Sayed have drawn scrutiny for suggesting that Arab Americans living in concentrated ethnic communities may experience certain health advantages, with researchers divided over the studies’ findings and methodology.
By yourNEWS Media Newsroom
Michigan Democratic Senate candidate Abdul El-Sayed is facing renewed scrutiny over academic research examining whether assimilation into American society is associated with negative health outcomes among Arab Americans, including increased risks of low birth weight and chronic disease.
A Daily Caller News Foundation investigation published Thursday, Oct. 22 examined several peer-reviewed studies El-Sayed coauthored between 2008 and 2011, highlighting their findings concerning ethnic communities, cultural assimilation and health disparities.
The research has prompted criticism from some health policy experts who question whether the studies relied too heavily on assumptions about ethnic identity and cultural differences. Other researchers defended the work as legitimate epidemiological research.
El-Sayed, who previously served as Detroit’s health director, has emphasized his public health experience while campaigning for the U.S. Senate.
“The single biggest problem that I’ve tried to bend my time and energy to solving is the fact that too many people in this country don’t get the health care they need and deserve,” El-Sayed said during a Tuesday campaign appearance.
However, his earlier academic work examined a narrower question: whether Arab Americans living in communities with large Arab populations experience different health outcomes than those living elsewhere.
In a 2010 study published in the Journal of Epidemiology & Community Health, El-Sayed and coauthor Sandro Galea analyzed 21,617 births to Arab American mothers in Michigan between 2000 and 2005.
The researchers found that Arab American mothers living in Dearborn had a 15% lower adjusted risk of delivering low-birth-weight infants compared with Arab American mothers elsewhere in Michigan.
Those living in Dearborn’s ZIP code 48126, which had an especially high concentration of Arab American residents, experienced a 19% lower adjusted risk.
The researchers suggested that preserving cultural practices through ethnic communities might contribute to those differences.
“As ethnic minority persons live and work in the USA and interact with the white majority, they acculturate,” the paper stated.
“In doing so, they may acquire cultural features from the majority that may” reduce protections against adverse birth outcomes associated with their original cultures, the authors wrote.
However, the researchers acknowledged that they had not directly measured acculturation and could not establish whether assimilation explained the observed differences.
A separate 2008 study examining Arab American birth outcomes following the Sept. 11 terrorist attacks explored whether concentrated ethnic communities could provide social support that helped offset the health consequences of discrimination.
“They may be more socially cohesive and more likely to benefit from positive health effects,” the researchers wrote.
Another study published in 2009 examined differences in life expectancy between Arab Americans and white Americans, recommending additional research into how cultural assimilation might influence health.
A subsequent 2011 paper on ethnic differences in mortality discussed how Arab Americans may experience “pressure to acculturate out of fear of discrimination,” potentially influencing health-related behaviors.
That study also identified higher age-adjusted mortality risks among Arab Americans compared with non-Hispanic white residents of Michigan, particularly from chronic diseases.
The authors considered whether cultural practices, including dietary patterns and attitudes toward body weight, might contribute to those differences.
The Daily Caller News Foundation interviewed Ian Kingsbury, senior director of the Center for Accountability in Medicine at Do No Harm, who sharply criticized the studies.
“It’s pretty radical in the sense that it seems to be basically advocating Arab separatism and isolation by couching it in pseudoscientific terms,” Kingsbury said.
He questioned the researchers’ statistical methodology, particularly their decision to control for factors associated with assimilation while examining whether ethnic community concentration influenced health outcomes.
“It’s like measuring the quality of a baseball team and controlling for hitting, catching and pitching,” Kingsbury said.
The 2010 study’s authors acknowledged several limitations, including incomplete socioeconomic information. Maternal education was included in their statistical analysis, but household income was not.
They also recognized that unmeasured socioeconomic differences and other neighborhood characteristics could account for some of their findings.
Kingsbury argued that those limitations undermined the conclusions.
“The reality is that this is lousy scholarship that does not support the conclusion that he makes,” he said.
“The state of scholarship across health disciplines, but especially in public health, is so unbelievably appalling. The gatekeeping that is supposed to be going on in the peer review process is so much tilted toward ideological conformity rather than rigor.”
Questions about the use of cultural explanations in epidemiological research predate El-Sayed’s publications.
A 2003 academic critique of racial and ethnic health studies warned against treating culture as a collection of loosely defined characteristics shared by entire ethnic populations.
“Culture is implicitly understood in this research to be a cluster of nebulous characteristics carried by ethnic group members,” the critique stated.
“Such dogma exists in the field of racial and ethnic studies, which because it is highly ideological, is not subjected to the usual conceptual and methodological scrutiny.”
Other experts disagreed with Kingsbury’s assessment.
Sally Satel, a senior fellow at the American Enterprise Institute, defended the research and pointed to El-Sayed’s collaboration with Galea, a widely published public health researcher.
“He has published with a very esteemed public health expert, Dr. Sandro Galea. Sandro, whom I happen to know and respect, and is now the dean of the School of Public Health at Washington University,” Satel told the Daily Caller News Foundation. “These papers look sound to me.”
Galea did not respond to the publication’s request for comment, and El-Sayed’s campaign also did not respond.
The research itself does not establish that adopting American customs causes poorer health or that living near white Americans creates a health hazard. Its findings concern statistical associations involving specific populations and health outcomes, with the authors identifying several possible explanations requiring further investigation.
The controversy comes as El-Sayed campaigns against Republican Mike Rogers ahead of the Nov. 3 election, placing renewed attention on his academic record and the public health research that preceded his political career.
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