Constructing [In]visibility: Racial categories, MENA, and the Architecture of Healthcare Open Access

Abstract

This thesis explores how racial classification functions as a form of structural power that shapes visibility, recognition, and access to care in U.S. healthcare and public policy. Focusing on Middle Eastern and North African (MENA) populations, it argues that their persistent classification as “White” is not a neutral bureaucratic decision, but a politically motivated act that produces ethical harm. By situating MENA classification within a broader history of legal and administrative governance—through naturalization cases, census policy, and public health data infrastructures—this project argues that racial categories do not simply reflect social realities but construct them in ways that determine which communities become visible, countable, and actionable within systems of care. The consequences of this exclusion are not abstract: MENA communities are routinely left out of public health research, denied targeted interventions, and rendered ineligible for funding and support. This thesis positions these outcomes as a form of ethical harm, one that bioethics must take seriously. It challenges the field to move beyond descriptive accounts of disparity and instead confront the classificatory regimes that produce and sustain them. In doing so, it reframes racial classification as a site of governance and ethical inquiry—calling for a bioethics that recognizes its own entanglement in systems of power, and that seeks not merely to mitigate harm but to expose and unsettle the conditions that make it possible. 

Table of Contents

Table of Contents:

Introduction.............................................................................................1 Chapter 1: The Problem of Classification—Bureaucracy and the Politics of Visibility....8 Historical Foundations of MENA Classifications in the United States...........8 Racial Categories as Governance.....................................................20 Surveillance.....................................................................21 Statistical Dominance of Whiteness........................................24 Denying Political and Resource Funding..................................26 The Role of Bureaucracy in Structuring Invisibility.................................32 Classification as Ethical Harm.......................................................37 Chapter 2: Lived Consequences—Health Disparities in MENA Communities............40 From Structure to Outcome..........................................................40 Documenting the Undocumented....................................................46 Cardiovascular Disease......................................................46 Cancer Disparities and Lack of Preventative Care.......................50 Mental Health and Psychological Distress................................51 Insurance and Socioeconomic Status.......................................52 Reframing Disparities Through Bioethics..........................................54 Chapter 3: Bioethics and the Politics of Recognition...........................................57 Strategic Reforms, Not Resolutions..................................................57 Provisional Category.........................................................57 Community-led Initiatives...................................................60 Embedding Recognition in Care.............................................63 Epistemic Injustice and the Ethics of Knowing....................................64 Conclusion: The Ethics of What Remains.......................................................67  References.................................................................................................71 

About this Master's Thesis

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School	Laney Graduate School
Department	Bioethics
Degree	M.A.
Submission	Master's Thesis
Language	English
Research Field	Ethics Philosophy Health Sciences, Public Health
Keyword	health equity philosophy public health Middle Eastern and North African bioethics biopolitics census policy institutionalized harm ethics structural inequity racial classification
Committee Chair / Thesis Advisor	Jonathan Crane, Emory University
Committee Members	Ju Zhang, Emory University Jim Lavery, Emory University

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