- C Spigner: Department of Health Services, Box 357660, School of Public Health and Community Medicine, University of Washington, Seattle, WA 98195, USA.
Individualism, in both its political and attitudinal senses, reinforces societal and institutional racism in the United States. Because of individualism's dominant focus on self-interest and self-reliance, any application of "participatory democracy" in community-based biomedical and behavioral research is fraught with dilemmas similar to those that Gunnar Myrdal observed between American racism and democracy. The research establishment is overwhelmed by well-meaning non-minorities who recognize racism and its consequences in health, but only greater representation of people-of-color in the health establishment can ameliorate the inherent contradictions of "participatory democracy" which is so fundamental to the process of community-based participatory research.