Cette recherche interroge l’émergence, les usages et les enjeux du recours à une catégorie de « migrants », dans les politiques françaises et actions de lutte contre les inégalités sociales face au diabète de type 2. La sociohistoire de l’émergence de la question du diabète des « migrants » réalisée, montre comment la littérature médicale peut, en pointant des facteurs de risques différents selon les groupes sociaux, participer à la construction de catégories de patients. L’analyse menée souligne l’amalgame entre groupes ethniques, groupes raciaux et groupes génétiquement homogènes, à l’origine du récit différencialiste des causes du diabète. Récit, aujourd’hui mobilisé par les autorités publiques pour organiser une distribution ciblée des soins préventifs du diabète et de ses complications. Au cœur des interactions soignants-soignés en milieu hospitalier, l’analyse des contours, des usages de cette catégorie, et des pratiques de soins qu’elle suscite (en particulier lors de l’éducation thérapeutique), souligne que les traitements différenciés qui y ont cours, n’ont pas toujours les effets escomptés sur la situation de ces soignés. La lecture culturaliste faisant des comportements des soignés la principale cause des écarts de santé, occulte les inégalités sociales et économiques préexistantes, et participe à les renforcer. Quadrillées par les directives de santé publique, l’analyse des marges de manœuvre des soignants et des soignés, permet de mettre en évidence que ces politiques visent moins à agir sur les déterminants sociaux des inégalités de santé qu’à enjoindre les acteurs sociaux à atteindre l’égalité en adoptant les comportements des groupes sociaux majoritaires. / This research questions the emergence, the uses and the direction of the resort to a category of “migrants”, in the French politics and the actions to reduce social inequalities in front of diabetes mellitus. The sociohistory of the emergence of the question about the diabetes of the "migrants", shows how the medical literature can, by pointing different risk factors according to the social groups, participate in the construction of categories of patients. The led analysis underlines the mixture between ethnic, racial and genetically groups, at the origin of the differentialist narrative about the causes of the diabetes. This reading is today mobilized by the public authorities to organize a specific distribution of health preventive care of diabetes and its complications. In health relation, the analysis of the practices, and in particular the therapeutic patient education, underlines that differential treatments exists, but all have no expected effects. The culturalist view making behavior of patients the main cause of their health condition, can impact the medical course, and also, increase the social inequalities. Guided by the directives of public health, the analysis of the margins of action of the professionals and patients, allows to see that these politics aim less to act on the social determinants of health inequalities that to order the individuals to reach the equality by adopting the majority social groups behaviors.

This thesis compares the political development of racial categories employed by the United States, Canada and Great Britain on their national censuses, particularly focusing on the enumeration of mixed-race individuals in the late 20th century. Though literature on race and the U.S. census often stresses the causal influence of social mobilization, this analysis reveals that the common explanations for the development of racial classifications such as interest group mobilization, demography and civil rights legislation are not viable in comparative context. To explore and explain how the racial state sees, this thesis conceptualizes race as a system of power relations and develops a framework of the schematic state, which operates concurrently as both an actor responsible for putting the underlying organizational pattern of race into place, solidifying a particular set of racial meanings, and implementing a scheme for the racial configuration of society, and an arena in which policy alternatives are contested and where the state itself participates among other actors. This characterization demonstrates that the schematizing impetus of the census is not an exemplar of a dichotomous relationship between an all-powerful state and powerless racial subjects; instead, the power and meaning of race exist well beyond the control of the fragmented and sometimes contradictory schematic state, from the transnational realm to the level of the group or individual. Contrary to the majority of the literature on race, this thesis demonstrates that state institutions do not act for purely domestic reasons; rather, institutions mediate between national nuances and transnational ideas about race that exist in excess of national boundaries. Thus, while the decision to count mixed-race can be explained by a crystallization of transnational ideational trends that are mediated by national politics, the domestic arena of policy making – or the policy network itself – emerges as a key factor that determines the method of multiracial enumeration. However, these domestic political and policy outcomes are not contained by borders. Once a policy is in place, it has the potential to reinforce domestic policy and contribute to the global discourse of race itself – and in its travels among these levels of abstraction, race transforms.

This thesis compares the political development of racial categories employed by the United States, Canada and Great Britain on their national censuses, particularly focusing on the enumeration of mixed-race individuals in the late 20th century. Though literature on race and the U.S. census often stresses the causal influence of social mobilization, this analysis reveals that the common explanations for the development of racial classifications such as interest group mobilization, demography and civil rights legislation are not viable in comparative context. To explore and explain how the racial state sees, this thesis conceptualizes race as a system of power relations and develops a framework of the schematic state, which operates concurrently as both an actor responsible for putting the underlying organizational pattern of race into place, solidifying a particular set of racial meanings, and implementing a scheme for the racial configuration of society, and an arena in which policy alternatives are contested and where the state itself participates among other actors. This characterization demonstrates that the schematizing impetus of the census is not an exemplar of a dichotomous relationship between an all-powerful state and powerless racial subjects; instead, the power and meaning of race exist well beyond the control of the fragmented and sometimes contradictory schematic state, from the transnational realm to the level of the group or individual. Contrary to the majority of the literature on race, this thesis demonstrates that state institutions do not act for purely domestic reasons; rather, institutions mediate between national nuances and transnational ideas about race that exist in excess of national boundaries. Thus, while the decision to count mixed-race can be explained by a crystallization of transnational ideational trends that are mediated by national politics, the domestic arena of policy making – or the policy network itself – emerges as a key factor that determines the method of multiracial enumeration. However, these domestic political and policy outcomes are not contained by borders. Once a policy is in place, it has the potential to reinforce domestic policy and contribute to the global discourse of race itself – and in its travels among these levels of abstraction, race transforms.

Thesis (MA)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: The 1994 election seems to stand as a clear divide between past and present in South Africa. But while it was believed that this election would catapult South Africa into a promising new era of democracy and equality, it has become all too clear that the transition was unfortunately limited to the political sphere. Despite some progress being made in the economic sphere, we still have a visible correlation between race and class – a correlation that certainly stems from the apartheid era, signifying a definite continuity of an era long past. In the social sphere we have also struggled to achieve complete integration. We find that racial categories of old have remained an important part of the ‘new’ South Africa. While we were promised a non-racial country, government policies such as Affirmative Action and Black Economic Empowerment have been a constant reminder of supposed racial differences – signifying another continuity of apartheid. While the post-apartheid period can be summarised as a period of change, we find that it can also be summarised by the continuities of the past. It was found that, specifically in my research area, a rural farmers’ community, the continuities of the past are visible in the everyday structures of society. For my research subjects, white Afrikaners, it was found that the 1994 election proved to be no ‘road to Damascus’ regarding beliefs about the racial other. I found that interracial social interaction is still governed by fixed racial boundaries that are rarely crossed and, if crossed, this is done so conditionally. These boundaries seemed to be reinforced by the active socialisation of a community. While many argue that the post-apartheid period has brought on an identity crisis for white Afrikaners, I found that my research subjects have failed to encounter such a crisis, as they have held on to fixed racial boundaries in an attempt to preserve and protect their identity. We find ourselves in a time where we are urged to move beyond our apartheid past, yet many are unable to do so. But the question remains: given our past, should this come as a surprise to anyone? / AFRIKAANSE OPSOMMING: Die verkiesing van 1994 staan as ‘n duidelike skeiding tussen die verlede en die hede in Suid-Afrika. Maar al is daar geglo dat hierdie verkiesing Suid-Afrika in ‘n belowende nuwe era van demokrasie en gelykheid sou inskiet, het dit al hoe meer duidelik geraak dat die oorgang ongelukkig tot die politieke sfeer beperk was. Ten spyte van vordering in die ekonomiese sfeer, vind ons nog steeds dat daar ‘n sigbare ooreenkoms tussen ras en klas is – ‘n ooreenkoms wat seer seker geërf is vanaf apartheid en dui op ‘n definitiewe voortsetting van ‘n era wat lankal verby is. In die sosiale sfeer sukkel ons ook om volkome integrasie te bereik. Ons vind dat die rasse-kategorieë van ouds steeds ‘n belangrike deel van die ‘nuwe’ Suid Afrika bly. Hoewel ‘n nie-rassige land belowe is, dien regeringsbeleide soos Regstellende Aksie en Swart Ekonomiese Bemagtiging as ‘n konstante herinnering aan sogenaamde rasseverskille – nog ‘n voortsetting van apartheid. Terwyl die post-apartheid tydperk opgesom kan word as ‘n tydperk van verandering, vind ons dat dit ook opgesom kan word deur voortsettings van die verlede. Veral in my navorsingsgebied, ‘n plattelandse boeregemeenskap, het ek gevind dat die voortsettings van die verlede sigbaar was in die alledaagse strukture van die samelewing. Vir my navorsingssubjekte, blanke Afrikaners, is dit gevind dat die 1994-verkiesing geensins gedien het as ‘n ‘pad na Damaskus’ in terme van oortuigings aangaande die ‘ander’ ras nie. Ek het gevind dat interrassige sosiale interaksie steeds regeer word deur gevestigde rasse grense wat selde oorgesteek word, en indien wel oorgesteek, word dit voorwaardelike gedoen. Dit wil voorkom of hierdie grense versterk word deur die aktiewe sosialisering van die gemeenskap. Terwyl baie outeurs argumenteer dat die post-apartheidtydperk ‘n identiteitskrisis vir blanke Afrikaners tot gevolg gehad het, het ek gevind dat my navorsingssubjekte nie so ‘n krisis ervaar het nie omdat hulle vasklou aan gevestigde rassegrense in ‘n poging om hul identiteit te bewaar en beskerm. Ons vind onsself in ‘n tyd waar ons aangespoor word om verby ons apartheid verlede te beweeg, maar steeds is baie mense nie in staat om dit te doen nie. Die vraag bly staan: gegewe ons verlede, kom dit vir enigiemand as ‘n verrassing?