Defining a population is often – perhaps always – an act of power because it involves determining which characteristics and groups receive attention or are given priority and which are not. And these choices have consequences. For example, if we define a population as “Canadians”, as opposed to “people living in Canada”, we may tend to exclude or misinterpret the needs and experiences of people who are not citizens or people who are living in Canada but do not consider themselves to be “Canadian”, such as those who believe that Quebec is or should be a nation rather than a province.
At the same time, defining a specific population involves different kinds of power depending on who is doing the defining. For instance, when the Canadian government defines the “Indian” population, it dictates which people have rights to services and benefits and which people do not. When the government revises its definition, people may gain or lose their status as “Indians” – and their benefits – even though nothing else about their lives has changed.
The power of defining a population doesn’t rest only with governments. For example, when First Nations people insist upon the right to define themselves, they are reclaiming power over their own identities as well as determining who belongs to their populations.
Individuals also routinely exercise the right to identify themselves in particular ways and this can affect how we think about and refer to populations. In the earliest days of the HIV epidemic, for instance, the population at greatest risk of infection was identified as “gay men”. But gradually research and experience revealed that men having sex with other men did not necessarily think of themselves as homosexual or bisexual and consequently did not respond to education or treatment programs aimed at gay men. As a result of this learning, we now refer to this population as “men who have sex with men”. It is not only the name of the population that has changed: our understanding of the characteristics and the needs of the population have also changed.
While it may seem obvious that we need to be clear about who is included in a population and who is not, it can be a challenging task. The costs of collecting information and the time it takes may limit our ability to learn about populations. National surveys, for example, are not completed by everyone, but rather by a sample of the people that researchers believe represent the population as whole.
At the same time, it may not be possible to include everyone or every characteristic in a population because we just don’t have enough information. For example, researchers are only just beginning to explore the needs and experiences of transgendered women and men.
These kinds of gaps or limitations in our knowledge can contribute to inequities. When we don’t fully understand the needs and experiences of a population, we may create policies or programs that don’t help or that even make things worse. Take the case of screening programs for breast and cervical cancer. Most of the equipment needed for these tests is not designed to accommodate women with disabilities with the result that this population is at a distinct disadvantage.
But inequity is not just the result of gaps in knowledge, it can also be the cause. Particular groups of people may be missing from evidence and analysis simply because we don’t routinely think about them. For instance, public education campaigns to promote regular pap tests (which check the cervix for abnormal cells) typically target heterosexual women, ignoring the needs of lesbians and bisexual women. Because we haven’t thought to include sexual orientation in our definition, we have created inequity for lesbians.