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In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.
Many racial and ethnic groups in the United States, including blacks, Hispanics, Asians, American Indians, and others, have historically faced severe discriminationâ€"pervasive and open denial of civil, social, political, educational, and economic opportunities. Today, large differences among racial and ethnic groups continue to exist in employment, income and wealth, housing, education, criminal justice, health, and other areas. While many factors may contribute to such differences, their size and extent suggest that various forms of discriminatory treatment persist in U.S. society and serve to undercut the achievement of equal opportunity. Measuring Racial Discrimination considers the definition of race and racial discrimination, reviews the existing techniques used to measure racial discrimination, and identifies new tools and areas for future research. The book conducts a thorough evaluation of current methodologies for a wide range of circumstances in which racial discrimination may occur, and makes recommendations on how to better assess the presence and effects of discrimination.
As the population of older Americans grows, it is becoming more racially and ethnically diverse. Differences in health by racial and ethnic status could be increasingly consequential for health policy and programs. Such differences are not simply a matter of education or ability to pay for health care. For instance, Asian Americans and Hispanics appear to be in better health, on a number of indicators, than White Americans, despite, on average, lower socioeconomic status. The reasons are complex, including possible roles for such factors as selective migration, risk behaviors, exposure to various stressors, patient attitudes, and geographic variation in health care. This volume, produced by a multidisciplinary panel, considers such possible explanations for racial and ethnic health differentials within an integrated framework. It provides a concise summary of available research and lays out a research agenda to address the many uncertainties in current knowledge. It recommends, for instance, looking at health differentials across the life course and deciphering the links between factors presumably producing differentials and biopsychosocial mechanisms that lead to impaired health.
This volume summarizes a range of scientific perspectives on the important goal of achieving high educational standards for all students. Based on a conference held at the request of the U.S. Department of Education, it addresses three questions: What progress has been made in advancing the education of minority and disadvantaged students since the historic Brown v. Board of Education decision nearly 50 years ago? What does research say about the reasons of successes and failures? What are some of the strategies and practices that hold the promise of producing continued improvements? The volume draws on the conclusions of a number of important recent NRC reports, including How People Learn, Preventing Reading Difficulties in Young Children, Eager to Learn, and From Neurons to Neighborhoods, among others. It includes an overview of the conference presentations and discussions, the perspectives of the two co-moderators, and a set of background papers on more detailed issues.
This book features contributions by international scholars who have worked to establish a theory- and empirics-based discussion on disadvantaged minorities and long-term economic development. Depending on their socio-demographic characteristics, minorities have long lived under the shadow of the groups, categories, or communities they presumably belong to. Despite the obstacles they have to face, they manage to demonstrate that, above all, they are entrepreneurs capable to start, run, and successfully complete their venture. Their motivations are often assimilated by the research community into “necessity entrepreneurship.” In addition to the external barriers they face, they have to overcome endogenous cognitive factors that hinder their entrepreneurial intention: anxiety before the future, the anguish of death, generativity, health condition as perceived by others, subjective age, and the cultural gap as viewed by natives, among others. The book integrates a diversity of challenges and disadvantages faced by entrepreneurs, allowing the reader to have a renewed understanding of entrepreneurial behavior. On the theoretical level, the chapters emphasize the need for integrating entrepreneurship theory with multidisciplinary approaches, such as the Theory of Cumulative Disadvantage/Advantage (CDA), cultural and geographical theories, and psychological theories. On the practical level, this book would raise the awareness of policy makers, mainly governmental and nongovernmental organizations concerning the disadvantages, and helping them adjust their actions either for local or international programs. Chapter "Intersectionality and Minority Entrepreneurship: At the Crossroad of Vulnerability and Power" is available open access under a Creative Commons Attribution 4.0 International License via link.springer.com.
An assessment of the relationship between race and poverty in the United States, and potential solutions for the issue. Renowned American sociologist William Julius Wilson takes a look at the social transformation of inner-city ghettos, offering a sharp evaluation of the convergence of race and poverty. Rejecting both conservative and liberal interpretations of life in the inner city, Wilson offers essential information and several solutions to policymakers. The Truly Disadvantaged is a wide-ranging examination, looking at the relationship between race, employment, and education from the 1950s onwards, with surprising and provocative findings. This second edition also includes a new afterword from Wilson himself that brings the book up to date and offers fresh insight into its findings. Praise for The Truly Disadvantaged “The Truly Disadvantaged should spur critical thinking in many quarters about the causes and possible remedies for inner city poverty. As policymakers grapple with the problems of an enlarged underclass they—as well as community leaders and all concerned Americans of all races—would be advised to examine Mr. Wilson’s incisive analysis.” —Robert Greenstein, New York Times Book Review “The Truly Disadvantaged not only assembles a vast array of data gleamed from the works of specialists, it offers much new information and analysis. Wilson has asked the hard questions, he has done his homework, and he has dared to speak unpopular truths.” —Los Angeles Times Book Review “Required reading for anyone, presidential candidate or private citizen, who really wants to address the growing plight of the black urban underclass.” —David J. Garrow, Washington Post Book World
Racial and ethnic disparities in health care are known to reflect access to care and other issues that arise from differing socioeconomic conditions. There is, however, increasing evidence that even after such differences are accounted for, race and ethnicity remain significant predictors of the quality of health care received. In Unequal Treatment, a panel of experts documents this evidence and explores how persons of color experience the health care environment. The book examines how disparities in treatment may arise in health care systems and looks at aspects of the clinical encounter that may contribute to such disparities. Patients' and providers' attitudes, expectations, and behavior are analyzed. How to intervene? Unequal Treatment offers recommendations for improvements in medical care financing, allocation of care, availability of language translation, community-based care, and other arenas. The committee highlights the potential of cross-cultural education to improve provider-patient communication and offers a detailed look at how to integrate cross-cultural learning within the health professions. The book concludes with recommendations for data collection and research initiatives. Unequal Treatment will be vitally important to health care policymakers, administrators, providers, educators, and students as well as advocates for people of color.
In their later years, Americans of different racial and ethnic backgrounds are not in equally good-or equally poor-health. There is wide variation, but on average older Whites are healthier than older Blacks and tend to outlive them. But Whites tend to be in poorer health than Hispanics and Asian Americans. This volume documents the differentials and considers possible explanations. Selection processes play a role: selective migration, for instance, or selective survival to advanced ages. Health differentials originate early in life, possibly even before birth, and are affected by events and experiences throughout the life course. Differences in socioeconomic status, risk behavior, social relations, and health care all play a role. Separate chapters consider the contribution of such factors and the biopsychosocial mechanisms that link them to health. This volume provides the empirical evidence for the research agenda provided in the separate report of the Panel on Race, Ethnicity, and Health in Later Life.
The Oxford Handbook of the Social Science of Poverty builds a common scholarly ground in the study of poverty by bringing together an international, inter-disciplinary group of scholars to provide their perspectives on the issue. Contributors engage in discussions about the leading theories and conceptual debates regarding poverty, the most salient topics in poverty research, and the far-reaching consequences of poverty on the individual and societal level.
Teen childbearing has risen to frighteningly high levels over the last four decades, jeopardizing the life chances of young parents and their offspring alike, particularly among minority communities. Or at least, that's what politicians on the right and left often tell us, and what the American public largely believes. But sociologist Frank Furstenberg argues that the conventional wisdom distorts reality. In Destinies of the Disadvantaged, Furstenberg traces the history of public concern over teen pregnancy, exploring why this topic has become so politically powerful, and so misunderstood. Based on over forty years of Furstenberg's research on teen childbearing, Destinies of the Disadvantaged relates how the issue emerged from obscurity to become one of the most heated social controversies in America. Both slipshod research by social scientists and opportunistic grandstanding by politicians have contributed to public misunderstanding of the issue. Although out-of-wedlock teen pregnancy rose notably between 1960 and 1990—a cause for concern given the burdens of single motherhood at a young age—this trend did not reflect a rise in the rate of overall teen pregnancies. In fact, teen pregnancy actually declined dramatically in the 1960s and 1970s. The number of unmarried teenage mothers rose after 1960, not because more young women became pregnant, but because those who did increasingly chose not to rush into marriage. Furstenberg shows how early social science research on this topic exaggerated the adverse consequences of early parenthood both for young parents and for their children. Researchers also inaccurately portrayed single teenage motherhood as a phenomenon concentrated among minorities. Both of these misapprehensions skewed subsequent political debates. The issue became a public obsession and remained so during the 1990s, even as rates of out-of-wedlock teen childbearing plummeted. Addressing teen pregnancy was originally a liberal cause, led by advocates of family planning services, legalized abortion, and social welfare programs for single mothers. The issue was later adopted by conservatives, who argued that those liberal remedies were encouraging teen parenthood. According to Furstenberg, the flexible political usefulness of the issue explains its hold on political discourse. The politics of teen parenthood is a fascinating case study in the abuse of social science for political ends. In Destinies of the Disadvantaged, Furstenberg brings that tale to life with the perspective of a historian and the insight of an insider, and provides the straight facts needed to craft effective policies to address teen pregnancy.