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In the fall of 2005 the streets of France were rocked by civil disturbances on a scale unseen for decades. Only months earlier Azouz Begag, France's first minister for equal opportunities and first-ever cabinet minister of North African immigrant origin, wrote an essay laying bare the festering social and ethnic injustices that, as can now be seen in hindsight, led to the riots.
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.
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.
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.
Challenging the dominant view of Hawai’i as a “melting pot paradise”—a place of ethnic tolerance and equality—Jonathan Okamura examines how ethnic inequality is structured and maintained in island society. He finds that ethnicity, not race or class, signifies difference for Hawaii’s people and therefore structures their social relations. In Hawai’i, residents attribute greater social significance to the presumed cultural differences between ethnicities than to more obvious physical differences, such as skin color. According to Okamura, ethnicity regulates disparities in access to resources, rewards, and privileges among ethnic groups, as he demonstrates in his analysis of socioeconomic and educational inequalities in the state. He shows that socially and economically dominant ethnic groups—Chinese Americans, Japanese Americans, and Whites—have stigmatized and subjugated the islands’ other ethnic groups—especially Native Hawaiians, Filipino Americans, and Samoans. He demonstrates how ethnic stereotypes have been deployed against ethnic minorities and how these groups have contested their subordinate political and economic status by articulating new identities for themselves.
Using an international approach, this book demonstrates the way that the intersection of gendered and ethnic identities operate at work and home. It provides an authoritative account of ethnicity and gender at work, and the theoretical underpinning explanations.
Available Open Access under CC-BY-NC licence. 50 years after the establishment of the Runnymede Trust and the Race Relations Act of 1968 which sought to end discrimination in public life, this accessible book provides commentary by some of the UK’s foremost scholars of race and ethnicity on data relating to a wide range of sectors of society, including employment, health, education, criminal justice, housing and representation in the arts and media. It explores what progress has been made, identifies those areas where inequalities remain stubbornly resistant to change, and asks how our thinking around race and ethnicity has changed in an era of Islamophobia, Brexit and an increasingly diverse population.
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.
Did George Bush's use of the Willie Horton story during the1988 presidential campaign communicate most effectively when no one noticed its racial meaning? Do politicians routinely evoke racial stereotypes, fears, and resentments without voters' awareness? This controversial, rigorously researched book argues that they do. Tali Mendelberg examines how and when politicians play the race card and then manage to plausibly deny doing so. In the age of equality, politicians cannot prime race with impunity due to a norm of racial equality that prohibits racist speech. Yet incentives to appeal to white voters remain strong. As a result, politicians often resort to more subtle uses of race to win elections. Mendelberg documents the development of this implicit communication across time and measures its impact on society. Drawing on a wide variety of research--including simulated television news experiments, national surveys, a comprehensive content analysis of campaign coverage, and historical inquiry--she analyzes the causes, dynamics, and consequences of racially loaded political communication. She also identifies similarities and differences among communication about race, gender, and sexual orientation in the United States and between communication about race in the United States and ethnicity in Europe, thereby contributing to a more general theory of politics. Mendelberg's conclusion is that politicians--including many current state governors--continue to play the race card, using terms like "welfare" and "crime" to manipulate white voters' sentiments without overtly violating egalitarian norms. But she offers some good news: implicitly racial messages lose their appeal, even among their target audience, when their content is exposed.