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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.
This book addresses major aspects of inequity, such as access, financing, financial risk protection, gender, service delivery and utilization, in the healthcare sector in India,. Further, it discusses various measures for defining inequity in each of these aspects, and employs different indices for each dimension of inequity, which include financing, utilization, region, health outcomes, caste and class, and gender. The book covers both theoretical and empirical issues, examining fifteen major Indian States, as well as selected case studies at the district level. Combining quantitative and qualitative analyses, the book provides an overall view of the outcomes attributable to both economic development and policy changes per se. While providing essential data and insights for policymakers and researchers alike, the book also outlines further feasible policy changes that could potentially mitigate the current inequities in Indian healthcare. As such, it offers a valuable resource for upper graduate-level students in health economics, as well as for researchers and policymakers.
In Medical Tourism and Inequity in India, Kristen Smith explores the role of private hospitals in India in the global healthcare service supply chain. Smith examines the medical tourism industry, the commodification of the Indian healthcare system, and the local populations facing critical health issues.
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.
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 timely contribution to the global literature on health inequities approaches the subject through a synthesis and analysis of relevant published literature on India. Amongst the BRICS countries, India ranks the lowest in the gender-gap index and has the highest poverty rate, and there is clear evidence that socio-economic inequalities have increased in India in the twenty-first century. These have direct impact on the health conditions of its people; however, there has been relatively little concerted research attention on health inequities in India. This volume fills the gap by synthesizing research evidence since the year 2000 on the topic. This is perhaps the first volume on this topic of such scope and breadth. Its uniqueness lies in the synthesis of evidence across a range of axes of disadvantages within a single volume: socio-economic position, caste, gender, other socially constructed vulnerabilities such as disability, HIV status, migrant status; and health-system factors contributing to or mitigating inequities in health. Each core chapter not only summarizes research findings but also engages critically with the perspectives reflected in the chapters and proposes a framework for understanding the mechanisms through which health inequities result. This volume highlights and addresses research gaps in both methodology and content, and is valuable to researchers and students of public health and allied health disciplines, including the social sciences, and also to policy makers and donors.
The Social Security Administration (SSA) administers two programs that provide benefits based on disability: the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program. This report analyzes health care utilizations as they relate to impairment severity and SSA's definition of disability. Health Care Utilization as a Proxy in Disability Determination identifies types of utilizations that might be good proxies for "listing-level" severity; that is, what represents an impairment, or combination of impairments, that are severe enough to prevent a person from doing any gainful activity, regardless of age, education, or work experience.
New Horizons in Health discusses how the National Institutes of Health (NIH) can integrate research in the social, behavioral, and biomedical sciences to better understand the causes of disease as well as interventions that promote health. It outlines a set of research priorities for consideration by the Office of Behavioral and Social Sciences Research (OBSSR), with particular attention to research that can support and complement the work of the National Institutes of Health. By addressing the range of interactions among social settings, behavioral patterns, and important health concerns, it highlights areas of scientific opportunity where significant investment is most likely to improve nationalâ€"and globalâ€"health outcomes. These opportunities will apply the knowledge and methods of the behavioral and social sciences to contemporary health needs, and give attention to the chief health concerns of the general public.
This book shows the important links between social conditions and health and begins to describe the processes through which these health inequalities may be generated. It reviews a range of methodologies that could be used by health researchers in this field and proposes innovative future research directions.