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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.
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.
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.
The United States is rapidly transforming into one of the most racially and ethnically diverse nations in the world. Groups commonly referred to as minorities-including Asian Americans, Pacific Islanders, African Americans, Hispanics, American Indians, and Alaska Natives-are the fastest growing segments of the population and emerging as the nation's majority. Despite the rapid growth of racial and ethnic minority groups, their representation among the nation's health professionals has grown only modestly in the past 25 years. This alarming disparity has prompted the recent creation of initiatives to increase diversity in health professions. In the Nation's Compelling Interest considers the benefits of greater racial and ethnic diversity, and identifies institutional and policy-level mechanisms to garner broad support among health professions leaders, community members, and other key stakeholders to implement these strategies. Assessing the potential benefits of greater racial and ethnic diversity among health professionals will improve the access to and quality of healthcare for all Americans.
This book analyzes migrants' labor market and political integration outcomes. It argues that assimilation trade-offs shape access to economic and political resources. Migrants who are more segregated have group mobilization resources to achieve economic and political success. Migrants who are more assimilated have fewer mobilization resources and worse economic and political outcomes. The book offers a unique perspective on why migrant groups have different integration outcomes, and provides the first systematic way of understanding why assimilation outcomes do not always match economic and political outcomes.
Greater racial diversity is good news for America's future Race is once again a contentious topic in America, as shown by the divisive rise of Donald Trump and the activism of groups like Black Lives Matter. Yet Diversity Explosion argues that the current period of profound racial change will lead to a less-divided nation than today's older whites or younger minorities fear. Prominent demographer William Frey sees America's emerging diversity boom as good news for a country that would otherwise face declining growth and rapid aging for many years to come. In the new edition of this popular Brookings Press offering, Frey draws from the lessons of the 2016 presidential election and new statistics to paint an illuminating picture of where America's racial demography is headed—and what that means for the nation's future. Using the U.S. Census, national surveys, and related sources, Frey tells how the rapidly growing "new minorities"—Hispanics, Asians, and multiracial Americans—along with blacks and other groups, are transforming and reinvigorating the nation's demographic landscape. He discusses their impact on generational change, regional shifts of major racial groups, neighborhood segregation, interracial marriage, and presidential politics. Diversity Explosion is an accessible, richly illustrated overview of how unprecedented racial change is remaking the United States once again. It is an essential guide for political strategists, marketers, investors, educators, policymakers, and anyone who wants to understand the magnitude, potential, and promise of the new national melting pot in the twenty-first century.
In a nation built by immigrants and bedeviled by the history and legacy of slavery and discrimination, issues of liberty, equality, and community continue to challenge Americans. In the fifth edition of this widely acclaimed text, Paula McClain and Joseph Stewart combine traditional elements of political science analysis - history, Constitutional theory, institutions, political behavior, and policy actors - with a fully updated survey of the political status of four major groups; blacks, Latinos, Asian Americans, and American Indians. McClain and Stewart show similarities and differences in these groups' political action and experience, and point the way toward coalition, competition, and consensus building in the face of ongoing conflict. Two dilemmas shape the book; How do we as a nation reconcile a commitment to equality with persistent inequality and discrimination? And what can we do about it - from the perspective of ethnic and racial minorities as well as within the dominant culture? Thoroughly updated following the historic 2008 presidential election, this new edition provides a concise overview of minority politics in America.
In order for the United States to maintain the global leadership and competitiveness in science and technology that are critical to achieving national goals, we must invest in research, encourage innovation, and grow a strong and talented science and technology workforce. Expanding Underrepresented Minority Participation explores the role of diversity in the science, technology, engineering and mathematics (STEM) workforce and its value in keeping America innovative and competitive. According to the book, the U.S. labor market is projected to grow faster in science and engineering than in any other sector in the coming years, making minority participation in STEM education at all levels a national priority. Expanding Underrepresented Minority Participation analyzes the rate of change and the challenges the nation currently faces in developing a strong and diverse workforce. Although minorities are the fastest growing segment of the population, they are underrepresented in the fields of science and engineering. Historically, there has been a strong connection between increasing educational attainment in the United States and the growth in and global leadership of the economy. Expanding Underrepresented Minority Participation suggests that the federal government, industry, and post-secondary institutions work collaboratively with K-12 schools and school systems to increase minority access to and demand for post-secondary STEM education and technical training. The book also identifies best practices and offers a comprehensive road map for increasing involvement of underrepresented minorities and improving the quality of their education. It offers recommendations that focus on academic and social support, institutional roles, teacher preparation, affordability and program development.