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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.
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 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.
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.
"Portions of chapters 1 and 2 were previously published as "Spirometry, Measurement, and Race in the Nineteenth Century," Journal of the History of Medicine and Allied Sciences 60 (2005): 135-169."
In this #1 New York Times bestseller, Ijeoma Oluo offers a revelatory examination of race in America Protests against racial injustice and white supremacy have galvanized millions around the world. The stakes for transformative conversations about race could not be higher. Still, the task ahead seems daunting, and it’s hard to know where to start. How do you tell your boss her jokes are racist? Why did your sister-in-law hang up on you when you had questions about police reform? How do you explain white privilege to your white, privileged friend? In So You Want to Talk About Race, Ijeoma Oluo guides readers of all races through subjects ranging from police brutality and cultural appropriation to the model minority myth in an attempt to make the seemingly impossible possible: honest conversations about race, and about how racism infects every aspect of American life. "Simply put: Ijeoma Oluo is a necessary voice and intellectual for these times, and any time, truth be told." ―Phoebe Robinson, New York Times bestselling author of You Can't Touch My Hair
In Calculating Race, Benjamin Wiggins analyzes the historical relationship between statistical risk assessment and race in the United States. He illustrates how, through a reliance on the variable of race, actuarial science transformed the nature of racism and helped usher racial disparities in wealth, incarceration, and housing from the nineteenth century into the twentieth. Wiggins begins by tracing how the life insurance industry utilized race in its calculations at the end of the nineteenth century, focusing particularly on Prudential and its aggressive battles with state regulators to discriminate against clients and adjust rates on the basis of race. He then turns his focus to the collection of racial statistics in the Illinois state penitentiary system in the late nineteenth century and the state's subsequent development of predictive sentencing and parole formulas in the 1920s that weighed race as a key factor. Next, he investigates the role of race in the state-sponsored mortgage insurance program of the Federal Housing Administration between the start of the New Deal and the beginning of the Cold War and its prolonged effects on mortgage lending. Wiggins concludes with an analysis of the use of race in the statistical risk assessments across financial institutions and government programs during the post-civil rights movement era, and how that practice has been transformed in the twenty-first century through "proxy" variables which stand in for the now taboo category of race. Offering readers a new perspective on the historical importance of actuarial science in structural racism, Calculating Race is a particularly timely contribution as Big Data and algorithmic decision making increasingly pervade our lives.
Filling a critical void in the literature, Race, Racism, and the Developing Child provides an important source of information for researchers, psychologists, and students on the recent advances in the unique developmental and social features of race and racism in children's lives. Thorough and accessible, this timely reference draws on an international collection of experts and scholars representing the breadth of perspectives, theoretical traditions, and empirical approaches in this field.