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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 volume examines trajectories of drug use among ethnic minority youth in the United States with a focus on African Americans and Hispanics. It also highlights what research designs have been employed to address these differences as well as suggests strategies for moving this discourse forward by identifying potential targets for prevention and intervention with minority youth. This book features essays by leading experts in the field who have grappled with this issue for decades. Inside, readers will find an insightful dialogue that addresses such questions as: Why are African American and Hispanic youth more likely than their White peers to abstain from drug use during adolescence but are more likely to become problem users later in life? What impact does the stress caused by discrimination have on potential drug use? To what extent does religiosity protect minority youth from drug use as past research suggests that it protects White youth? What is the influence of neighborhood context on exposure to and use of substances among urban African American children? Taken together, the essays in this book identify underexplored risk and protective factors and gaps in the current state of knowledge that can be used to develop effective, culturally specific drug abuse prevention strategies. This book is for anyone with an interest in the initiation and escalation of drug use among African Americans and Hispanics/Latinos and factors that influence these patterns over the life course. It will also be an ideal resource for those interested in better understanding the mechanisms by which risk and protective factors are related to the development of drug use and addiction, particularly the ways in which such factors contribute to health differences and have disproportionately more negative consequences for ethnic minorities.
Estimates indicate that as many as 1 in 4 Americans will experience a mental health problem or will misuse alcohol or drugs in their lifetimes. These disorders are among the most highly stigmatized health conditions in the United States, and they remain barriers to full participation in society in areas as basic as education, housing, and employment. Improving the lives of people with mental health and substance abuse disorders has been a priority in the United States for more than 50 years. The Community Mental Health Act of 1963 is considered a major turning point in America's efforts to improve behavioral healthcare. It ushered in an era of optimism and hope and laid the groundwork for the consumer movement and new models of recovery. The consumer movement gave voice to people with mental and substance use disorders and brought their perspectives and experience into national discussions about mental health. However over the same 50-year period, positive change in American public attitudes and beliefs about mental and substance use disorders has lagged behind these advances. Stigma is a complex social phenomenon based on a relationship between an attribute and a stereotype that assigns undesirable labels, qualities, and behaviors to a person with that attribute. Labeled individuals are then socially devalued, which leads to inequality and discrimination. This report contributes to national efforts to understand and change attitudes, beliefs and behaviors that can lead to stigma and discrimination. Changing stigma in a lasting way will require coordinated efforts, which are based on the best possible evidence, supported at the national level with multiyear funding, and planned and implemented by an effective coalition of representative stakeholders. Ending Discrimination Against People with Mental and Substance Use Disorders: The Evidence for Stigma Change explores stigma and discrimination faced by individuals with mental or substance use disorders and recommends effective strategies for reducing stigma and encouraging people to seek treatment and other supportive services. It offers a set of conclusions and recommendations about successful stigma change strategies and the research needed to inform and evaluate these efforts in the United States.
Stigma leads to poorer health. In The Oxford Handbook of Stigma, Discrimination, and Health, leading scholars identify stigma mechanisms that operate at multiple levels to erode the health of stigmatized individuals and, collectively, produce health disparities. This book provides unique insights concerning the link between stigma and health across various types of stigma and groups.
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.
African American Psychology: From Africa to America, Fourth Edition provides comprehensive coverage of the field of African American psychology. Authors Faye Z. Belgrave and Kevin W. Allison skillfully convey the integration of African and American influences on the psychology of African Americans using a consistent theme throughout the text—the idea that understanding the psychology of African Americans is closely linked to understanding what is happening in the institutional systems in the United States. The Fourth Edition reflects notable advances and important developments in the field over the last several years, and includes evidence-based practices for improving the overall well-being of African American communities. New to the Fourth Edition Coverage of current issues affecting African Americans and causing changes in the social-political environment include the Black Lives Matter movement, racial trauma, and more. Content from blogs has been added to chapter-opening cover stories to reflect the more modern ways news and information are obtained. More coverage of literature and research on Blacks throughout the diaspora, especially in Africa, provide historical context and documents heterogeneity among African Americans in the United States. Expanded coverage of topics as a result of recent research includes LGBTQ individuals, African American fathers, colorism, intersectionality, electronic cigarettes, social media, and more.
Women’s Mental Health Across the Lifespan examines women’s mental health from a developmental perspective, looking at key stressors and strengths from adolescence to old age. Chapters focus in detail on specific stressors and challenges that can impact women’s mental health, such as trauma, addictions, and mood and anxiety disorders. This book also examines racial and ethnic disparities in women’s physical and mental health, mental health of sexual minorities and women with disabilities, and women in the military, and includes valuable suggestions for putting knowledge into practice.
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.
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.