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Social justice is a matter of life and death. It affects the way people live, their consequent chance of illness, and their risk of premature death. We watch in wonder as life expectancy and good health continue to increase in parts of the world and in alarm as they fail to improve in others.
'Punchily written ... He leaves the reader with a sense of the gross injustice of a world where health outcomes are so unevenly distributed' Times Literary Supplement 'Splendid and necessary' Henry Marsh, author of Do No Harm, New Statesman There are dramatic differences in health between countries and within countries. But this is not a simple matter of rich and poor. A poor man in Glasgow is rich compared to the average Indian, but the Glaswegian's life expectancy is 8 years shorter. The Indian is dying of infectious disease linked to his poverty; the Glaswegian of violent death, suicide, heart disease linked to a rich country's version of disadvantage. In all countries, people at relative social disadvantage suffer health disadvantage, dramatically so. Within countries, the higher the social status of individuals the better is their health. These health inequalities defy usual explanations. Conventional approaches to improving health have emphasised access to technical solutions – improved medical care, sanitation, and control of disease vectors; or behaviours – smoking, drinking – obesity, linked to diabetes, heart disease and cancer. These approaches only go so far. Creating the conditions for people to lead flourishing lives, and thus empowering individuals and communities, is key to reduction of health inequalities. In addition to the scale of material success, your position in the social hierarchy also directly affects your health, the higher you are on the social scale, the longer you will live and the better your health will be. As people change rank, so their health risk changes. What makes these health inequalities unjust is that evidence from round the world shows we know what to do to make them smaller. This new evidence is compelling. It has the potential to change radically the way we think about health, and indeed society.
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.
Americans are living longer, and the elder population is growing larger. To meet the ongoing need for quality information on elder health, the Encyclopedia of Aging and Public Health combines multiple perspectives to offer readers a more accurate and complete picture of the aging process. The book takes a biopsychosocial approach to the complexities of its subject. In-depth introductory chapters include coverage on a historical and demographic overview of aging in America, a guide to biological changes accompanying aging, an analysis of the diversity of the U.S. elder population, legal issues commonly affecting older adults, and the ethics of using cognitively impaired elders in research. From there, over 425 entries cover the gamut of topics, trends, diseases, and phenomena: -Specific populations, including ethnic minorities, custodial grandparents, and centenarians -Core medical conditions associated with aging, from cardiac and pulmonary diseases to Parkinson’s and Alzheimer’s -Mental and emotional disorders -Drugs/vitamins/alternative medicine -Disorders of the eyes, feet, and skin -Insomnia and sleep disorders; malnutrition and eating disorders -Sexual and gender-related concerns -And a broad array of social and political issues, including access to care, abuse/neglect, veterans’ affairs, and assisted suicide Entries on not-quite-elders’ concerns (e.g., midlife crisis, menopause) are featured as well. And all chapters and entries include references and resource lists. The Encyclopedia has been developed for maximum utility to clinicians, social workers, researchers, and public health professionals working with older adults. Its multidisciplinary coverage and scope of topics make this volume an invaluable reference for academic and public libraries.
This book offers a novel and proven approach to the retention and success of underrepresented students. It advocates a strategic approach through which an institution sets clear goals and metrics and integrates the identity support work of cultural / diversity centers with skill building through cohort activities, enabling students to successfully navigate college, graduate on time and transition to the world of work. Underlying the process is an intersectional and identity-conscious, rather than identity-centered, framework that addresses the complexity of students’ assets and needs as they encounter the unfamiliar terrain of college.In the current landscape of higher education, colleges and universities normally divide their efforts between departments and programs that explicitly work on developing students’ identities and separate departments or programs that work on retaining and graduating higher-risk students. This book contends that the gap between cultural/diversity centers and institutional retention efforts is both a missed opportunity and one that perpetuates the opportunity gap between students of color and low-income students and their peers.Identity-consciousness, the central framework of this book, differs from an identity-centric approach where the identity itself is the focus of the intervention. For example, a Latino men’s program can be developed as an identity-centered initiative if the outcomes of the program are all tied to a deeper or more complex understanding of one’s Latino-ness and/or masculinity. Alternately, this same program can be an identity-conscious student success program if it is designed from the ground up with the students’ racial and gender identities in mind, but the intended outcomes are tied to student success, such as term-to-term credit completion, yearly persistence, engagement in high-impact practices, or timely graduation.Following the introductory chapter focused on framing how we understand risk and success in the academy, the remaining chapters present programmatic interventions that have been tested and found effective for students of color, working class college students, and first-generation students. Each chapter opens with a student story to frame the problem, outlines the key research that informs the program, and offers sufficient descriptive information for staff or faculty considering implementing a similar identity-conscious intervention on their campus. The chapters conclude with a discussion of assessment, and suggested “Action Items” as starting points.
Black and Hispanic students are not learning enough in our public schools, and their typically poor performance is the most important source of ongoing racial inequality in America today—thus, say Abigail and Stephan Thernstrom, the racial gap in school achievement is the nation's most critical civil rights issue and an educational crisis; it's no wonder that "No Child Left Behind," the 2001 revision of the Elementary and Secondary Education Act, made closing the racial gap in education its central goal. An employer hiring the typical Black high school graduate or the college that admits the average Black student is choosing a youngster who has only an eighth-grade education. In most subjects, the majority of twelfth-grade Black students do not have even a "partial mastery" of the skills and knowledge that the authoritative National Assessment of Educational Progress calls "fundamental for proficient work" at their grade. No Excuses marshals facts to examine the depth of the problem, the inadequacy of conventional explanations, and the limited impact of Title I, Head Start, and other familiar reforms. Its message, however, is one of hope: Scattered across the country are excellent schools getting terrific results with high-needs kids. These rare schools share a distinctive vision of what great schooling looks like and are free of many of the constraints that compromise education in traditional public schools. In a society that espouses equal opportunity we still have a racially identifiable group of educational have-nots—young African Americans and Latinos whose opportunities in life will almost inevitably be limited by their inadequate education. When students leave high school without high school skills, their futures—and that of the nation—are in jeopardy. With successful schools already showing the way, no decent society can continue to turn a blind eye to such racial and ethnic inequality.
Women now represent over half of medical school matriculants, almost half of residents and fellows, and over a third of practicing physicians nationally. Despite considerable representation among the physician workforce, women are paid 75 cents on the dollar compared with their male counterparts after accounting for specialty, geography, time in practice, and average hours per week worked. This pay gap is significantly greater than the one reported for US women workers as a whole and has shown little improvement over time. While much has been written about the problem, a robust discussion about how to rectify the situation has been missing from the conversation. Closing the Gender Pay Gap in Medicine is the first comprehensive assessment of how cultural expectations and compensation methodologies in medicine work together to perpetuate salary disparities between men and women physicians. Since the gender gap reflects a convergence of forces within our healthcare enterprises, achieving pay equity can be an overwhelming undertaking for institutions and their leaders. However, compensation is foremost a business endeavor. Therefore, a roadmap for operationalizing equity within the finance, human resources, and compliance structures of our organizations is critical to eliminating disparities. The roadmap described in this book breaks down the component parts of compensation methodology to reveal their unintentional impact on salary equity and lays out processes and procedures that support new approaches to generate fair and equitable outcomes. Additionally, the roadmap is anchored in change management principles that address institutional culture and provide momentum toward salary equity. The book begins with a review of the evidence on the gender pay gap in medicine. The following chapter discusses how gender-based differences in performance assessments, specialty choice, domestic responsibilities, negotiation, professional resources, sponsorship, and clinical productivity accumulate across women’s careers in medicine and impact evaluation, promotion, and therefore compensation in the healthcare workplace. The next two chapters focus, respectively, on how compensation is determined - highlighting potential pitfalls for pay equity - and regulatory and legal considerations. Chapters 5 and 6 explore organizational infrastructure, salary data collection and analysis, and culture change strategies necessary to rectify compensation inequities. Chapter 7 offers a detailed account of one medical institution’s successful journey to achieve salary equity. The book’s final chapter emphasizes that closing the gender pay gap is at its essence a business endeavor and recommends that organizations assess progress and cost with the same attention, rigor, and regularity as afforded other operating expenses. Closing the Gender Pay Gap in Medicine offers a detailed roadmap for healthcare organizations seeking to close the gender pay gap among their physician workforce. This first-of-its-kind book will assist institutions plan courses of action and identify potential pitfalls so they can be understood and mitigated. It will also prove a valuable resource for transformational leadership and systems-based change critical to attaining compensation equity.
The WHO European Region has seen remarkable health gains, though inequities persist both between and within countries. Much more is understood now about the extent and social causes of these inequities, particularly since the 2008 report of the Commission on Social Determinants of Health. This review of inequities in health across the 53 Member States of the Region was commissioned to support the development of the new European policy framework for health and well-being, Health 2020. It builds on the global evidence and recommends policies to reduce health inequities and the health divide across all countries, including those with low incomes. The report is presented in four parts. Part I provides the context and background to the review, and sets out the key principles underpinning the recommendations and the rationale for grouping them into four broad themes: life-course stages, wider society, the broader macro-level context, and governance, delivery and monitoring systems. Part II summarizes current evidence on the magnitude of the health divide among European Region countries, describing the inequities in health and their social determinants. Part III focuses on the four themes, making recommendations with supporting evidence. Part IV outlines the implementation issues, summarizes the framework for action, discusses reasons for failure, provides guidance on good practice and summarizes the review's conclusions and recommendations. The review is a wake-up call to political and professional leaders alike, an opportunity for them to facilitate the work of those dedicated to improving health outcomes and narrow the health gap between and within the countries of the Region.
School counsellors can play a powerful role in closing the achievement gap by incorporating principles of social justice - that is, equity and advocacy for all students - into their practice. This new resource for pre-service and in-service counsellors addresses the reasons why some students are more likely to encounter academic failure (racism, sexism, heterosexism, classism), and challenges readers to play an active role in bringing about the conditions for student success. Offering a variety of vignettes, strategies, activities, and reflective individual and group study questions, the book provides the framework for how school counsellors can mitigate the impact of negative factors hampering academic performance and healthy development. The book details six functions of a school counsellors that move schools toward more just practices and, ultimately, to higher test scores and increased student achievement.
Chapters in this book, based on the efforts of the Urban Education National Network Task Force, define the nature of obstacles to the academic performance of urban students and identify, validate, and disseminate a knowledge base of theory and practice to inform decision making about urban schools. The chapters are: (1) "The Nature of the Achievement Gap: The Call for a Vision To Guide Change" (Belinda Williams); (2) "Bridging the Achievement Gap in Urban Schools: Reducing Educational Segregation and Advancing Resilience-Promoting Strategies" (Margaret C. Wang and John A. Kovach); (3) "Cultural Values in Learning and Education" (Patricia Marks Greenfield, Catherine Raeff, and Blanca Quiroz); (4) "Educating Teachers To Close the Achievement Gap: Issues of Pedagogy, Knowledge, and Teacher Preparation" (Kenneth M. Zeichner); (5) "Closing the Achievement Gap: Opportunity To Learn, Standards, and Assessment" (Floraline Ingram Stevens); (6) "Fostering Resiliency in Urban Schools" (Bonnie Benard); (7) "Teacher Engagement and Real Reform in Urban Schools" (Karen Seashore Louis and BetsAnn Smith); and (8) "A Social Vision for Urban Education: Focused, Comprehensive, and Integrated Change" (Belinda Williams). An appendix lists the Regional Educational Laboratories. Most chapters contain references. (Contains one figure.) (SLD)