Assessing Race Ethnicity And Gender In Health

This book deals specifically with the historical basis for use of terms in race, gender, ethnicity, sex and sexual orientation. It brings much needed clarity to the debate by identifying the ethical issues as well as the technical challenges inherent in measuring these elusive concepts. The author expands on her work begun in Gender, Ethnicity, and Health Research by paralleling the evolution of racial and sexual categories with the development of health research. In addition, the book provides a salient guide to assessment tools currently used in measuring racial and sexual constructs, identity, and experience.

Health researchers routinely evaluate health and illness across subgroups defined by their sex, gender, ethnicity, and race. All too often, these classifications are proffered as an explanation for any differences that may be detected, for example, in access to care, frequency of disease, or response to treatment. Relatively few researchers, however, have examined what these classifications mean on a theoretical level or in the context of their own research. Assume, for example, that a researcher concludes from his or her data that African- Americans utilize certain surgical procedures less frequently than whites. This conclusion may mean little without an examination of the various underlying issues. Is there such a construct as race at all? How were whites and African-Americans classified as such? Does this finding reflect inappropriate overutilization of the specific procedures among whites or inappropriate underutilization among African-Americans? To what extent are socioeconomic status and method of payment related to the less frequent use? Are there differences in the manner in which health care providers present the various treatment options to whites and to African- Americans that could account for these differences in utilization? Are there differences in health care-seeking and health care preferences between the two groups that would explain the difference in utilization? Is the racial classification a surrogate measure for another variable that has remained unidentified and unmeasured? All too often, unfortunately, such issues are ignored or lightly dismissed with an entreaty for additional research.

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.

Disparities in health and health care across racial, ethnic, and socioeconomic backgrounds in the United States are well documented. The reasons for these disparities are, however, not well understood. Current data available on race, ethnicity, SEP, and accumulation and language use are severely limited. The report examines data collection and reporting systems relating to the collection of data on race, ethnicity, and socioeconomic position and offers recommendations.

This volume investigates race, ethnicity and gender as factors in health and health care.

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.

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.

Race, Ethnicity and Health, Second Edition, is a new andcritical selection of hallmark articles that address healthdisparities in America. It effectively documents the need for equaltreatment and equal health status for minorities. Intended as aresource for faculty and students in public health as well as thesocial sciences, it will be also be valuable to public healthadministrators and frontline staff who serve diverse racial andethnic populations. The book brings together the bestpeer reviewed research literature from the leading scholars andfaculty in this growing field, providing a historical and politicalcontext for the study of health, race, and ethnicity, with keyfindings on disparities in access, use, and quality. This volumealso examines the role of health care providers in healthdisparities and discusses the issue of matching patients anddoctors by race. There has been considerable new research since the originalmanuscript’s preparation in 2001 and publication in 2002, andreflecting this, more than half the book is newcontent. New chapters cover: reflections on demographicchanges in the US based on the current census; metrics andnomenclature for disparities; theories of genetic basis fordisparities; the built environment; residential segregation;environmental health; occupational health; health disparities inintegrated communities; Latino health; Asian populations; stressand health; physician/patient relationships; hospital treatment ofminorities; the slavery hypertension hypothesis; geographicdisparities; and intervention design.