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• Race, Ethnicity, and Health: A Public Health Reader
• Copyright
• Contents
• Sources
• The Editors
• The Authors
• Introduction: The Ethnic Demographic Transition
• Race, Ethnicity, and Health
• About This Book
• Acknowledgments
• References
• Chapter 1: Defining Health and Health Care Disparities and Examining Disparities Across the Life Spa
• History of Health Disparities
• Health Disparity Versus Health Inequality Versus Health Inequity
• Health Disparities
• Health Inequalities
• Health Equity and Inequities
• Health Status Disparities and Health Care Disparities
• Disparities Across the Life Span
• Morbidity
• Summary
• References
• Part 1: Historical and Political Considerations
• Chapter 2: The Color Line: Race Matters in the Elimination of Health Disparities
• Race Matters
• The Historical Perspective
• References
• Chapter 3: Health Care Disparities—Science, Politics, and Race
• References
• Part 2: Conceptualizing Race and Ethnicity
• Chapter 4: Why Genes Don’t Count (for Racial Differences in Health)
• The Myth of Race as Biology
• The Double Error Inherent in Genetic Explanations of Racial Differences
• Why Race-as-Genes Fails in Practice
• From Studies of Race-as-Genetics to Studies of Racialism and Racism
• Acknowledgments
• References
• Chapter 5: Using “Socially Assigned Race” to Probe White Advantages in Health Status
• Introduction
• Methods
• Data Analysis
• Results
• Discussion
• Conclusion
• Acknowledgments
• References
• Author Contributions
• Part 3: Explaining Racial and Ethnic Disparities
• Psychosocial and Individual-Level Determinants
• Chapter 6: Racism as a Stressor for African Americans: A Biopsychosocial Model
• Conceptualizations of Racism
• Evidence of Racism
• Biopsychosocial Effects of Perceived Racism in African Americans: A Contextual Model
• Environmental Stimuli
• Moderator Variables
• Mediator Variables
• Summary
• Conclusions and Recommendations
• 1. What Is the Relationship Between Perceived Racism and Health Outcomes for African Americans?
• 2. What Are the Psychological and Physiological Concomitants of Perceived Racism?
• 3. What Are Some of the General and Racism-Specific Responses Used in Response to Perceived Racism?
• 4. Does the Context in Which Racism Is Perceived Modify Its Psychological and Physiological Effects?
• 5. What Other Factors Influence the Relationship Between Perceived Racism and Health Outcomes?
• References
• Chapter 7: A Systematic Review of Empirical Research on Self-Reported Racism and Health
• Methods
• Results
• Defining Racism
• Exposure Measurement
• Socio-Demographic Variations in Self-Reported Racism
• Associations Between Self-Reported Racism and Health-Related Outcomes
• Associations Between Study/Exposure Characteristics and Health-Related Outcomes
• Effect Modification of the Association Between Self-Reported Racism and Health-Related Outcomes
• Mediation of the Association Between Self-Reported Racism and Health-Related Outcomes
• Discussion
• Acknowledgments
• References
• Chapter 8: Stress, Coping, and Health Outcomes Among African-Americans: A Review of the John Henryis
• John Henryism
• Empirical Support for the John Henryism Hypothesis
• Methodological Approaches to the Study of John Henryism
• Race
• Gender
• Measurement of John Henryism
• Determinants of John Henryism
• Alternative Mediating Mechanisms
• Conclusion
• References
• Chapter 9: Race and Unhealthy Behaviors: Chronic Stress, the HPA Axis, and Physical and Mental Healt
• Racial and Ethnic Health Disparities
• The Hypothalamic-Pituitary-Adrenalcortical Axis
• Methods
• Measures
• Analyses
• Results
• Discussion
• Limitations
• Conclusions
• References
• Chapter 10: Epigenetics and the Embodiment of Race: Developmental Origins of U.S. Racial Disparities
• Background
• Early Environments and Adult Health
• The Mechanisms of Phenotypic “Memory”—Growth, Development, and the Epigenetic Code
• Epigenetics and Adult Cardiovascular Disease Risk
• An Epigenetic Model of Black-White Disparities in CVD
• Birth Weight and Adult CVD Risk in African Americans
• Lower African American Birth Weight
• Social Origins of African American Low Birth Weight
• Transgenerational Impacts
• Discussion
• Epigenetics as a Challenge to the Concept of Genetic Race
• Literature Cited
• The Effects of Culture
• Chapter 11: Acculturation and Latino Health in the United States: A Review of the Literature and Its
• Introduction
• Acculturation and Assimilation: A History of the Concepts
• Definitions of Acculturation Used in the Public Health Literature
• Unidimensional and Bidimensional Acculturation Models
• Acculturation Measures and Scales
• Current Evidence Regarding the Effects of Acculturation on Latino Health Outcomes
• Literature Review Methods
• Overview of Findings
• Acculturation Is Associated with Improved Access to Care and Use of Preventive Health Services Among
• In Other Areas, the Effects of Acculturation Are Not Clear to Date
• Recommendations for Public Health Practice and Research
• Public Health Practice Recommendations
• Research Recommendations
• Conclusions
• Acknowledgments
• Literature Cited
• Chapter 12: Measuring Culture: A Critical Review of Acculturation and Health in Asian Immigrant Popu
• Introduction
• Background
• The Study of Acculturation
• Method
• Literature Review
• Measures and Findings
• The Acculturation Scales
• Mental Health
• Health Services Use
• Physical Health
• Non-Scale Acculturation Measures
• Time Measures
• Westernization
• Discussion
• Sociodemographic Variables and Acculturation: Effect Modifiers?
• Socio-Economic Status
• Gender
• Ethnic Heterogeneity: How Generalizable Are Acculturation Measures?
• Measurement of Biculturalism and Endogenous Change
• Conclusion
• Acknowledgments
• Appendix A
• Notes
• References
• Chapter 13: Racial Influences Associated with Weight-Related Beliefs in African American and Caucasi
• Introduction
• Method
• Participants
• Procedure
• Analysis
• Measures
• Results
• Discussion
• Limitations
• Implications
• References
• Author Contributions
• Chapter 14: Adverse Pregnancy Outcomes: Differences Between U.S.- and Foreign-Born Women in Major U.
• Introduction
• Methods
• Data
• Variables
• Statistical Analysis
• Results
• Discussion
• Acknowledgments
• References
• Social Determinants
• Chapter 15: Levels of Racism: A Theoretic Framework and a Gardener’s Tale
• Levels of Racism
• Levels of Racism: A Gardener’s Tale
• References
• Chapter 16: Racial Residential Segregation: A Fundamental Cause of Racial Disparities in Health
• Nature and Origins of Residential Segregation
• Segregation and Health Status: Individual and Household SES
• Segregation and Educational Opportunity
• Segregation and Employment Opportunities
• Consequences of Segregation: Racial Differences in SES
• Race, SES, and Health
• Segregation and the Effects of Place
• Segregation and Neighborhood and Housing Quality
• Segregation and Health Behaviors
• Segregation and Medical Care
• Segregation and Crime, Homicide, and Social Context
• Research Directions
• Conclusion
• References
• Chapter 17: Life Course Theories of Race Disparities: A Comparison of the Cumulative Dis/Advantage T
• Introduction
• Overview
• How Social Disadvantage Affects Health
• Similarities and Distinctions Between the CDA Perspective and the Weathering Hypothesis
• Future Directions for the CDA Perspective and the Weathering Hypothesis in Health Disparities Resear
• Summary
• References
• Chapter 18: U.S. Socioeconomic and Racial Differences in Health: Patterns and Explanations
• Introduction
• Socioeconomic Status and Health
• Widening Inequality
• Nature of the Gradient
• Measuring Socioeconomic Position
• Other Emerging Issues
• Racial/Ethnic Differences in Health Status
• Worsening Health Status
• Major Historical Events
• Race and SES
• Racism
• Acculturation
• Conceptualization of Race
• Problems with Racial Data
• Mechanisms Underlying SES and Racial Differences in Health
• Medical Care
• Health Behavior
• Working Conditions
• Environmental Exposure
• The Economy and Health
• Personality
• Early Life Conditions
• Power
• Are Inequalities in Health Inevitable?
• Conclusion
• Literature Cited
• Chapter 19: Exploring Health Disparities in Integrated Communities
• Introduction
• Limited Data
• Different Health Risk Exposures
• Confounding of Race and Socioeconomic Status
• Exploring Health Disparities in Integrated Communities—EHDIC
• Analysis Strategy
• Findings from the EHDIC-SWB Study
• Hypertension
• Diabetes
• Obesity
• Tobacco
• Alcohol
• Health Services Utilization
• Race Inequalities, Health Policy, and Social Conditions
• References
• Environmental Determinants
• Chapter 20: Race/Ethnicity, the Social Environment, and Health
• Perceptions of Race/Ethnicity and Socio-Economic Status
• Understanding the Social Context of Health
• Reasons for Racial/Ethnic Differences in Health
• Race/Ethnicity and Health
• The Social Environment and Substance Use
• Methodological Issues in Studying Race/Ethnicity and the Social Environment
• Importance of Research on Race/Ethnicity and the Social Environment
• References
• Chapter 21: Built Environments and Obesity in Disadvantaged Populations
• Introduction
• Background
• Methods
• Results
• Food Environment
• Urban Form: Density, Connectivity, and Land Use Mix
• Sidewalks, Parks, and Exercise Facilities
• Aesthetics and Safety
• Discussion
• References
• Chapter 22: Health Risk and Inequitable Distribution of Liquor Stores in African American Neighborho
• Background
• Methods
• Results
• Summary and Conclusions
• References
• Chapter 23: Environmental Health Disparities: A Framework Integrating Psychosocial and Environmental
• Health Disparities and the Environment
• The Stress-Exposure Disease Framework
• The Exposure-Disease Paradigm
• Race and Residential Location
• Environmental Hazards and Pollutants
• Structural Factors
• Community Stressors
• Health Effects of Stress
• Types of Community Stressors
• Racial Disparities in Exposure to Stressors
• Neighborhood Resources
• Community Stress
• Future Directions
• Conclusions
• References
• Chapter 24: Sick and Tired of Being Sick and Tired: Scientific Evidence, Methods, and Research Impli
• People of Color in the US Workforce
• Classic Case Studies
• Disproportionate Exposure, Disproportionate Disease
• Methodological Issues
• Strategies to Decrease Injury and Disease
• Research and Surveillance Agenda
• References
• Part 4: Health Services and Health System Effects
• Patients
• Chapter 25: Attitudes About Racism, Medical Mistrust, and Satisfaction with Care Among African Ameri
• New Contribution
• Conceptual Framework
• Methods
• Results
• Discussion
• Appendix
• References
• Chapter 26: The Legacy of Tuskegee and Trust in Medical Care: Is Tuskegee Responsible for Race Diffe
• Introduction
• Methods
• Study Design and Population
• Measures
• Results
• Respondent Characteristics
• Discussion
• References
• Chapter 27: Patient Race/Ethnicity and Quality of Patient–Physician Communication During Medical V
• Methods
• Study Design and Population
• Data Collection
• Measures of Communication
• Patient and Physician Characteristics
• Statistical Analysis
• Results
• Recruitment and Sample Characteristics
• Quality of Medical-Visit Communication
• Discussion
• References
• Providers
• Chapter 28: Implicit Bias Among Physicians and Its Prediction of Thrombolysis Decisions for Black an
• Background
• Methods
• Participants and Study Procedures
• Study Design
• Analysis
• Results
• Physicians’ Explicit and Implicit Racial Biases
• Diagnosis of CAD and Treatment with Thrombolysis
• Implicit (But Not Explicit) Bias Predicts Differences in Physicians’ Thrombolysis Decisions
• Participants Who Were Aware of the Study’s Purpose
• Comment
• Appendix
• Clinical Case Vignette
• References
• Chapter 29: The Effect of Patient Race and Socio-Economic Status on Physicians’ Perceptions of Patie
• Introduction
• Methods
• Sample
• Clinical/Medical Record Data Collection Procedures
• Sample Characteristics
• Measures
• Results
• Summary of Results
• Discussion
• Limitations
• Conclusion
• References
• Chapter 30: Ethnicity and Analgesic Practice
• Introduction
• Materials and Methods
• Results
• Discussion
• References
• Chapter 31: The Effect of Race and Sex on Physicians’ Recommendations for Cardiac Catheterization
• Methods
• Survey Instrument
• Study Subjects and Data Collection
• Statistical Analysis
• Results
• Discussion
• References
• System
• Chapter 32: Advancing Health Disparities Research Within the Health Care System: A Conceptual Framew
• Three Phases of Health Disparities Research
• Background and Theoretical Underpinning
• Phase 1: Detection
• What Is a Health Disparity?
• Disparities as Gaps in Quality
• Consider Selection Effects
• Disparities in Patient Preferences
• Vulnerable Populations
• Defining Vulnerable Populations
• Phase 2: Understanding
• Considering Multilevel Factors
• Individual Preferences
• Biology and Genetics
• Provider Factors
• Health Care Organizational Culture
• Phase 3: Reducing Disparities
• Developing Interventions
• Evaluation
• Implementation and Translation
• Researcher–Community Collaborations
• Conclusions
• References
• Chapter 33: Linking Cultural Competence Training to Improved Health Outcomes: Perspectives from the
• The Evolution and Key Principles of Cultural Competence
• The “Buy-In” Is Critical
• Focus on Cases and Clinical Applications
• Address the Demand for the Categorical Approach
• Think Longitudinally
• Integrate When Possible
• Evaluating Cultural Competence and Linking It to Health Care Outcomes
• Key Framework for Evaluation
• Choosing Measures
• Control for Confounders
• Summing Up
• References
• Chapter 34: “We Don’t Carry That”—Failure of Pharmacies in Predominantly Nonwhite Neighborhoods to
• Methods
• Results
• Discussion
• References
• Chapter 35: Do Hospitals Provide Lower-Quality Care to Minorities Than to Whites?
• Study Data And Methods
• Data
• Quality Measures
• Limitations and Strengths of PSIs and IQIs
• Methods
• Study Results
• Overall Rates of Mortality and Adverse Events
• Comparison of Hospitals
• Pairwise Comparisons
• Discussion
• Limitations
• Conclusions
• Notes
• Part 5: Health Disparities Solutions
• Chapter 36: Linking Science and Policy Through Community-Based Participatory Research to Study and A
• Methods
• Results
• Addressing Diesel Bus Pollution and Its Health Consequences
• Addressing Food Insecurity
• Facilitating Factors Across Sites
• Tensions and Challenges Across Sites
• Discussion
• Conclusions
• References
• Chapter 37: The National Health Plan Collaborative to Reduce Disparities and Improve Quality
• Genesis of the NHPC
• Design of the NHPC
• Progress to Date
• Obtaining Race/Ethnicity Data
• Identifying Disparities
• Targeting and Testing Interventions
• Challenges and Lessons Learned
• Next Steps
• Summary and Conclusions
• Epilogue
• References
• Chapter 38: Interventions to Reduce Racial and Ethnic Disparities in Health Care
• New Contribution
• Conceptual Model of Racial and Ethnic Disparities in Health Care
• Key Questions
• Lessons Learned from Each Paper
• Cardiovascular Disease
• Hypertension
• Tobacco Cessation
• Hyperlipidemia and Physical Inactivity
• Coronary Artery Disease and Heart Failure
• Diabetes
• Patient
• Provider
• Health Care Organizations and Community
• Multitarget
• Depression
• Breast Cancer
• Screening
• Expedited Diagnostic Testing and Treatment
• Culture
• Performance Incentive Programs: Pay-for-Performance and Public Reporting
• Summary Conclusions
• Promising Intervention Strategies
• Questions for Future Research
• References
• Index