Understanding Racial and Ethnic Differences in Health in Late Life

Understanding Racial and Ethnic Differences in Health in Late Life

Author: National Research Council

Publisher: National Academies Press

Published: 2004-09-08

Total Pages: 184

ISBN-13: 0309165865

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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.


Unequal Treatment

Unequal Treatment

Author: Institute of Medicine

Publisher: National Academies Press

Published: 2009-02-06

Total Pages: 781

ISBN-13: 030908265X

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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.


Communities in Action

Communities in Action

Author: National Academies of Sciences, Engineering, and Medicine

Publisher: National Academies Press

Published: 2017-04-27

Total Pages: 583

ISBN-13: 0309452961

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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.


Just Medicine

Just Medicine

Author: Dayna Bowen Matthew

Publisher: NYU Press

Published: 2016-10-25

Total Pages: 310

ISBN-13: 1479888567

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Offers an innovative plan to eliminate inequalities in American health care and save the lives they endanger Over 84,000 black and brown lives are needlessly lost each year due to health disparities: the unfair, unjust, and avoidable differences between the quality and quantity of health care provided to Americans who are members of racial and ethnic minorities and care provided to whites. Health disparities have remained stubbornly entrenched in the American health care system—and in Just Medicine Dayna Bowen Matthew finds that they principally arise from unconscious racial and ethnic biases held by physicians, institutional providers, and their patients. Implicit bias is the single most important determinant of health and health care disparities. Because we have missed this fact, the money we spend on training providers to become culturally competent, expanding wellness education programs and community health centers, and even expanding access to health insurance will have only a modest effect on reducing health disparities. We will continue to utterly fail in the effort to eradicate health disparities unless we enact strong, evidence-based legal remedies that accurately address implicit and unintentional forms of discrimination, to replace the weak, tepid, and largely irrelevant legal remedies currently available. Our continued failure to fashion an effective response that purges the effects of implicit bias from American health care, Matthew argues, is unjust and morally untenable. In this book, she unites medical, neuroscience, psychology, and sociology research on implicit bias and health disparities with her own expertise in civil rights and constitutional law. In a time when the health of the entire nation is at risk, it is essential to confront the issues keeping the health care system from providing equal treatment to all.


Medical Apartheid

Medical Apartheid

Author: Harriet A. Washington

Publisher: Vintage

Published: 2008-01-08

Total Pages: 530

ISBN-13: 076791547X

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NATIONAL BOOK CRITICS CIRCLE AWARD WINNER • The first full history of Black America’s shocking mistreatment as unwilling and unwitting experimental subjects at the hands of the medical establishment. No one concerned with issues of public health and racial justice can afford not to read this masterful book. "[Washington] has unearthed a shocking amount of information and shaped it into a riveting, carefully documented book." —New York Times From the era of slavery to the present day, starting with the earliest encounters between Black Americans and Western medical researchers and the racist pseudoscience that resulted, Medical Apartheid details the ways both slaves and freedmen were used in hospitals for experiments conducted without their knowledge—a tradition that continues today within some black populations. It reveals how Blacks have historically been prey to grave-robbing as well as unauthorized autopsies and dissections. Moving into the twentieth century, it shows how the pseudoscience of eugenics and social Darwinism was used to justify experimental exploitation and shoddy medical treatment of Blacks. Shocking new details about the government’s notorious Tuskegee experiment are revealed, as are similar, less-well-known medical atrocities conducted by the government, the armed forces, prisons, and private institutions. The product of years of prodigious research into medical journals and experimental reports long undisturbed, Medical Apartheid reveals the hidden underbelly of scientific research and makes possible, for the first time, an understanding of the roots of the African American health deficit. At last, it provides the fullest possible context for comprehending the behavioral fallout that has caused Black Americans to view researchers—and indeed the whole medical establishment—with such deep distrust.


Blacks in Medicine

Blacks in Medicine

Author: Richard Allen Williams

Publisher: Springer Nature

Published: 2020-04-24

Total Pages: 219

ISBN-13: 3030419606

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This socially conscious, culturally relevant book explores the little-known history and present climate of Black people in the medical field. It reveals the deficiencies in the American healthcare structure that have contributed to the mismanagement of healthcare in the Black population, and examines cross-currents that intersect with the major events in minority medical history. Illustrated across 10 expertly written chapters, this text features a longitudinal timeline with the presentation of evidence-based information drawn from historical, political, and clinical sources. The book begins with an analysis of diseases particularly prevalent in the Black community due to socioeconomic inequalities in available medical care. These diseases include sickle cell anemia, hypertension, heart failure, drug addiction, and HIV/AIDS. Bolstered by profiles of historically well-known Black physicians, stories of success in medical education, and the remarkable impact of Black medical organizations, subsequent chapters address the triumphs and tribulations of the Black medical professional in America. Concluding with an examination of the current health status of Black people in the United States, the book makes a case for future systemic improvements in healthcare delivery to minority communities. A unique, noteworthy reference, Blacks in Medicine: Clinical, Demographic, and Socioeconomic Correlations is written for a broad range of physicians and health providers, as well as professionals in the social sciences and public health.


Caring for Equality

Caring for Equality

Author: David McBride

Publisher: Rowman & Littlefield

Published: 2018-08-24

Total Pages: 208

ISBN-13: 1442260602

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African Americans today continue to suffer disproportionately from heart disease, diabetes, and other health problems. In Caring for Equality David McBride chronicles the struggle by African Americans and their white allies to improve poor black health conditions as well as inadequate medical care—caused by slavery, racism, and discrimination—since the arrival of African slaves in America. Black American health progress resulted from the steady influence of what David McBride calls the health equality ideal: the principle that health of black Americans could and should be equal to that of whites and other Americans. Including a timeline, selected primary sources, and an extensive bibliographic essay, McBride’s book provides a superb starting point for students and readers who want to explore in greater depth this important and understudied topic in African American history.


An American Health Dilemma

An American Health Dilemma

Author: W. Michael Byrd

Publisher: Routledge

Published: 2012-10-02

Total Pages: 708

ISBN-13: 1135960488

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At times mirroring and at times shockingly disparate to the rise of traditional white American medicine, the history of African-American health care is a story of traditional healers; root doctors; granny midwives; underappreciated and overworked African-American physicians; scrupulous and unscrupulous white doctors and scientists; governmental support and neglect; epidemics; and poverty. Virtually every part of this story revolves around race. More than 50 years after the publication of An American Dilemma, Gunnar Myrdal's 1944 classic about race relations in the USA, An American Health Dilemma presents a comprehensive and groundbreaking history and social analysis of race, race relations and the African-American medical and public health experience. Beginning with the origins of western medicine and science in Egypt, Greece and Rome the authors explore the relationship between race, medicine, and health care from the precursors of American science and medicine through the days of the slave trade with the harrowing middle passage and equally deadly breaking-in period through the Civil War and the gains of reconstruction and the reversals caused by Jim Crow laws. It offers an extensive examination of the history of intellectual and scientific racism that evolved to give sanction to the mistreatment, medical abuse, and neglect of African Americans and other non-white people. Also included are biographical portraits of black medical pioneers like James McCune Smith, the first African American to earn a degree from a European university, and anecdotal vignettes,like the tragic story of "the Hottentot Venus", which illustrate larger themes. An American Health Dilemma promises to become an irreplaceable and essential look at African-American and medical history and will provide an invaluable baseline for future exploration of race and racism in the American health system.


The Impacts of Racism and Bias on Black People Pursuing Careers in Science, Engineering, and Medicine

The Impacts of Racism and Bias on Black People Pursuing Careers in Science, Engineering, and Medicine

Author: National Academies of Sciences, Engineering, and Medicine

Publisher: National Academies Press

Published: 2020-12-18

Total Pages: 107

ISBN-13: 0309679540

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Despite the changing demographics of the nation and a growing appreciation for diversity and inclusion as drivers of excellence in science, engineering, and medicine, Black Americans are severely underrepresented in these fields. Racism and bias are significant reasons for this disparity, with detrimental implications on individuals, health care organizations, and the nation as a whole. The Roundtable on Black Men and Black Women in Science, Engineering, and Medicine was launched at the National Academies of Sciences, Engineering, and Medicine in 2019 to identify key levers, drivers, and disruptors in government, industry, health care, and higher education where actions can have the most impact on increasing the participation of Black men and Black women in science, medicine, and engineering. On April 16, 2020, the Roundtable convened a workshop to explore the context for their work; to surface key issues and questions that the Roundtable should address in its initial phase; and to reach key stakeholders and constituents. This proceedings provides a record of the workshop.


The Hidden History of American Healthcare

The Hidden History of American Healthcare

Author: Thom Hartmann

Publisher: Berrett-Koehler Publishers

Published: 2021-09-07

Total Pages: 134

ISBN-13: 1523091657

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Popular progressive radio host and New York Times bestselling author Thom Hartmann reveals how and why attempts to implement affordable universal healthcare in the United States have been thwarted and what we can do to finally make it a reality. "For-profit health insurance is the largest con job ever perpetrated on the American people—one that has cost trillions of dollars and millions of lives since the 1940s,” says Thom Hartmann. Other countries have shown us that affordable universal healthcare is not only possible but also effective and efficient. Taiwan's single-payer system saved the country a fortune as well as saving lives during the coronavirus pandemic, enabling the country to implement a nationwide coronavirus test-and-contact-trace program without shutting down the economy. This resulted in just ten deaths, while more than 500,000 people have died in the United States. Hartmann offers a deep dive into the shameful history of American healthcare, showing how greed, racism, and oligarchic corruption led to the current “sickness for profit” system. Modern attempts to create versions of government healthcare have been hobbled at every turn, including Obamacare. There is a simple solution: Medicare for all. Hartmann outlines the extraordinary benefits this system would provide the American people and economy and the steps we need to take to make it a reality. It's time for America to join every industrialized country in the world and make health a right, not a privilege.