Critical Perspectives on Racial and Ethnic Differences in Health in Late Life

Critical Perspectives on Racial and Ethnic Differences in Health in Late Life

Author: National Research Council

Publisher: National Academies Press

Published: 2004-10-16

Total Pages: 753

ISBN-13: 0309092116

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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.


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.


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.


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.


Racial and Ethnic Differences in the Health of Older Americans

Racial and Ethnic Differences in the Health of Older Americans

Author: National Research Council

Publisher: National Academies Press

Published: 1997-09-23

Total Pages: 312

ISBN-13: 0309175569

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Older Americans, even the oldest, can now expect to live years longer than those who reached the same ages even a few decades ago. Although survival has improved for all racial and ethnic groups, strong differences persist, both in life expectancy and in the causes of disability and death at older ages. This book examines trends in mortality rates and selected causes of disability (cardiovascular disease, dementia) for older people of different racial and ethnic groups. The determinants of these trends and differences are also investigated, including differences in access to health care and experiences in early life, diet, health behaviors, genetic background, social class, wealth and income. Groups often neglected in analyses of national data, such as the elderly Hispanic and Asian Americans of different origin and immigrant generations, are compared. The volume provides understanding of research bearing on the health status and survival of the fastest-growing segment of the American population.


Shades of Citizenship

Shades of Citizenship

Author: Melissa Nobles

Publisher: Stanford University Press

Published: 2000

Total Pages: 268

ISBN-13: 9780804740593

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This book explores the politics of race, censuses, and citizenship, drawing on the complex history of questions about race in the U.S. and Brazilian censuses. It reconstructs the history of racial categorization in American and Brazilian censuses from each country’s first census in the eighteenth and nineteenth centuries up through the 2000 census. It sharply challenges certain presumptions that guide scholarly and popular studies, notably that census bureaus are (or are designed to be) innocent bystanders in the arena of politics, and that racial data are innocuous demographic data. Using previously overlooked historical sources, the book demonstrates that counting by race has always been a fundamentally political process, shaping in important ways the experiences and meanings of citizenship. This counting has also helped to create and to further ideas about race itself. The author argues that far from being mere producers of racial statistics, American and Brazilian censuses have been the ultimate insiders with respect to racial politics. For most of their histories, American and Brazilian censuses were tightly controlled by state officials, social scientists, and politicians. Over the past thirty years in the United States and the past twenty years in Brazil, however, certain groups within civil society have organized and lobbied to alter the methods of racial categorization. This book analyzes both the attempt of America’s multiracial movement to have a multiracial category added to the U.S. census and the attempt by Brazil’s black movement to include racial terminology in census forms. Because of these efforts, census bureau officials in the United States and Brazil today work within political and institutional constraints unknown to their predecessors. Categorization has become as much a "bottom-up” process as a "top-down” one.


Ethnic Constructs in Antiquity

Ethnic Constructs in Antiquity

Author: Ton Derks

Publisher: Amsterdam University Press

Published: 2009

Total Pages: 353

ISBN-13: 9089640789

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A bold and original examination of the relationships between ethnicity and political power in the ancient world.


Pigmentocracies

Pigmentocracies

Author: Edward Telles

Publisher: UNC Press Books

Published: 2014-10-22

Total Pages: 320

ISBN-13: 1469617846

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Pigmentocracies--the fruit of the multiyear Project on Ethnicity and Race in Latin America (PERLA)--is a richly revealing analysis of contemporary attitudes toward ethnicity and race in Brazil, Colombia, Mexico, and Peru, four of Latin America's most populous nations. Based on extensive, original sociological and anthropological data generated by PERLA, this landmark study analyzes ethnoracial classification, inequality, and discrimination, as well as public opinion about Afro-descended and indigenous social movements and policies that foster greater social inclusiveness, all set within an ethnoracial history of each country. A once-in-a-generation examination of contemporary ethnicity, this book promises to contribute in significant ways to policymaking and public opinion in Latin America. Edward Telles, PERLA's principal investigator, explains that profound historical and political forces, including multiculturalism, have helped to shape the formation of ethnic identities and the nature of social relations within and across nations. One of Pigmentocracies's many important conclusions is that unequal social and economic status is at least as much a function of skin color as of ethnoracial identification. Investigators also found high rates of discrimination by color and ethnicity widely reported by both targets and witnesses. Still, substantial support across countries was found for multicultural-affirmative policies--a notable result given that in much of modern Latin America race and ethnicity have been downplayed or ignored as key factors despite their importance for earlier nation-building.