Unequal Coverage
Unequal Coverage

Author: Jessica M. Mulligan

Publisher: NYU Press

Published: 2018

Total Pages: 316

ISBN-13: 1479848735

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"The Affordable Care Act set off an unprecedented wave of health insurance enrollment as the most sweeping overhaul of the U.S. health insurance system since 1965. In the years since its enactment, some 20 million uninsured Americans gained access to coverage. And yet, the law remained unpopular and politically vulnerable. While the ACA extended social protections to some groups, its implementation was troubled and the act itself created new forms of exclusion. Access to affordable coverage options were highly segmented by state of residence, income, and citizenship status. Unequal Coverage documents the everyday experiences of individuals and families across the U.S. as they attempted to access coverage and care in the five years following the passage of the ACA. It argues that while the Affordable Care Act succeeded in expanding access to care, it did so unevenly, ultimately also generating inequality and stratification. The volume investigates the outcomes of the ACA in communities throughout the country and provides up-close, intimate portraits of individuals and groups trying to access and provide health care for both the newly insured and those who remain uncovered. The contributors use the ACA as a lens to examine more broadly how social welfare policies in a multiracial and multiethnic democracy purport to be inclusive while simultaneously embracing certain kinds of exclusions"--Publisher's website.

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.

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.

Access to Health Care in America
Access to Health Care in America

Author: Institute of Medicine

Publisher: National Academies Press

Published: 1993-02-01

Total Pages: 240

ISBN-13: 0309047420

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Americans are accustomed to anecdotal evidence of the health care crisis. Yet, personal or local stories do not provide a comprehensive nationwide picture of our access to health care. Now, this book offers the long-awaited health equivalent of national economic indicators. This useful volume defines a set of national objectives and identifies indicatorsâ€"measures of utilization and outcomeâ€"that can "sense" when and where problems occur in accessing specific health care services. Using the indicators, the committee presents significant conclusions about the situation today, examining the relationships between access to care and factors such as income, race, ethnic origin, and location. The committee offers recommendations to federal, state, and local agencies for improving data collection and monitoring. This highly readable and well-organized volume will be essential for policymakers, public health officials, insurance companies, hospitals, physicians and nurses, and interested individuals.

Analyzing Inequality
Analyzing Inequality

Author: Stefan Svallfors

Publisher: Stanford University Press

Published: 2007-01-05

Total Pages: 200

ISBN-13: 9780804757577

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An examination of the state of the art in stratification research, looking at data, methods, theory, and new empirical findings in social inequality, life course, and cross-national comparative sociology.

Handbook on Health Inequality Monitoring
Handbook on Health Inequality Monitoring

Author: World Health Organization

Publisher: World Health Organization

Published: 2013

Total Pages: 123

ISBN-13: 9241548630

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"The Handbook on health inequality monitoring: with a special focus on low- and middle-income countries is a resource that enables countries to do just that. It presents a comprehensive yet clear overview of health inequality monitoring in a user-friendly manner. The handbook succeeds in giving those involved in health inequality monitoring an appreciation of the complexities of the process, as well as building the practical knowledge and skills for systematic monitoring of health inequalities in low- and middle-income countries. The use of the handbook will enable countries to better monitor and evaluate their progress and performance with a high degree of accountability and transparency, and allow them to use the results to formulate evidenced-based policies, programmes and practices to tackle inequalities in an effective manner."--Publisher's description.

Uneven Odds, Unequal Outcomes
Uneven Odds, Unequal Outcomes

Author: Nandini Krishnan

Publisher: World Bank Publications

Published: 2016-06-28

Total Pages: 197

ISBN-13: 1464807876

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Perceptions of eroding living standards and low life satisfaction are widespread in the Middle East and North Africa region today, along with pessimism about prospects for economic mobility. Conventional measures of economic well-being offer little in the way of explanation †“ in most countries in the region, extreme poverty is low and declining and economic inequality is lower than in other parts of the world. This book investigates possible reasons for this disconnect, focusing on the role played by inadequate and unequal access to opportunities to realize one’s aspirations for economic mobility. The inability of most countries in the region to meet the aspirations of citizens is closely linked to persistent weaknesses in the labor markets where the pace of job creation has been chronically below levels required to absorb the growing and increasingly better educated population. A high degree of segmentation in the labor markets also puts the youth and women in the region at a particular disadvantage. While labor markets are critical for mobility, opportunities and life paths can diverge even earlier in life if access to basic services in health, education and infrastructure are unequally distributed among children in their formative years. This book documents sharp disparities in the quality of services available to children of varying birth circumstances in the region. Although the most intense debates in development coalesce around inequality of income or wealth, the notion of inequality of opportunity has an intuitive appeal that can bridge ideological differences. By drawing attention to the notion of equality of opportunity to create a level playing field for all sections of society, the book highlights the need to critically examine the social contract and governance structures that guide the delivery of services and are instrumental for implementing necessary reforms to make labor markets more dynamic and equitable.

Health Care for Some
Health Care for Some

Author: Beatrix Hoffman

Publisher: University of Chicago Press

Published: 2012-09-15

Total Pages: 357

ISBN-13: 0226348032

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The 2010 Affordable Care Act is a sweeping reform to the US health care system. Hoffman offers an engaging and in-depth look at America's long tradition of unequal access to health care. She argues that two main features have characterized the US health system: a refusal to adopt a right to care and a particularly American type of rationing. Unlike rationing in most countries, which is intended to keep costs down, rationing in the United States has actually led to increased costs, resulting in the most expensive health care system in the world.

America's Children
America's Children

Author: Institute of Medicine and National Research Council

Publisher: National Academies Press

Published: 1998-11-27

Total Pages: 217

ISBN-13: 0309065607

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America's Children is a comprehensive, easy-to-read analysis of the relationship between health insurance and access to care. The book addresses three broad questions: How is children's health care currently financed? Does insurance equal access to care? How should the nation address the health needs of this vulnerable population? America's Children explores the changing role of Medicaid under managed care; state-initiated and private sector children's insurance programs; specific effects of insurance status on the care children receive; and the impact of chronic medical conditions and special health care needs. It also examines the status of "safety net" health providers, including community health centers, children's hospitals, school-based health centers, and others and reviews the changing patterns of coverage and tax policy options to increase coverage of private-sector, employer-based health insurance. In response to growing public concerns about uninsured children, last year Congress voted to provide $24 billion over five years for new state insurance initiatives. This volume will serve as a primer for concerned federal policymakers and regulators, state agency officials, health plan decisionmakers, health care providers, children's health advocates, and researchers.