Communities in Action


Book Description

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 City


Book Description

Chicago has long struggled with racial residential segregation, high rates of poverty, and deepening class stratification, and it can be a challenging place for adolescents to grow up. Unequal City examines the ways in which Chicago’s most vulnerable residents navigate their neighborhoods, life opportunities, and encounters with the law. In this pioneering analysis of the intersection of race, place, and opportunity, sociologist and criminal justice expert Carla Shedd illuminates how schools either reinforce or ameliorate the social inequalities that shape the worlds of these adolescents. Shedd draws from an array of data and in-depth interviews with Chicago youth to offer new insight into this understudied group. Focusing on four public high schools with differing student bodies, Shedd reveals how the predominantly low-income African American students at one school encounter obstacles their more affluent, white counterparts on the other side of the city do not face. Teens often travel long distances to attend school which, due to Chicago’s segregated and highly unequal neighborhoods, can involve crossing class, race, and gang lines. As Shedd explains, the disadvantaged teens who traverse these boundaries daily develop a keen “perception of injustice,” or the recognition that their economic and educational opportunities are restricted by their place in the social hierarchy. Adolescents’ worldviews are also influenced by encounters with law enforcement while traveling to school and during school hours. Shedd tracks the rise of metal detectors, surveillance cameras, and pat-downs at certain Chicago schools. Along with police procedures like stop-and-frisk, these prison-like practices lead to distrust of authority and feelings of powerlessness among the adolescents who experience mistreatment either firsthand or vicariously. Shedd finds that the racial composition of the student body profoundly shapes students’ perceptions of injustice. The more diverse a school is, the more likely its students of color will recognize whether they are subject to discriminatory treatment. By contrast, African American and Hispanic youth whose schools and neighborhoods are both highly segregated and highly policed are less likely to understand their individual and group disadvantage due to their lack of exposure to youth of differing backgrounds.




The Health Gap


Book Description

'Punchily written ... He leaves the reader with a sense of the gross injustice of a world where health outcomes are so unevenly distributed' Times Literary Supplement 'Splendid and necessary' Henry Marsh, author of Do No Harm, New Statesman There are dramatic differences in health between countries and within countries. But this is not a simple matter of rich and poor. A poor man in Glasgow is rich compared to the average Indian, but the Glaswegian's life expectancy is 8 years shorter. The Indian is dying of infectious disease linked to his poverty; the Glaswegian of violent death, suicide, heart disease linked to a rich country's version of disadvantage. In all countries, people at relative social disadvantage suffer health disadvantage, dramatically so. Within countries, the higher the social status of individuals the better is their health. These health inequalities defy usual explanations. Conventional approaches to improving health have emphasised access to technical solutions – improved medical care, sanitation, and control of disease vectors; or behaviours – smoking, drinking – obesity, linked to diabetes, heart disease and cancer. These approaches only go so far. Creating the conditions for people to lead flourishing lives, and thus empowering individuals and communities, is key to reduction of health inequalities. In addition to the scale of material success, your position in the social hierarchy also directly affects your health, the higher you are on the social scale, the longer you will live and the better your health will be. As people change rank, so their health risk changes. What makes these health inequalities unjust is that evidence from round the world shows we know what to do to make them smaller. This new evidence is compelling. It has the potential to change radically the way we think about health, and indeed society.




Growing Unequal? Income Distribution and Poverty in OECD Countries


Book Description

This report provides evidence of a fairly generalised increase in income inequality over the past two decades across OECD countries, but the timing, intensity and causes of the increase differ from what is typically suggested in the media.




Unequal Treatment


Book Description

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.







Humanity Divided


Book Description

This report revisits the theoretical concepts of inequalities including their measurements, analyzes their global trends, presents the policy makers' perception of inequalities in 15 countries and identifies various policy options in combating this major development challenge of our time. The report makes the basic point that in spite of the impressive progress humanity has made on many fronts over the decades, it still remains deeply divided. In that context, it is intended to help development actors, citizens, and policy makers contribute to global dialogues and initiate conversations in their own countries about the drivers and extent of inequalities, their impact, and the ways in which they can be curbed.




Causes and Consequences of Income Inequality


Book Description

This paper analyzes the extent of income inequality from a global perspective, its drivers, and what to do about it. The drivers of inequality vary widely amongst countries, with some common drivers being the skill premium associated with technical change and globalization, weakening protection for labor, and lack of financial inclusion in developing countries. We find that increasing the income share of the poor and the middle class actually increases growth while a rising income share of the top 20 percent results in lower growth—that is, when the rich get richer, benefits do not trickle down. This suggests that policies need to be country specific but should focus on raising the income share of the poor, and ensuring there is no hollowing out of the middle class. To tackle inequality, financial inclusion is imperative in emerging and developing countries while in advanced economies, policies should focus on raising human capital and skills and making tax systems more progressive.




New Horizons in Health


Book Description

New Horizons in Health discusses how the National Institutes of Health (NIH) can integrate research in the social, behavioral, and biomedical sciences to better understand the causes of disease as well as interventions that promote health. It outlines a set of research priorities for consideration by the Office of Behavioral and Social Sciences Research (OBSSR), with particular attention to research that can support and complement the work of the National Institutes of Health. By addressing the range of interactions among social settings, behavioral patterns, and important health concerns, it highlights areas of scientific opportunity where significant investment is most likely to improve nationalâ€"and globalâ€"health outcomes. These opportunities will apply the knowledge and methods of the behavioral and social sciences to contemporary health needs, and give attention to the chief health concerns of the general public.




Inequality of Opportunity


Book Description

Eight papers, both theoretical and applied, on the concept of equality of opportunity which says that a society should guarantee its members equal access to advantage regardless of their circumstances, while holding them responsible for turning that access into actual advantage by the application of effort.