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.




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


Book Description

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.




Eliminating Health Disparities


Book Description

Disparities in health and health care across racial, ethnic, and socioeconomic backgrounds in the United States are well documented. The reasons for these disparities are, however, not well understood. Current data available on race, ethnicity, SEP, and accumulation and language use are severely limited. The report examines data collection and reporting systems relating to the collection of data on race, ethnicity, and socioeconomic position and offers recommendations.




Decentralized Governance and Accountability


Book Description

Reviews recent lessons about decentralized governance and implications for future development programs and policies.




Ethnic Policy in China


Book Description

Following significant interethnic violence beginning in 2008, Chinese intellectuals and policymakers are now engaged in unprecedented debate over the future direction of their country's ethnic policies. This study attempts to gauge current Chinese opinion on this once-secretive and still highly sensitive area of national policy. Domestic Chinese opinion on ethnic policies over the last five years is reviewed and implications for future policies under the new leadership of CPC Secretary General Xi Jinping are explored. Careful review of a wide spectrum of contemporary Chinese commentary identifies an emerging consensus for ethnic-policy reform. Leading public intellectuals, as well as some party officials, now openly call for new measures strengthening national integration at the expense of minority rights and autonomy. These reformers argue that divisive ethnic policies adopted from the former USSR must be replaced by those supporting an ethnic "melting pot" concept. Despite this important shift in opinion, such radical policy changes as ending regional ethnic autonomy or minority preferences are unlikely over the short-to-medium term. Small-yet-significant adjustments in rhetoric and policy emphasis are, however, expected as the party-state attempts to strengthen interethnic cohesiveness as a part of its larger agenda of stability maintenance. About the author James Leibold is a senior lecturer in Politics and Asian Studies at La Trobe University in Melbourne, Australia. He is the author of Reconfiguring Chinese Nationalism (2007) and co-editor of Critical Han Studies (2012) and Minority Education in China (forthcoming). His research on ethnicity, nationalism, and race in modern China has appeared in The China Journal, The China Quarterly, The Journal of Asian Studies, Modern China, and other publications.




In the Nation's Compelling Interest


Book Description

The United States is rapidly transforming into one of the most racially and ethnically diverse nations in the world. Groups commonly referred to as minorities-including Asian Americans, Pacific Islanders, African Americans, Hispanics, American Indians, and Alaska Natives-are the fastest growing segments of the population and emerging as the nation's majority. Despite the rapid growth of racial and ethnic minority groups, their representation among the nation's health professionals has grown only modestly in the past 25 years. This alarming disparity has prompted the recent creation of initiatives to increase diversity in health professions. In the Nation's Compelling Interest considers the benefits of greater racial and ethnic diversity, and identifies institutional and policy-level mechanisms to garner broad support among health professions leaders, community members, and other key stakeholders to implement these strategies. Assessing the potential benefits of greater racial and ethnic diversity among health professionals will improve the access to and quality of healthcare for all Americans.




Understanding Racial and Ethnic Differences in Health in Late Life


Book Description

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.




Mental Health


Book Description




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.




Indigenous Peoples, Poverty, and Development


Book Description

This is the first book that documents poverty systematically for the world's indigenous peoples in developing regions in Asia, Africa, and Latin America. The volume compiles results for roughly 85 percent of the world's indigenous peoples. It draws on nationally representative data to compare trends in countries' poverty rates and other social indicators with those for indigenous sub-populations and provides comparable data for a wide range of countries all over the world. It estimates global poverty numbers and analyzes other important development indicators, such as schooling, health, and social protection. Provocatively, the results show a marked difference in results across regions, with rapid poverty reduction among indigenous (and non-indigenous) populations in Asia contrasting with relative stagnation - and in some cases falling back - in Latin America and Africa. Two main factors motivate the book. First, there is a growing concern among poverty analysts worldwide that countries with significant vulnerable populations - such as indigenous peoples - may not meet the Millennium Development Goals, and thus there exists a consequent need for better data tracking conditions among these groups. Second, there is a growing call by indigenous organizations, including the United Nations Permanent Forum on Indigenous Peoples, for solid, disaggregated data analyzing the size and causes of the "development gap."