Health disparities in the United States : social class, race, ethnicity, and the social determinants of health

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Title:

Author:

Barr, Donald A., 1946- author.

ISBN:

9781421432571

9781421432588

Personal Author:

Barr, Donald A., 1946- author.

Edition:

Third edition.

Physical Description:

xvii, 356 pages : illustrations ; 24 cm

Abstract:

With extensive new data, Donald A. Barr illuminates the ways low socioeconomic status, race, and ethnicity interact to create and perpetuate health disparities in the United States. This thoroughly updated edition focuses on a new challenge the United States last experienced more than half a century ago: successive years of declining life expectancy. Barr addresses the causes of this decline, including what are commonly referred to as "deaths of despair"--Opiate overdose or suicide. Exploring the growing role geography plays in health disparities, Barr asks why people living in rural areas suffer the greatest increases in these deaths. He also analyzes recent changes under the Affordable Care Act and considers the literature on how race and ethnicity affect the way health care providers evaluate and treat patients.

Contents:

Introduction to the social roots of health disparities -- What is "health"? how should we define it? how should we measure it? -- The relationship between socioeconomic status and health, or, "they call it 'poor health' for a reason" -- Understanding how low social status leads to poor health -- Race, ethnicity, and health -- Race/ethnicity, socioeconomic status, and health : which is more important in affecting health status? -- Children's health disparities -- All things being equal, does race/ethnicity affect how physicians treat patients? -- Why does race/ethnicity affect the way physicians treat patients? -- When, if ever, is it appropriate to use a patient's race/ethnicity to guide medical decisions? -- What should we do to reduce health disparities?

Subject Term:

Health services accessibility -- United States.

Social medicine -- United States.

Minorities -- Health and hygiene -- United States.

Equality -- Health aspects -- United States.

Health -- Social aspects -- United States.

Medical economics -- United States.

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Library	Material Type	Call Number	Status	Item Holds
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Summary

Challenging students to think critically about the complex web of social forces that leads to health disparities in the United States.

The health care system in the United States has been called the best in the world. Yet wide disparities persist between social groups, and many Americans suffer from poorer health than people in other developed countries. In this revised edition of Health Disparities in the United States , Donald A. Barr provides extensive new data about the ways low socioeconomic status, race, and ethnicity interact to create and perpetuate these health disparities. Examining the significance of this gulf for the medical community and society at large, Barr offers potential policy- and physician-based solutions for reducing health inequity in the long term.

This thoroughly updated edition focuses on a new challenge the United States last experienced more than half a century ago: successive years of declining life expectancy. Barr addresses the causes of this decline, including what are commonly referred to as "deaths of despair"--from opiate overdose or suicide. Exploring the growing role geography plays in health disparities, Barr asks why people living in rural areas suffer the greatest increases in these deaths. He also analyzes recent changes under the Affordable Care Act and considers the literature on how race and ethnicity affect the way health care providers evaluate and treat patients.

As both a physician and a sociologist, Barr is uniquely positioned to offer rigorous medical explanations alongside sociological analysis. An essential text for courses in public health, health policy, and sociology, this compelling book is a vital teaching tool and a comprehensive reference for social science and medical professionals.

Reviews (1)

Choice Review

In this third edition Barr (Stanford Univ.) thoroughly examines how various forms of social disparity lead to differences in clinical outcomes, average life expectancy, and access to care. The text is a revised and expanded version including new data, analyses, and support from recent peer-reviewed literature. It provides a timely, up-to-date assessment of how social class, race, ethnicity, and other social factors become determining influences on the health of populations. The book's present focus is broader than in previous versions, including, for example, an assessment of health disparities among children. Barr begins by establishing a definition of health disparities and examines how they are related in the US to lower levels of life expectancy and higher rates of infant mortality than might be expected. A definition of health itself is also provided in the context of its relationship with socioeconomic status across history. Barr explores the concept of allostatic load and its relationship to health throughout our lives, the diversity hidden by constructs of race and ethnicity, and the disparities that arise from acceptance of these categories. Also asking whether race/ethnicity can justifiably be used to help guide medical decisions, Barr finally offers public policy recommendations for identifying and eliminating health disparities based on socioeconomic status, race, or ethnicity. Summing Up: Recommended. All readers. --Harry Holt, West Chester University

0 Preface

1 Introduction to the Social Roots of Health Disparities

0 A\New Challenge: Falling life expectancy in the U.S.

2 What Is "Health"? How Should We Define It? How Should We Measure It?

0 Six People: Healthy or Unhealthy?

0 Defining Health at the Level of an Individual

0 Health as a Multidimensional Concept

0 The\Danger of Approaching Health as a Moral Imperative

0 Measuring the Health of a Community or a Society

0 Comparing Health Status Globally

3 The\Relationship between Socioeconomic Status and Health, or, "They Call It 'Poor Health' for a Reason"

0 Terminology: Socioeconomic Status or Socioeconomic Position?

0 What is Socioeconomic Status? How Should We Measure It?

0 Is Race a Measure of SES Independent of Education, Income, and Occupation?

0 Developing a Model of the Various Measures of SES

0 Social Anomie and a Loss of Trust in Society

0 Understanding the Nature of a Social Hierarchy

0 The\Association of Transition among SES Categories and Health Outcomes

0 The\Social Roots of Health Inequality: "The Status Syndrome"

4 Understanding How Low Social Status Leads to Poor Health

0 The\Physiological Response to Stress: The Hypothalamic-Pituitary-Adrenal Axis

0 The\Physiological Effects of Chronically Elevated Allostatic Load

0 Stress in the Workplace, Hypertension, and the Whitehall Study

0 Economic Inequality as a Magnifier of Differences in Social Status

0 Social Capital: Explaining the Association between Inequality and Health

0 Measuring Subjective Social Status: Where Do I Stand on the Ladder of Society?

0 The\Other Face of Social Capital: Social Networks

0 Building a Causal Model of the Association between Low Social Status and Poor Health

0 A\New Social Determinate of Health: Despair

0 Distribution of Opioid Deaths by Age, Race/Ethnicity, and Geography

5 Race, Ethnicity, and Health

0 What Are Race and Ethnicity?

0 The\Overlap between Race and Ethnicity

0 The\History of the Use of "Race" as a Category in the United States

0 Is There a Generic Basis for Race?

0 Problems in the Continued Use of Race to Measure Health Outcomes

0 Can We Use Hispanic Ethnicity to Predict Health Status?

0 What Race Is and Isn't

6 Race/Ethnicity, Socioeconomic Status, and Health

0 Linking Race and Ethnicity to Socioeconomic Status

0 Does Race/Ethnicity Still Affect Health Status after Taking into Account Socioeconomic Status?

0 Race/Ethnicity, Socioeconomic Status, and Geography

0 Race/Ethnicity, Socioeconomic Status, and Infant Mortality

0 The\"Latina Paradox": Reduced Infant Mortality Despite Reduced Socioeconomic Status

0 Sources for the Persisting Association between Race and Health Status

7 Children's Health Disparities

0 The\Changing Demographics of Children in the United States

0 The\Importance of Early Child Development as a Source of Health Disparities

0 Mischel's Marshmallow Experiment, and the Predictive Ability of Childhood Behaviors

0 Disparities in Childhood Asthma

0 Confronting Pollution in the Water Children Drink - The Case of Flint, Michigan

0 Disparities in Childhood Obesity

0 Summary

8 All Things Being Equal, Does Race/Ethnicity Affect How Physicians Treat Patients?

0 Residential Segregation and Access to Medical Care

0 Racial/Ethnic Disparities in the Treatment of Heart Disease

0 Race/Ethnicity and the Treatment of Cancer

0 Race/Ethnicity and the Treatment of Pain

0 Race/Ethnicity and the Treatment of Kidney Failure

0 Race/Ethnicity and the Treatment of Mental Illness

0 Reviewing the Patterns of Racial Disparity in Access to Care

9 Why Does Race/Ethnicity Affect the Way Physicians Treat Patients?

0 The\Study of Racial Bias among Physicians

0 Perceptions of Racial Bias in Care among the Public and among Physicians

0 Is Racism on the Part of Physicians a Source of Racial Disparities in Care?

0 Racial Stereotypes as a Source of Racial Bias

0 Unconscious Aversion as a Form of Racial Bias

0 Racial Bias in Police Responses to Civilians - Black Lives Do Matter

0 Differentiating among the Forms of Racial Bias

10 When, if Ever, Is It Appropriate to Use a Patient's Race/Ethnicity to Guide Medical Decisions?

0 Race and the Prevention of Skin Cancer

0 Race and the Treatment of Glaucoma

0 Race/Ethnicity and Breast Cancer

0 Race/Ethnicity and the Treatment of High Blood Pressure

0 Race and the Treatment of Congestive Heart Failure: The First "Blacks Only" Medication

0 College-Educated Women in the Early Stages of Pregnancy

11 What Should We Do to Reduce Health Disparities?

0 Eliminate Unconscious Race and Ethnic Bias as a Cause of Health Disparities

0 Monitor Patterns of Care to Identify and Eliminate Unconscious Racial/Ethnic Bias

0 Strengthen the Physician-Patient Relationship, Especially When Physician and Patient Are from Differing Backgrounds

0 Increase Diversity of the Health Professions as a Means to Reduce Disparities

0 Access to Care as a First Step to Reducing Health Disparities

0 Addressing the Social Determinants of Health as Part of the Health Care System

0 How Far Have We Come in Reducing Health Disparities?

0 References

0 Index

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Table of Contents