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China's agricultural sector has developed very rapidly in the past 30 years and agricultural technological progress is deemed one of the most substantial factors leading to its rapid agricultural GDP growth. The purpose of this paper is to assess the impacts of China's agricultural technological changes on its regional disparity.

The study uses a computable general equilibrium (CGE) model of multiple regions and multiple sectors to investigate the impacts of agricultural technological changes on regional disparity. The CGE model structure includes production side, demand side, and market clearing conditions.

The results suggest that agricultural technological changes significantly reduced China's agricultural regional disparity and accounted for 40 percent reduction in agricultural regional disparity in terms of agricultural GDP per capita. Agricultural technological changes, however, led to an increase in China's overall regional disparity and accounted for 6 percent increase in its overall regional disparity in terms of per capita GDP.

China's GDP has been growing very rapidly since 1978 and agricultural GDP has been playing a decreasing role in China's overall GDP. Regional disparity in non‐agricultural GDP per capita overweighted the equalization of agricultural GDP per capita. The results imply that the Chinese government should resort more to non‐agricultural development to fight against the enlarging regional disparity.

China's agricultural technological changes have led to an increase in China's overall regional disparity while the changes have significantly reduced China's agricultural regional disparity.

Scholars and activists working both within and outside the massive health-related machinery of government and the private sector and within and outside communities of color address the same fundamental questions: Why do health disparities exist? Why have they persisted over such a long time? What can be done to significantly reduce or eliminate them?

As the size of the U.S. population age 65 and older continues to grow, racial disparities within this population persist despite near universal insurance coverage provided through Medicare. Reform of the government administered program in 2003 has the potential to influence racial disparities due to increased privatization. This study compares racial disparities in health service utilization between Medicare fee-for-service and managed care, the two drastically different ways Medicare administers health care. Data was analyzed from the National Health Interview Survey (NHIS), a nationally representative study of the U.S. civilian, noninstitutionalized, household population. Included in this study were African American and white respondents aged 65 and older who participated in the NHIS in any year from 2004 to 2008 (N=22,364). Small differences were found in regard to the number of medical office visits, with African Americans reporting fewer visits. However, these differences were significant in only 25% of the analyses conducted. Across both types of Medicare, significant differences between African Americans and whites regarding consultations with a medical specialist and having surgery were found in 75% of analyses. In all analyses, African Americans were less likely to have interacted with a specialist or have surgery. The greatest difference in racial disparity between fee-for-service and managed care for all three health service use indicators was observed among those who were chronically ill and poor, and the smallest difference was observed among those who were chronically ill and very poor. These racial disparities in health service use may be linked to earlier life disparities in access to health care, higher out-of-pocket costs in Medicare fee-for-service, and the for-profit structure of managed care plans.

This chapter provides an introduction to volume 27, Research in the Sociology of Health Care, Social Sources of Disparities in Health and Health Care and Linkages to Policy, Population Concerns and Providers of Care. It introduces the topic of social sources of disparities in health and health care and discusses the approach to this issue in the United States based on federal government efforts as well as based on research by medical sociologists, political scientists, epidemiologists and researchers in health care more generally, such as those in public health. This chapter serves as an introduction to the volume also. As such, the chapter explains the organization of the volume and briefly comments on each of the chapters included in the volume.

This chapter explores the rise in genetic approaches to health disparities at the turn of the twenty-first century.

Analysis of public health policies, genome project records, ethnography of project leaders and leading genetic epidemiologists, and news coverage of international projects demonstrates how the study of health disparities and genetic causes of health simultaneously took hold just as the new field of genomics and matters of racial inequality became a global priority for biomedical science and public health.

As the U.S. federal government created policies to implement racial inclusion standards, international genome projects seized the study race, and diseases that exhibit disparities by race. Genomic leaders made health disparities research a central feature of their science. However, recent attempts to move toward analysis of gene-environment interactions in health and disease have proven insufficient in addressing sociological contributors to health disparities. In place of in-depth analyses of environmental causes, pharmacogenomics drugs, diagnostics, and inclusion in sequencing projects have become the frontline solutions to health disparities.

The chapter argues that genetic forms of medicalization and racialization have taken hold over science and public health around the world, thereby engendering a divestment from sociological approaches that do not align with the expansion of genomic science. The chapter thus contributes to critical discussions in the social and health sciences about the fundamental processes of medicalization, racialization, and geneticization in contemporary society.

This chapter explores public perceptions of health disparities by taking political ideology and political party identification into account and applies theories of cognitive dissonance, cognitive prejudice, and moral prejudice to understand the impact of political ideology on perceptions of health disparities.

A statewide telephone survey asked 1,036 people about health disparities. Eight independent variables – political ideology, political party identification, gender, race, age, community type, income, and education achieved – were entered in an additive stepwise regression containing one of four dependent variables – unfair treatment based on health insurance, unfair treatment based on ability to speak English, minorities unable to get care when needed, and quality of care for minorities.

Political ideology entered all four equations while political party identity entered only two. Liberals were most likely to believe that minorities were unable to get routine care when needed and democrats that ability to speak English meant differential treatment. Respondents with low education were most likely to believe people were treated unfairly based on insurance, while those with lower incomes were more likely to believe that minorities received higher quality of care than whites.

A public opinion survey in one state cannot be generalized for the whole country. The survey was conducted in the spring of 2009 just as the debate over the proposed health care reform legislation was reaching a crescendo, which may explain the importance of political ideology on perceptions of health disparities.

This chapter explicitly examines the effect of political ideology and party identification on perceptions of health disparities by utilizing theories of cognitive and moral prejudice. Political ideology reflecting cognitive and moral prejudice may combine with support for a social movement or political faction that supports or opposes reducing health disparities.

Purpose – This study analyzed individual factors of race and dual eligibility on emergency room (ER) utilization of older adult Medicare patients treated by RHCs in CMS Region 4.

Methodology/approach – A prospective, longitudinal design was employed to analyze health disparities that potentially exist among RHC Medicare beneficiary patients (+65) in terms of ER use. The years of investigation were 2010 through 2012, using mixed multilevel, binary logistic regression.

Findings – This study found that dual eligible RHC patients utilized ER services at higher rates than nondual eligible, Medicare only RHC patients at: 77%, 80%, and 66%, in 2010, 2011, and 2012, respectively; and above the White reference group, Black RHC Medicare patients utilized ER services at higher rates of: 18%, 20%, and 34%, in 2010, 2011, and 2012, respectively.

Research limitations/implications – Regarding limitations, cohort data observations within the window of 3 years were only analyzed; regarding generalizability, in different CMS regions, results will likely vary; and linking other variables together in the study was limited by the accessible data. Future research should consider these limitations, and attempt to refine. The findings support that dual Medicare and Medicaid eligibility, as a proxy measure of socioeconomic status, and race continue to influence higher rates of ER utilization in CMS Region 4.

Originality/value – In terms of ER utilization disparities, persistently, as recent as 2012, Black, dual eligible RHC Medicare beneficiary patients age 65 years and over may be twice as likely to utilize ER services for care than their counterparts in the Southeastern United States.

This chapter provides both an introduction to the volume and a review of literature on health disparities and social determinants.

Literature Review.

The chapter argues for the importance of greater consideration of social determinants of health disparities. This includes a consideration of race/ethnicity and socioeconomic status factors, geographic and place factors, and disparities especially linked to particular diseases.

Reviews the topic of health disparities and social determinants and previews this book.

Purpose: We present findings from a longitudinal investigation, the purpose of which was to compare health disparities of rural Latino older adult patients diagnosed with diabetes to their non-Latino White counterparts.

Methodology/Approach: A pre-post design was implemented treating Medicare Accountable Care Organization (ACO) participation by Rural Health Clinics (RHCs) as an intervention, and using diabetes-related hospitalizations to measure disparities. Data for a nationwide panel of 2,683 RHCs were analyzed for a study period of eight years: 2008–2015. In addition, data were analyzed for a subset of 116 RHCs located in Florida, Texas, and California that participated in a Medicare ACO in one or more years of the study period.

Findings: Two broad findings resulted from this investigation. First, for both the nationwide panel of RHCs and the three-state sample of “ACO RHCs,” there was a decrease in the mean disparities in diabetes-related hospitalization rates over the eight-year study period. Second, in comparing a three-year time period after Medicare ACO implementation in 2012 to a four-year period before the implementation, a statistically significant difference in mean disparities was found for the nationwide panel.

Research Limitations/Implications: There are a number of factors that may contribute to the decrease in diabetes-related hospitalization rates for Latinos in more recent years. Future research will identify specific contributors to reducing diabetes-related hospitalization disparities between Latinos and the general population, including the possible influence of ACO participation by RHCs.

Originality/Value of Paper: This chapter presents original research conducted using data related to rural Latino older adults. The data represent multiple states and an eight-year time period. The US Latino population is growing at a rapid pace. As a group, they are at a high risk for developing diabetes, the complications of which are serious and costly to the patient and the US healthcare system. With the continued growth of the Latino population, it is critical that their health disparities be monitored, and that factors that contribute to their health and well-being be identified and promoted.

Research on health care disparities is making important descriptive and analytical strides, and the issue of disparities has gained the attention of policymakers in the United States, other nation-states, and international organizations. Still, disparities research scholarship remains US-centric and too rarely takes a cross-national comparative approach to answering its questions. The US-centricity of disparities research has fostered a fixation on race and ethnicity that, although essential to understanding health disparities in the United States, has truncated the range of questions that researchers investigate. In this chapter, we make a case for comparative research that highlights its ability to identify the institutional factors that may affect disparities.

We discuss the central methodological challenges to comparative research. After describing current solutions to such problems, we use data from the World Values Survey to show the impact of key social fault lines on self-assessed health in Europe and the United States.

The negative impact of socioeconomic status (SES) on health is more generalizable across context, than the impact of race/ethnicity or gender.

Our analysis includes a limited number of countries and relies on one measure of health.

The chapter represents a first step in a research agenda to understand health inequalities within and across societies.