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Book part
Publication date: 4 September 2013

Jennie Jacobs Kronenfeld

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

Abstract

Purpose

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

Methodology/approach

Literature Review.

Findings

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.

Originality/value of paper

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

Details

Social Determinants, Health Disparities and Linkages to Health and Health Care
Type: Book
ISBN: 978-1-78190-588-3

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Book part
Publication date: 14 August 2014

Sigrun Olafsdottir, Jason Beckfield and Elyas Bakhtiari

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…

Abstract

Purpose

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.

Methodology/approach

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.

Findings

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

Research limitations/implications

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

Originality/value of chapter

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

Details

Social Determinants, Health Disparities and Linkages to Health and Health Care
Type: Book
ISBN: 978-1-78190-588-3

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Article
Publication date: 14 August 2007

Wally R. Smith

This paper aims to compare and contrast quality improvement in the domain of health care disparities with quality improvement in other domains.

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Abstract

Purpose

This paper aims to compare and contrast quality improvement in the domain of health care disparities with quality improvement in other domains.

Design/methodology/approach

The author provides a descriptive essay and review to put forward the findings of their research.

Findings

In the USA, health care quality improvement systems have largely been accepted and institutionalized. Most if not all hospital and health care systems now have quality monitoring and improvement teams. In contrast, despite a plethora of stark reports in the literature showing that the US health care system has failed to deliver health care with equity when the care of Whites is compared with that of racial and ethnic minorities, there is not a parallel health care disparities improvement system in most health care settings.

Practical implications

Paralleling many steps that have been taken to improve quality in general, health care workers and health systems must take steps to improve structures and processes of care to reduce health care disparities.

Originality/value

Pinpoints some important distinctions between improving structures and processes of care related to health care disparities, and those related to other aspects of quality improvement. Doing so will save lives, and in the process improve overall quality.

Details

Clinical Governance: An International Journal, vol. 12 no. 3
Type: Research Article
ISSN: 1477-7274

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Book part
Publication date: 23 October 2003

Lynn Weber and Deborah Parra-Medina

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…

Abstract

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?

Details

Gender Perspectives on Health and Medicine
Type: Book
ISBN: 978-1-84950-239-9

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Book part
Publication date: 24 September 2010

Noah J. Webster

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…

Abstract

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.

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The Impact of Demographics on Health and Health Care: Race, Ethnicity and Other Social Factors
Type: Book
ISBN: 978-1-84950-715-8

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Book part
Publication date: 29 July 2009

Jennie Jacobs Kronenfeld

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…

Abstract

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.

Details

Social Sources of Disparities in Health and Health Care and Linkages to Policy, Population Concerns and Providers of Care
Type: Book
ISBN: 978-1-84855-835-9

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Book part
Publication date: 16 July 2015

Catherine Bliss

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

Abstract

Purpose

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

Methodology/approach

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.

Findings

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.

Originality/value

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.

Details

Genetics, Health and Society
Type: Book
ISBN: 978-1-78350-581-4

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Book part
Publication date: 4 September 2013

Harry Perlstadt

This chapter explores public perceptions of health disparities by taking political ideology and political party identification into account and applies theories of…

Abstract

Purpose

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.

Methodology/approach

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.

Findings

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.

Research limitations/implications

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.

Originality/value of chapter

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.

Details

Social Determinants, Health Disparities and Linkages to Health and Health Care
Type: Book
ISBN: 978-1-78190-588-3

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Book part
Publication date: 28 September 2020

Matt T. Bagwell and Thomas T. H. Wan

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…

Abstract

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.

Details

Race, Ethnicity, Gender and Other Social Characteristics as Factors in Health and Health Care Disparities
Type: Book
ISBN: 978-1-83982-798-3

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Book part
Publication date: 8 August 2016

Jennie Jacobs Kronenfeld

This chapter provides both an introduction to the volume and a brief review of literature on special social groups and social factors as linked to disparities in health

Abstract

Purpose

This chapter provides both an introduction to the volume and a brief review of literature on special social groups and social factors as linked to disparities in health and health care services.

Methodology/approach

This chapter takes the form of a literature review.

Findings

The chapter argues for the importance of greater examination of special social groups and other social factors in understanding disparities in health and health care services.

Originality/value

Reviews the issues of special social groups and other social factors and previews this volume.

Details

Special Social Groups, Social Factors and Disparities in Health and Health Care
Type: Book
ISBN: 978-1-78635-467-9

Keywords

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