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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.

This chapter takes the form of a literature review.

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.

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

Recent national policy adoptions of the social determinants of health approach present enormous challenges to practitioners designing health promotion programs aimed at eliminating health disparities. This chapter provides a framework for understanding the social determinant rationale embedded in Healthy People 2020 and introduces the concept of place as an important consideration.

This chapter presents a conceptual explanation of social determinant thinking and describes the potential impact for traditional health promotion activities that target the at-risk populations.

Two major resources, the Health Impact Assessment Toolkit and the HHS Disparities Action Plan, have emerged as frameworks for developing a health in all policies approach that will enable health practitioners to enhance their social determinant interventions.

Current social determinant approaches and models need to be strategically tailored to interventions aiming to reduce health disparities. Additional research focusing on how these approaches are integrated within the existing health promotion program frameworks is required.

Very few health practitioners have had the opportunity to integrate a social determinant approach that emphasizes the concept of place and explores the consequences of using a health in all policies approach. This chapter serves as a practical introduction and outlines the major challenges.

The tipping point for the inclusion of social determinants of health in addressing health disparities occurred with the publication of Healthy People 2020. As this innovation begins to diffuse throughout the country, health practitioners will benefit by reviews and applications of the new rationale and model.

This chapter provides both an introduction to the volume and a brief review of literature on technology, communications, and health disparities.

Literature review.

The chapter argues for the importance of greater examination of technology, communications, and their linkages to health disparities and other related factors.

Reviews the topic of technology, communication, and health disparities and previews this book.

This chapter provides an introduction to Volume 28, The Impact of Demographics on Health and Health Care: Race, Ethnicity and Other Social Factors. This chapter introduces the topic of demographic factors leading to differences and disparities in health and health care by reviewing more recent literature within sociology addressing social factors leading to differences in health and health. This chapter also serves as an introduction to the volume. As such, the chapter explains the organization of the volume and briefly comments on each of the chapters included in the volume.

The “Social Determinants of Health” construct is well-entrenched in the way that both health care providers and researchers think about the effects of social conditions on health. Although there are a number of theories that fall under this rubric for the social production of health and illness, the core of this construct is the idea that social stratification leads to health disparity. In this chapter we show how such a mechanism might work for relating social stratification and job stress.

We used the pooled 2002, 2006, 2010 Quality of Work Life modules of the General Social Survey to test a model of the relationships between gender, age, education, and nativity with “bad jobs” and indicators of health status.

Findings show that social status is positively associated with job quality and with health in turn. Lower social status characteristics are related to bad jobs and poorer health.

Health disparities are thus “explained” by the consequences of social status for occupation and job quality, thereby depicting exactly how health disparities arise in normal social life. The theory and results underscore the importance of explicitly modeling social status factors in explanations of health disparities.

It is common to relate health disparities to social status but it is not common to show the mechanisms whereby social status actually produces health disparities. Addressing health disparities means addressing the consequences of social inequalities for normal activities of social life such as work. Improving job quality would be a health “treatment” that addresses health disparities.

This chapter demonstrates the value of explicitly tracing the consequences of status differences on differences in social context such as work conditions and then health. In the study of health disparities this is not often done. In this chapter we show how social inequality leads to occupational and job quality differences that, in turn, lead to health differences.

This review integrates and builds linkages among existing theoretical and empirical literature from across disciplines to further broaden our understanding of the relationship between inequality, imprisonment, and health for black men. The review examines the health impact of prisons through an ecological theoretical perspective to understand how factors at multiple levels of the social ecology interact with prisons to potentially contribute to deleterious health effects and the exacerbation of race/ethnic health disparities.

This review finds that there are documented health disparities between inmates and non-inmates, but the casual mechanisms explaining this relationship are not well-understood. Prisons may interact with other societal systems – such as the family (microsystem), education, and healthcare systems (meso/exosystems), and systems of racial oppression (macrosystem) – to influence individual and population health.

The review also finds that research needs to move the discussion of the race effects in health and crime/justice disparities beyond the mere documentation of such differences toward a better understanding of their causes and effects at the level of individuals, communities, and other social ecologies.

The COVID-19 pandemic has impacted every community across the globe, but the global COVID-19 data show that the United States remains the most affected country where well over 666,000 people died, and approximately 40 million citizens became ill due to the virus' spread by mid-2021 (CDC, 2021). It is also noteworthy that extreme racial disparities in rates of COVID-19 cases and deaths are high in the United States, specifically among African American population. This situation is particularly evident among African American population in Alabama's Black Belt. Subsequently, COVID-19, racial disparities, and health inequalities have become central to the national and regional conversation. This chapter examines the associations between COVID-19, social determinants of health, and the systematic health disparity in African American population in Alabama's Black Belt region using Geographic Information Systems and the concept of uneven spatial development. Understanding the relationship between COVID-19 and these disparities within a spatial context vital to developing pathways to overcome the pandemic's effects and combat the systemic discrimination in this region. The derived policy recommendation could apply to other regions experiencing social inequality and health disparity.

The second national goal for Healthy People 2010 is the elimination of health disparities related to social disadvantage in the United States. Unfortunately, progress to date has been limited. Our national strategy to achieve this goal has been too narrowly focused on public health. Success will require a broader strategy including alignment of existing national policies in non-health areas that affect the health of the socially disadvantaged such as education, health care, labor, welfare, housing, criminal justice, the environment, and taxation if it is to succeed. Key criteria are needed to begin to prioritize areas for federal investment to achieve this goal. These include the impact of the targeted condition on disparities, evidence base for the intervention, potential impact of the policy on disparities, economic impact, and federal politics. Two “big ideas” offer promise including federal investment in early child education and enhanced primary care within federally qualified community health centers. The proposed criteria are applied to each proposed policy.

While Americans have often believed that the United States has the best health care system in the world and that, as one of the wealthiest nations, we therefore must have the best health care available to our citizens, researchers in medical sociology, public health and health services research have emphasized for decades that America tolerates extremes of wealth and poverty much greater than in many European countries. This toleration of extremes extends to the approach to the delivery of social and health services, as well as to consumer goods. Over 40 million Americans do not have health insurance and thus have limited access to expensive health care services (Morone & Jacobs, 2005b). Even more may have very poor health coverage, so that if a serious illness were to occur, the person would have a very hard time finding care and paying for that care. Even if people have coverage for major health care problems, many people do not have insurance that covers areas of health care such as vision care, dental care and audiology services. While these are not life threatening health care concerns, they are health care concerns that impact quality of life and even ability to achieve. A child who cannot see well has trouble succeeding in school. A person in pain from tooth problems has trouble concentrating on tasks, and poor oral health is one contributor to nutrition concerns among the elderly. Lack of access to hearing aids increases the social isolation of the elderly, but these services are not covered by Medicare, the federal program that does provide access to health care services for most of the elderly in the United States.

This chapter provides an introduction to the volume and reviews some issues related to provision of health care services to racial and ethnic minorities and other underserved population. In addition to this review of some of the material on underserved populations and what has often been called in the US “health care disparities” concerns, this chapter also serves as an introduction to the volume. As such, the chapter explains the organization of the volume and briefly comments on each of the chapters included in the volume.