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Racial and ethnic minorities utilize less healthcare than their similarly situated white counterparts in the United States, resulting in speculation that these actions may stem in part from less desire for care. In order to adequately understand the role of care-seeking for racial and ethnic disparities in healthcare, we must fully and systematically consider the complex set of social factors that influence healthcare seeking and use.

Data for this study come from a 2005 national survey of community-dwelling Medicare beneficiaries (N = 2,138). We examine racial and ethnic variation in intentions to seek care, grounding our analyses in the behavioral model of healthcare utilization. Our analysis consists of a series of nested multivariate logistic regression models that follow the sequencing of the behavioral model while including additional social factors.

We find that Latino, Black, and Native American older adults express greater preferences for seeking healthcare compared to whites. Worrying about one’s health, having skepticism toward doctors in general, and living in a small city rather than a Metropolitan Area, but not health need, socioeconomic status, or healthcare system characteristics, explain some of the racial and ethnic variation in care-seeking preferences. Overall, we show that even after comprehensively accounting for factors known to influence disparities in utilization, elderly racial and ethnic minorities express greater desire to seek care than whites.

We suggest that future research examine social factors such as unmeasured wealth differences, cultural frameworks, and role identities in healthcare interactions in order to understand differences in care-seeking and, importantly, the relationship between care-seeking and disparities in utilization.

This study represents a systematic analysis of the ways individual, social, and structural context may account for racial and ethnic differences in seeking medical care. We build on healthcare seeking literature by including more comprehensive measures of social relationships, healthcare and system-level characteristics, and exploring a wide variety of health beliefs and expectations. Further, our study investigates care seeking among multiple understudied racial and ethnic groups. We find that racial and ethnic minorities are more likely to say they would seek healthcare than whites, suggesting that guidelines promoting the elicitation and understanding of patient preferences in the context of the clinical interaction is an important step toward reducing utilization disparities. These findings also underscore the notion that health policy should go further to address the broader social factors relating to care-seeking in the first place.

We present a critical literature review debating Brazilian research on social and environmental accounting (SEA). The aim of this study is to understand the role of politics in the construction of hegemonies in SEA research in Brazil. In particular, we examine the role of hegemony in relation to the co-option of SEA literature and sustainability in the Brazilian context by the logic of development for economic growth in emerging economies. The methodological approach adopts a post-structural perspective that reflects Laclau and Mouffe’s discourse theory. The study employs a hermeneutical, rhetorical approach to understand and classify 352 Brazilian research articles on SEA. We employ Brown and Fraser’s (2006) categorizations of SEA literature to help in our analysis: the business case, the stakeholder–accountability approach, and the critical case. We argue that the business case is prominent in Brazilian studies. Second-stage analysis suggests that the major themes under discussion include measurement, consulting, and descriptive approach. We argue that these themes illustrate the degree of influence of the hegemonic politics relevant to emerging economics, as these themes predominantly concern economic growth and a capitalist context. This paper discusses trends and practices in the Brazilian literature on SEA and argues that the focus means that SEA avoids critical debates of the role of capitalist logics in an emerging economy concerning sustainability. We urge the Brazilian academy to understand the implications of its reifying agenda and engage, counter-hegemonically, in a social and political agenda beyond the hegemonic support of a particular set of capitalist interests.

A devastating racial logic remains at play in the moment of a “post-civil rights” Black presidency. Barack Obama's ascent has amplified a national mythology of racial progress in the US multiculturalist age. This mythology has fundamentally undermined both the credibility and critical traction of existing scholarly-activist languages of racism, antiracism, white supremacy, and institutionalized racial dominance. Thus, the discourse of national-racial vindication that animates Obama's ascendance can and must be radically opposed with creative historical narrations. These narrations must attempt to explain how and why systems of racial dominance and state-condoned, state-sanctioned racist violence remain central to the shaping of our present tense. The chapter approaches this problematic by examining how the historical social logics of racial chattel slavery cannot be historically compartmentalized and temporally isolated into a discrete “past,” because they are genocidal in their structuring and are thus central to the constitution of our existing social and cultural systems. The apparatus of the North American racial chattel institution must be theorized in its present tense articulations because its logics of power, domination, and violence have never really left us. The essay offers a schematic elaboration of this reconceptualization of racial genocide focusing on how the slavery's abolition in the latter-19th century provides the political, cultural, and legal basis for slavery's “reform” into the apparatuses of policing, criminalization, widespread and state-sanctioned antiblack bodily violence, and ultimately massive imprisonment. This examination allows for an elaboration of how slavery's genocidal social logics permeate the present tense social formation, particularly at the site of massive racial criminalization and imprisonment.