Social Sources Of Racial Disparities In Health

Abstract

Racial disparities in mortality over time reflect divergent pathways to the current large racial disparities in health. The residential concentration of African Americans is high and distinctive, and the related inequities in neighborhood environments, socioeconomic circumstances, and medical care are important factors in initiating and maintaining racial disparities in health. Efforts are needed to identify and maximize health-enhancing resources that may reduce some of the negative effects of psychosocial factors on health. Health and health disparities are embedded in larger historical, geographic, sociocultural, economic, and political contexts. Changes in a broad range of public policies are likely to be central to effectively addressing racial disparities. R ac i a l di s pa r i t i e s i n h e a lt h in the United States are substantial. The overall death rate for blacks today is comparable to the rate for whites thirty years ago, with about 100,000 blacks dying each year who would not die if the death rates were equivalent. 1 This paper outlines factors in the social environment that can initiate and sustain racial disparities in health. Race is a marker for differential exposure to multiple disease-producing social factors. Thus, racial disparities in health should be understood not only in terms of individual characteristics but also in light of patterned racial inequalities in exposure to societal risks and resources.We illustrate some of these social processes by examining racial differences in mortality from 1950 to 2000 for five causes of death that reveal divergent pathways to current health disparities. Three of these causes of death-homicide, heart disease, and cancer-show wide disparities between black and white populations; two of these causes-pneumonia and flu, and suicide-show virtually no disparities. Data are available for blacks and whites for the 1950-2002 time period only. We present both absolute (black-white differences) and relative (black-white ratios) indicators of disparity.

Family health information sharing among older adults: reaching more family members

“…Most studies of FHH communication were conducted with clinic-based populations (Bowen et al 2003). Therefore, we have limited knowledge about the facilitators of FHH communication among general community-based older adults, especially those of minority population who are disproportionately affected by common complex diseases (Williams and Jackson 2005). Heart disease and cancer were the first and second leading causes of deaths in the USA in 2011 (CDC 2012).…”

Neighborhood Disadvantage and Changes in Condom Use among African American Adolescents

“…Researchers have reported findings to support this theory as an explanation for a variety of outcomes. Neighborhood factors have been found to affect several health outcomes via segregation and racial discrimination, 19 poor quality housing, 20 disproportionate exposure to environmental toxins, 21 lack of accessible food markets, 22 healthcompromising behaviors, 23,24 poor quality jobs and decreased income earnings, 25 limited access to social service assistance, 26 strained social networks and increased stress, 27 and lack of access to medical care. 28,29 Among the studies examining neighborhood characteristics and youth sexual behaviors, neighborhood disadvantage (i.e., concentrated economic disadvantage) has been posited to limit the availability of social capital and HIV/STI prevention within these communities.…”

Assessing the Nutritional Health Outcomes of African American Women with HIV and Substance Abuse Disorders Using a Socioecological Approach

“…In addition to limited healthy food options, individuals living in impoverished neighborhoods may experience other environmental obstacles to maintaining optimum health, including inadequacies in access and utilization of information sources emphasizing nutritional risk awareness and knowledge (Williams & Jackson, 2005). Public entitlements such as soup kitchens, shelters, food pantries, and community centers frequently report providing some form of nutrition intervention in addition to free food services (Richards & Smith, 2006).…”