Inequality

Black–White Differences in Avoidable Mortality in the USA, 1980–2005

Black–White Differences in Avoidable Mortality in the USA, 1980–2005
Journal of Epidemiology and Community Health, Vol. 63 no. 9, pp. 715-721. 10.1136/jech.2008.081141

Macinko, J., and I.T. Elo
09/01/2009

Background: Avoidable Mortality (AM) describes causes of death that should not occur in the presence of highquality and timely medical treatment and from causes that can be influenced at least in part by public policy/ behaviour. This study analyses black–white disparities in AM.

Methods: Mortality under age 65 was analysed from: (1) conditions amenable to medical care; (2) those sensitive to public policy and/or behaviour change; (3) ischaemic heart disease; (4) HIV/AIDS; and (5) the remaining causes of death. Age-standardised death rates (ASDRs) were constructed for each race and sex group using vital statistics and census data from 1980–2005. Absolute rate differences and the proportionate contribution of each cause of death group to all-cause black–white mortality disparities are calculated based on the ASDRs. Negative binomial regression was used to model relative risks of death.

Results: In 2005, medical care amenable mortality was the largest source of absolute black–white mortality disparity, contributing 30% of the black–white difference in all-cause mortality among men and 42% among women; mortality subject to policy/behaviour interventions contributed 20% of the black–white difference for men and 4% for women. Although absolute black–white differences for most conditions diminished over time, relative disparities as measured by rate ratios showed little change, except for HIV/AIDS for which relative risks increased substantially for black men and women.

Conclusions: There is considerable potential for narrowing of the black–white difference in AM, especially from causes amenable to medical care and (for men) policy/behaviour interventions.

Race, Gender and the Recession: Job Creation and Employment

Race, Gender and the Recession: Job Creation and Employment

C. Nicole Mason, Ph.D
05/01/2009

This report focuses on the effect of the recession and the American Recovery and Reinvestment Act (ARRA) on economically marginalized communities. The Network highlights four key areas of impact for women of color and their families: job creation and employment, housing and social services, education, and tax cuts to individuals.

The Impact of Primary Healthcare on Population Health in Low‐ and Middle‐Income Countries

The Impact of Primary Healthcare on Population Health in Low‐ and Middle‐Income Countries
Journal of Ambulatory Care Management, Vo. 32 no. 2, pp. 150-171. 10.1097/JAC.0b013e3181994221

Macinko, J., B. Starfield, and T. Erinosho
04/01/2009

This article assesses 36 peer-reviewed studies of the impact of primary healthcare (PHC) on health outcomes in low- and middle-income countries. Studies were abstracted and assessed according to where they took place, the research design used, target population, primary care measures, and overall conclusions. Results indicate that the bulk of evidence for PHC effectiveness is focused on infant and child health, but there is also evidence of the positive role PHC has on population health over time. Although the peer-reviewed literature is lacking in rigorous experimental studies, a small number of relatively well-designed observational studies and the consistency of findings generally support the contention that an integrated approach to primary care can improve health. A few large-scale experiences also help identify elements of good practice. The review concludes with several recommendations for future studies, including a focus on better conceptualizing and measuring PHC, further investigation into the advantages of comprehensive over selective PHC, need for experimental or quasi-experimental research designs that allow testing of the independent effect of primary care on outcomes over time, and a more detailed conceptual framework guiding overall evaluation design that places limits on the parameters under consideration and describes relationships among different levels and types of data likely to be collected in the evaluation process.

A critical Review of Race and Ethnicity in the Leadership Literature: Surfacing Context, Power and the Collective Dimensions of Leadership.

A critical Review of Race and Ethnicity in the Leadership Literature: Surfacing Context, Power and the Collective Dimensions of Leadership.
The Leadership Quarterly, 20  

Ospina, S. and E. G. Foldy
01/01/2009


Leadership studies focusing on race–ethnicity provide particularly rich contexts to illuminate the human condition as it pertains to leadership. Yet insights about the leadership experience of people of color from context-rich research within education, communications and black studies remain marginal in the field. Our framework integrates these, categorizing reviewed studies according to the effects of race–ethnicity on perceptions of leadership, the effects of race–ethnicity on leadership enactments, and actors' approach to the social reality of race–ethnicity. The review reveals a gradual convergence of theories of leadership and theories of race–ethnicity as their relational dimensions are increasingly emphasized. A shift in the conceptualization of race–ethnicity in relation to leadership is reported, from a constraint to a personal resource to a simultaneous consideration of its constraining and liberating capacity. Concurrent shifts in the treatment of context, power, agency versus structure and causality are also explored, as are fertile areas for future research.

Seeing Power in Action: The Roles of Deliberation, Implementation, and Action in Inferences of Power

Seeing Power in Action: The Roles of Deliberation, Implementation, and Action in Inferences of Power
Journal of Experimental Social Psychology, 45, 1-14.

Magee, J.C.
01/01/2009

Six experiments investigate the hypothesis that social targets who display a greater action orientation are perceived as having more power (i.e., more control, less dependence, and more influence) than less action-oriented targets. I find evidence that this inference pattern is based on the pervasive belief that individuals with more power experience less constraint and have a greater capacity to act according to their own volition. Observers infer that targets have more power and influence when they exhibit more implementation than deliberation in the process of making decisions in their personal lives (Study 1a), in a public policy context (Study 1b), and in small groups (Study 2). In an organizational context, observers infer that a target who votes for a policy to change from the status quo has more power than a target who votes not to change from the status quo (Study 3). People also infer greater intra-organizational power and higher hierarchical rank in targets who take physical action toward a personal goal than in those who do not (Studies 4–5).

Siting, Spillovers, and Segregation: A Re-examination of the Low Income Housing Tax Credit Program

Siting, Spillovers, and Segregation: A Re-examination of the Low Income Housing Tax Credit Program
In Edward Glaeser and John Quigley, Eds. Housinmg Markets and the Economy: Risk, Regulation, Policy; Essays in Honor of Karl Case. Cambridge, Mass: Lincoln Institute for Land Policy, pp. 233-267.

Ingrid Ellen, Katherine O'Regan, Ioan Voicu
01/01/2009

The timing of this volume could not be more opportune. It is based on a 2007 conference to honor the work of Karl "Chip" Case, who is renowned for his scientific contributions to the economics of housing and public policy. The chapters analyze risk in the housing market, the regulation of housing markets by government, and other issues in U.S. housing policy. Chapters investigate derivative markets; the role that home equity insurance can play in reducing risk; the role that the regulation of government-sponsored enterprises has played in extending credit to home purchasers in low-income neighborhoods; and the growth in the market for subprime mortgages. The impact of local zoning regulations on housing prices and new construction is also considered. This is a must read during a time of restructuring our nation’s system of housing finance.

Changes in Medical Care Experiences of Racial and Ethnic Groups in the United States, 1996-2002

Changes in Medical Care Experiences of Racial and Ethnic Groups in the United States, 1996-2002
International Journal of Health Services, Vol. 38 no. 4, pp. 653-670

Shi, L., and J. Macinko
09/01/2008

The authors examined changes in medical care experiences of racial/ethnic groups (non-Hispanic white, Asian and Pacific Islander, Hispanic, and non- Hispanic black) between 1996 and 2002, using data from the Household Component of Medical Expenditure Panel Surveys. Proportions and adjusted odds ratios for each group's primary care experience are presented. Comparisons are made between groups at each time period and within groups between the two time periods. Multivariable analyses control for demographic and socioeconomic characteristics, health care needs and source of care, and health insurance. Racial/ethnic minorities experienced worse medical care than non-Hispanic whites, but results differed among groups. Non-Hispanic blacks were no different from non-Hispanic whites and showed a slight improvement over time, except for lower odds of having a usual source of care and worse sociodemographic and health indicators. Hispanics had worse experiences than whites in 5 of 8 indicators in 2002 (vs. 3 in 1996). Asians assessed their experience as worse than that of whites in 6 of 8 indicators in 2002 (vs. 3 in 1996), yet had higher self-rated health and education than non-Hispanic whites. Disparities in medical care experience have increased for some groups, and efforts must be made to reduce financial and nonfinancial barriers to care for racial/ethnic minority populations.

Understanding Client and Occupation Barriers in New York City

Understanding Client and Occupation Barriers in New York City

Women of Color Policy Network
09/01/2008

In 2006, the Network was commissioned by United Way of New York to access the viability of New York City's first workforce development program. Using a mix method approach of surveys, individual interviews with program participants and extensive secondary data, the Network helped identify labor and workforce trends as well as barriers and challenges to sustained employment within low-income communities. A three-part series of our findings and recommendations for future programs in workforce development was released. An Assessment of Client Barriers: A Sample of NYC Works Program Participants Industry and Occupational Assessment of NYC Works NYCWorks program staff perceptions of Client Barriers

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