Download or read book Perceived Racism and Trust in Health Care written by Sara N. Sayre and published by . This book was released on 2013 with total page 149 pages. Available in PDF, EPUB and Kindle. Book excerpt: Disparities in healthcare are a significant social problem affecting millions of racial and ethnic minorities in the United States. The sources of health disparities are many and range from institutional barriers, provider influences, and even patient factors (Smedley, et al., 2003). In comparison to research on provider contributions to health disparities, there is far less research on patient factors (Bird & Bogart, 2001; Smedley et al., 2003). The purpose of this study was to further examine patient-level factors which may be related to disparities in health care. Specifically, this study focused on how medical mistrust, perceived racial discrimination, and perceived health care specific discrimination were related to African Americans' intentions to seek medical help. A primary purpose of this study was to better understand how medical mistrust relates to intentions to seek help. African Americans' health care behavior was examined within the theoretical framework of the Behavioral Model for Vulnerable Populations (BVMP), in which, medical mistrust functions as a predisposing factor in the process of health services use (Gelberg, Andersen, & Leake, 2000). In addition to using the structure of the BMVP to examine the variables of interest, multiple additional explanatory models were utilized to gain a better understanding how these variables of interest relate to one another, and to determine if medical mistrust may function as a mediator between experiences of discrimination and intentions to seek medical help. The sample included 322 participants who identified as Black/African American. Participants completed an anonymous survey which included demographic questions and 46-items assessing the constructs of perceived racial discrimination, perceived health specific racial discrimination, mistrust of the medical system, and intentions to seek medical help. Consistent with hypotheses, perceived racial discrimination, perceived health care specific racial discrimination, and medical mistrust were significantly negatively related to intentions to seek medical care. Hierarchical regression and path analysis were used to test four explanatory models of relationships among the primary variables of interest. Results indicated support for the Partially Mediated Model where medical mistrust functions as a mediator between discrimination, both within and outside the health care system, and intentions to seek medical help.
Download or read book Unequal Treatment written by Institute of Medicine and published by National Academies Press. This book was released on 2009-02-06 with total page 781 pages. Available in PDF, EPUB and Kindle. Book excerpt: Racial and ethnic disparities in health care are known to reflect access to care and other issues that arise from differing socioeconomic conditions. There is, however, increasing evidence that even after such differences are accounted for, race and ethnicity remain significant predictors of the quality of health care received. In Unequal Treatment, a panel of experts documents this evidence and explores how persons of color experience the health care environment. The book examines how disparities in treatment may arise in health care systems and looks at aspects of the clinical encounter that may contribute to such disparities. Patients' and providers' attitudes, expectations, and behavior are analyzed. How to intervene? Unequal Treatment offers recommendations for improvements in medical care financing, allocation of care, availability of language translation, community-based care, and other arenas. The committee highlights the potential of cross-cultural education to improve provider-patient communication and offers a detailed look at how to integrate cross-cultural learning within the health professions. The book concludes with recommendations for data collection and research initiatives. Unequal Treatment will be vitally important to health care policymakers, administrators, providers, educators, and students as well as advocates for people of color.
Download or read book Communities in Action written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2017-04-27 with total page 583 pages. Available in PDF, EPUB and Kindle. Book excerpt: In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.
Download or read book Understanding the Predictors of Patient Trust and Its Role in Utilization and Outcomes written by Sheikilya Lewis Thomas and published by . This book was released on 2013 with total page 117 pages. Available in PDF, EPUB and Kindle. Book excerpt: The purpose of this dissertation is to examine patient-related factors that predict trust in one's physician, and subsequently identify the role of patient trust in health care utilization and clinical outcomes among low-income African American men and women diagnosed with hypertension. Three separate studies are conducted using an adapted version of the Interaction Model for Client Health Behavior (IMCHB). The first paper is a three-step systematic review of quantitative studies that investigate the (a) distinctive patient characteristics that influence trust; (b) impact of trust on medication adherence, compliance with doctor's orders, and utilization frequency; and (c) impact of trust on outcomes like patient satisfaction, self-efficacy, and clinical outcomes. Based on the predictors identified in the first study, the second study examines the significance of these predictors among African Americans, a group that tends to report lower trust. The final study uses the same sample from the second study and examines the association of perceived racism and low trust on low utilization, blood pressure control, and glycemic control. In the first study, the review showed that the main patient-related predictors are race, perceived racism, and experiences of discrimination. Education and religiosity also emerge as non-race related predictors. Previous research also exposes a recurring association between trust and adherence, preventive screening, delayed check-ups and unmet health needs. Patient satisfaction and clinical improvement (i.e., glycemic control) are the two major trust-related outcomes from the literature review. In the second study, the results indicate that perceived racism and an active response to discrimination are significantly associated with trust but in opposing directions. The third and final study reveals that perceived racism and low trust are associated with low utilization, but trust does not mediate the relationship between perceived racism and utilization. Low trust is associated with low utilization and poor glycemic control, but neither perceived racism or trust have a significant relationship with blood pressure control. The findings from this dissertation can contribute to the current literature on patient trust by describing its significance in a chronic condition that often requires frequent health care interactions for optimal health management. Patients with low trust may anticipate a negative encounter with their physician and avoid health care visits. Although this potential avoidance is not associated with their blood pressure levels, it was associated with poor glycemic control. Health care avoidance among individuals with chronic diseases leads to poor disease management and increased risk for negative outcomes.
Download or read book Health Disparities Among Under served Populations written by Sheri R. Notaro and published by Emerald Group Publishing. This book was released on 2012-08-13 with total page 300 pages. Available in PDF, EPUB and Kindle. Book excerpt: An anthology that critically examines the devastating impact of race, class, and gender on the health and health care of African Americans, Latinos and American Indians, with particular focus on children and adolescents. It includes chapters that focus on issues such as: substance abuse, psychological coping, trauma, infant mortality, and racism.
Download or read book Mistrust written by and published by . This book was released on 2015 with total page 141 pages. Available in PDF, EPUB and Kindle. Book excerpt: This dissertation explored mistrust through focus group discussions (study 1), responses to standardized laboratory vignettes (study 2), and survey questionnaires (study 3). In the first study, I found that African American community members (N=60) experienced perceived discrimination, medical mistrust, and poor communication in numerous and interrelated ways. For example, medical mistrust occurred when clinicians did not convey respect to patients, leaving patients to wonder whether their clinician's treatment was discriminatory or not. Based on these findings, I wanted to see whether these experiences of perceived discrimination and mistrust were related to other dimensions of Black experience, such as racial identity. I conducted a secondary analysis of data from a laboratory study (Somnath Saha, PI) in which 104 primary care patients viewed video-recorded, standardized vignettes depicting a cardiologist recommending heart bypass surgery to a patient diagnosed with angina and 3-vessel coronary artery disease. In this study, those who viewed a video of European American cardiologist-actors had lower physician mistrust and lower hypothetical likelihood of having bypass surgery compared to those who viewed the video of African American cardiologist-actors. However, racial centrality did not moderate the relationship between ethnicity of the cardiologist-actor and patients' decision making. The third study explored other dimensions of racial identity (e.g., unfavorable public regard for African Americans) and mistrust (e.g., medical mistrust), while also exploring their association with perceived healthcare discrimination among African American community members (N=210). In this study, perceived discrimination was positively associated with racial centrality, but not associated with unfavorable public regard. Perceived discrimination was also positively associated with medical mistrust and physician mistrust. Although racial centrality and unfavorable public regard were not significant moderators between perceived discrimination and the two dimensions of mistrust, they were positively associated with medical mistrust. Together, these studies provide a better understanding of African Americans' healthcare attitudes and experiences, particularly mistrust toward medical institutions and clinicians. For example, the association between racial centrality and perceived discrimination may suggest that past experience of discrimination in healthcare may influence a person to seek others who experience similar stressors, giving way to identifying more with her or his racial group. Racial centrality may influence a person's trust towards healthcare, prior to entering the doctor's office. However, once the person enters the doctor's office, racial centrality may play a less significant role the patient's trust towards her or his provider. These findings generated new questions to explore for future studies. For example, future studies should explore the relationship between racial centrality and African Americans' healthcare behavioral responses. In addition, the current studies only focused only on attitudes and perspectives; future studies should investigate how the construct medical mistrust may influence health-related outcomes such as adherence in race-discordant patient-provider relationships.
Download or read book The Oxford Handbook of Stigma Discrimination and Health written by Brenda Major and published by Oxford University Press. This book was released on 2018 with total page 577 pages. Available in PDF, EPUB and Kindle. Book excerpt: Stigma leads to poorer health. In The Oxford Handbook of Stigma, Discrimination, and Health, leading scholars identify stigma mechanisms that operate at multiple levels to erode the health of stigmatized individuals and, collectively, produce health disparities. This book provides unique insights concerning the link between stigma and health across various types of stigma and groups.
Download or read book White Fragility written by Dr. Robin DiAngelo and published by Beacon Press. This book was released on 2018-06-26 with total page 194 pages. Available in PDF, EPUB and Kindle. Book excerpt: The New York Times best-selling book exploring the counterproductive reactions white people have when their assumptions about race are challenged, and how these reactions maintain racial inequality. In this “vital, necessary, and beautiful book” (Michael Eric Dyson), antiracist educator Robin DiAngelo deftly illuminates the phenomenon of white fragility and “allows us to understand racism as a practice not restricted to ‘bad people’ (Claudia Rankine). Referring to the defensive moves that white people make when challenged racially, white fragility is characterized by emotions such as anger, fear, and guilt, and by behaviors including argumentation and silence. These behaviors, in turn, function to reinstate white racial equilibrium and prevent any meaningful cross-racial dialogue. In this in-depth exploration, DiAngelo examines how white fragility develops, how it protects racial inequality, and what we can do to engage more constructively.
Download or read book Why I m No Longer Talking to White People About Race written by Reni Eddo-Lodge and published by Bloomsbury Publishing. This book was released on 2020-11-12 with total page 272 pages. Available in PDF, EPUB and Kindle. Book excerpt: 'Every voice raised against racism chips away at its power. We can't afford to stay silent. This book is an attempt to speak' The book that sparked a national conversation. Exploring everything from eradicated black history to the inextricable link between class and race, Why I'm No Longer Talking to White People About Race is the essential handbook for anyone who wants to understand race relations in Britain today. THE NO.1 SUNDAY TIMES BESTSELLER WINNER OF THE BRITISH BOOK AWARDS NON-FICTION NARRATIVE BOOK OF THE YEAR 2018 FOYLES NON-FICTION BOOK OF THE YEAR BLACKWELL'S NON-FICTION BOOK OF THE YEAR WINNER OF THE JHALAK PRIZE LONGLISTED FOR THE BAILLIE GIFFORD PRIZE FOR NON-FICTION LONGLISTED FOR THE ORWELL PRIZE SHORTLISTED FOR A BOOKS ARE MY BAG READERS AWARD
Download or read book Perceptions of Racism and Classism in Health Care written by Roberta Anne Downing and published by . This book was released on 2004 with total page 314 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Race Ethnicity and Health written by Thomas A. LaVeist and published by John Wiley & Sons. This book was released on 2012-10-16 with total page 848 pages. Available in PDF, EPUB and Kindle. Book excerpt: Race, Ethnicity and Health, Second Edition, is a critical selection of hallmark articles that address health disparities in America. It effectively documents the need for equal treatment and equal health status for minorities. Intended as a resource for faculty and students in public health as well as the social sciences, it will be also be valuable to public health administrators and frontline staff who serve diverse racial and ethnic populations. The book brings together the best peer reviewed research literature from the leading scholars and faculty in this growing field, providing a historical and political context for the study of health, race, and ethnicity, with key findings on disparities in access, use, and quality. This volume also examines the role of health care providers in health disparities and discusses the issue of matching patients and doctors by race. New chapters cover: reflections on demographic changes in the US based on the current census; metrics and nomenclature for disparities; theories of genetic basis for disparities; the built environment; residential segregation; environmental health; occupational health; health disparities in integrated communities; Latino health; Asian populations; stress and health; physician/patient relationships; hospital treatment of minorities; the slavery hypertension hypothesis; geographic disparities; and intervention design.
Download or read book Embodying Inequality written by Nancy Krieger and published by Routledge. This book was released on 2016-12-05 with total page 512 pages. Available in PDF, EPUB and Kindle. Book excerpt: To advance the epidemiological analysis of social inequalities in health, and of the ways in which population distributions of disease, disability, and death reflect embodied expressions of social inequality, this volume draws on articles published in the "International Journal of Health Services" between 1990 and 2000. Framed by ecosocial theory, it employs ecosocial constructs of "embodiment"; "pathways of embodiment"; "cumulative interplay of exposure, susceptibility, and resistance across the lifecourse"; and "accountability and agency" to address the question; and who and what drives current and changing patterns of social inequalities in health.
Download or read book An American Health Dilemma written by W. Michael Byrd and published by Taylor & Francis. This book was released on 2012-10-02 with total page 617 pages. Available in PDF, EPUB and Kindle. Book excerpt: At times mirroring and at times shockingly disparate to the rise of traditional white American medicine, the history of African-American health care is a story of traditional healers; root doctors; granny midwives; underappreciated and overworked African-American physicians; scrupulous and unscrupulous white doctors and scientists; governmental support and neglect; epidemics; and poverty. Virtually every part of this story revolves around race. More than 50 years after the publication of An American Dilemma, Gunnar Myrdal's 1944 classic about race relations in the USA, An American Health Dilemma presents a comprehensive and groundbreaking history and social analysis of race, race relations and the African-American medical and public health experience. Beginning with the origins of western medicine and science in Egypt, Greece and Rome the authors explore the relationship between race, medicine, and health care from the precursors of American science and medicine through the days of the slave trade with the harrowing middle passage and equally deadly breaking-in period through the Civil War and the gains of reconstruction and the reversals caused by Jim Crow laws. It offers an extensive examination of the history of intellectual and scientific racism that evolved to give sanction to the mistreatment, medical abuse, and neglect of African Americans and other non-white people. Also included are biographical portraits of black medical pioneers like James McCune Smith, the first African American to earn a degree from a European university, and anecdotal vignettes,like the tragic story of "the Hottentot Venus", which illustrate larger themes. An American Health Dilemma promises to become an irreplaceable and essential look at African-American and medical history and will provide an invaluable baseline for future exploration of race and racism in the American health system.
Download or read book The Impacts of Racism and Bias on Black People Pursuing Careers in Science Engineering and Medicine written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2020-12-18 with total page 107 pages. Available in PDF, EPUB and Kindle. Book excerpt: Despite the changing demographics of the nation and a growing appreciation for diversity and inclusion as drivers of excellence in science, engineering, and medicine, Black Americans are severely underrepresented in these fields. Racism and bias are significant reasons for this disparity, with detrimental implications on individuals, health care organizations, and the nation as a whole. The Roundtable on Black Men and Black Women in Science, Engineering, and Medicine was launched at the National Academies of Sciences, Engineering, and Medicine in 2019 to identify key levers, drivers, and disruptors in government, industry, health care, and higher education where actions can have the most impact on increasing the participation of Black men and Black women in science, medicine, and engineering. On April 16, 2020, the Roundtable convened a workshop to explore the context for their work; to surface key issues and questions that the Roundtable should address in its initial phase; and to reach key stakeholders and constituents. This proceedings provides a record of the workshop.
Download or read book Extreme Measures written by Dr. Jessica Nutik Zitter, M.D. and published by Penguin. This book was released on 2021-08-24 with total page 353 pages. Available in PDF, EPUB and Kindle. Book excerpt: For readers of Being Mortal and Modern Death, an ICU and Palliative Care specialist offers a framework for a better way to exit life that will change our medical culture at the deepest level In medical school, no one teaches you how to let a patient die. Jessica Zitter became a doctor because she wanted to be a hero. She elected to specialize in critical care—to become an ICU physician—and imagined herself swooping in to rescue patients from the brink of death. But then during her first code she found herself cracking the ribs of a patient so old and frail it was unimaginable he would ever come back to life. She began to question her choice. Extreme Measures charts Zitter’s journey from wanting to be one kind of hero to becoming another—a doctor who prioritizes the patient’s values and preferences in an environment where the default choice is the extreme use of technology. In our current medical culture, the old and the ill are put on what she terms the End-of-Life Conveyor belt. They are intubated, catheterized, and even shelved away in care facilities to suffer their final days alone, confused, and often in pain. In her work Zitter has learned what patients fear more than death itself: the prospect of dying badly. She builds bridges between patients and caregivers, formulates plans to allay patients’ pain and anxiety, and enlists the support of loved ones so that life can end well, even beautifully. Filled with rich patient stories that make a compelling medical narrative, Extreme Measures enlarges the national conversation as it thoughtfully and compassionately examines an experience that defines being human.
Download or read book Race Ethnicity and Language Data written by Institute of Medicine and published by National Academies Press. This book was released on 2009-12-30 with total page 286 pages. Available in PDF, EPUB and Kindle. Book excerpt: The goal of eliminating disparities in health care in the United States remains elusive. Even as quality improves on specific measures, disparities often persist. Addressing these disparities must begin with the fundamental step of bringing the nature of the disparities and the groups at risk for those disparities to light by collecting health care quality information stratified by race, ethnicity and language data. Then attention can be focused on where interventions might be best applied, and on planning and evaluating those efforts to inform the development of policy and the application of resources. A lack of standardization of categories for race, ethnicity, and language data has been suggested as one obstacle to achieving more widespread collection and utilization of these data. Race, Ethnicity, and Language Data identifies current models for collecting and coding race, ethnicity, and language data; reviews challenges involved in obtaining these data, and makes recommendations for a nationally standardized approach for use in health care quality improvement.
Download or read book Racial Attitudes in the 1990s written by Jack Martin and published by Bloomsbury Publishing USA. This book was released on 1997-10-28 with total page 279 pages. Available in PDF, EPUB and Kindle. Book excerpt: More than half a century has passed since the publication of An American Dilemma: The Negro Problem and Modern Democracy, Gunnar Myrdal's agonizing portrait of the pervasiveness of racially prejudiced attitudes and discriminatory practices in American life. Central to Myrdal's work was the paradox posed by the coexistence of race-based social, economic, and political inequality on the one hand, and the cherished American cultural values of freedom and equality on the other. In the five decades since the publication of this work, there has been a dramatic decline in white Americans' overt expressions of anti-black and anti-integrationist sentiments and in many of the inequalities Myrdal highlighted in his monumental work. Yet the persistence of racial antipathy is evidence of the continuing dilemma of race in American society. This collection of original essays by leading race relations experts focuses on the recent history and current state of racial attitudes in the United States. It addresses key issues and debates in the literature, and it includes chapters on the racial attitudes of African-Americans as well as whites. The volume will be of great importance to students and scholars concerned with the sociology and politics of contemporary American race relations.
