Impact of Race in Healthcare

Explores the social inequality of clinical drug testing and its effects on scientific results Imagine that you volunteer for the clinical trial of an experimental drug. The only direct benefit of participating is that you will receive up to $5,175. You must spend twenty nights literally locked in a research facility. You will be told what to eat, when to eat, and when to sleep. You will share a bedroom with several strangers. Who are you, and why would you choose to take part in this kind of study? This book explores the hidden world of pharmaceutical testing on healthy volunteers. Drawing on two years of fieldwork in clinics across the country and 268 interviews with participants and staff, it illustrates how decisions to take part in such studies are often influenced by poverty and lack of employment opportunities. It shows that healthy participants are typically recruited from African American and Latino/a communities, and that they are often serial participants, who obtain a significant portion of their income from these trials. This book reveals not only how social inequality fundamentally shapes these drug trials, but it also depicts the important validity concerns inherent in this mode of testing new pharmaceuticals. These highly controlled studies bear little resemblance to real-world conditions, and everyone involved is incentivized to game the system, ultimately making new drugs appear safer than they really are. Adverse Events provides an unprecedented view of the intersection of racial inequalities with pharmaceutical testing, signaling the dangers of this research enterprise to both social justice and public health.

Outstanding Academic Title, Choice magazine The health care system in the United States has been called the best in the world. Yet wide health disparities persist between different social groups, and many Americans suffer from poorer health than people in other developed countries. Donald A. Barr's Health Disparities in the United States explores how socioeconomic status, race, and ethnicity interact with socioeconomic inequality to create and perpetuate these health disparities. Examining the significance of this gulf for the medical community, cultural subsets, and society at large, Barr offers potential policy- and physician-based solutions for reducing health inequity in the long term. This popular course book, which has been fully updated, now incorporates significant new material, including a chapter on the profound effects of inequality on child development, behavioral choices, and adult health status. An essential text for courses in public health, health policy, and sociology, the second edition analyzes the complex web of social forces that influence health outcomes in the United States. This book is a vital teaching tool and a comprehensive reference for social science and medical professionals.

Offers an innovative plan to eliminate inequalities in American health care and save the lives they endanger. Over 84,000 black and brown lives are needlessly lost each year due to health disparities: the unfair, unjust, and avoidable differences between the quality and quantity of health care provided to Americans who are members of racial and ethnic minorities and care provided to whites. Health disparities have remained stubbornly entrenched in the American health care system--and in Just Medicine Dayna Bowen Matthew finds that they principally arise from unconscious racial and ethnic biases held by physicians, institutional providers, and their patients. Implicit bias is the single most important determinant of health and health care disparities. Because we have missed this fact, the money we spend on training providers to become culturally competent, expanding wellness education programs and community health centers, and even expanding access to health insurance will have only a modest effect on reducing health disparities. We will continue to utterly fail in the effort to eradicate health disparities unless we enact strong, evidence-based legal remedies that accurately address implicit and unintentional forms of discrimination, to replace the weak, tepid, and largely irrelevant legal remedies currently available. Our continued failure to fashion an effective response that purges the effects of implicit bias from American health care, Matthew argues, is unjust and morally untenable. In this book, she unites medical, neuroscience, psychology, and sociology research on implicit bias and health disparities with her own expertise in civil rights and constitutional law.

In "Precarious Prescriptions," Laurie B. Green, John Mckiernan-Gonzilez, and Martin Summers bring together essays that place race, citizenship, and gender at the center of questions about health and disease. Exploring the interplay between disease as a biological phenomenon, illness as a subjective experience, and race as an ideological construct, this volume weaves together a complicated history to show the role that health and medicine have played throughout the past in defining the ideal citizen. By creating an intricate portrait of the close associations of race, medicine, and public health, "Precarious Prescriptions" helps us better understand the long and fraught history of health care in America.

Race, Ethnicity and Health, Second Edition, is a new andcritical selection of hallmark articles that address healthdisparities in America. It effectively documents the need for equal treatment and equal health status for minorities. Intended as aresource 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 andethnic populations. The book bring 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.

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.