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This Week in PubHub: Health, Place, and Race/Ethnicity

May 16, 2011

(Kyoko Uchida manages PubHub, the Foundation Center's online catalog of foundation-sponsored publications. In her previous post, she highlighted nine reports that address various aspects of the global war on terror, including strategies and tactics in that conflict, their effectiveness, and their long-term implications and consequences for detainees and the U.S.)

The issue of racial/ethnic disparities in health outcomes isn't new. Less discussed is how structural racism, environmental conditions, and indequate health inputs reinforce one another, perpetuating those disparities. This week in PubHub we're featuring reports that examine the need for race-conscious strategies that take into account individual health-related interventions as well as broader efforts to improve socioeconomic and physical conditions in communities of color.

Why Place & Race Matter (113 pages, PDF), a report from PolicyLink and the California Endowment, describes how structural racism continues to shape the economic, social, and physical environments of communities of color, which in turn affects educational and financial opportunities for residents of those communities, and how, even at higher income levels, discrimination based on race can affect one's physical and mental health. The report highlights strategies for building healthy, thriving communities by dismantling entrenched patterns of inequality, residential segregation, and unequal resource distribution, all of which contribute to the concentration of poverty in inner-city neighborhoods.

The UCLA Center for Health Policy report Income Disparities in Asthma Burden and Care in California (22 pages, PDF) finds that asthma disproportionately affects low-income Californians -- especially children and people of color -- who are more likely to be uninsured, lack access to quality health care, and be exposed to environmental risk factors such as second-hand smoke, mold, and air pollution. As a result, low-income Calfornians experience more frequent asthma attacks, visit emergency rooms and are hospitalized more often, and miss more days of work and school than their higher-income peers. Diminished productivity and poor attendance in turn affect low-income asthma sufferers' employment opportunities and income, which tends to exacerbate their negative health outcomes. Funded by the California Endowment, the report calls for expanding coverage and benefits for low-income Californians with special healthcare needs as well as improving their access to patient-centered medical homes, disease and case management, and culturally appropriate patient education.

To be sure, differences in health coutcomes among racial/ethnic groups can vary in unexpected ways, as illustrated by The Unequal Distribution of Health in the Twin Cities (44 page, PDF), a recent report from the Blue Cross and Blue Shield of Minnesota Foundation. For example, while mortality rates for Native Americans, African Americans, and foreign-born Southeast Asians in the region are higher than they are for non-Latino whites, they are slightly lower among Asians, foreign-born blacks, and Latinos. And while racial/ethnic disparities in health outcomes were indeed narrower in higher-income areas, the link between per-capita income and life expectancy is clear, with every $10,000 increase in a neighborhood's median income appearing to buy its residents another year of life. Funded by the Amherst H. Wilder Foundation, the report recommends targeting the lowest-income Native-American and African-American communities with comprehensive interventions designed to close race-based disparities in educational and economic opportunity, ending economic and residential segregation, and improving health outcomes for all Twin Cities residents.

Finally, in Regional and Racial Variation in Primary Care and the Quality of Care Among Medicare Beneficiaries (36 pages, PDF), the Dartmouth Institute for Health Policy & Clinical Practice questions whether merely expanding access to primary care is sufficient to overcome racial disparities in health and health care. Funded by the National Institute on Aging and the California HealthCare, Robert Wood Johnson, United Health, and WellPoint foundations, the report found that neither a greater supply of primary care physicians in a given region nor regular visits to a primary care physician was a guarantee of better treatment or outcomes, and that addressing such disparities is likely to require more effective integration and coordination of care among primary care clinicians and other healthcare providers.

Do you have any examples of or stories that illustrate the links between race/ethnicity, place, and health? Are you aware of any promising strategies or initiatives in this area? Feel free to share your thoughts in the comments section.

And don't forget to visit PubHub, where you can browse more than eighteen hundred reports on health-related topics.

-- Kyoko Uchida

Comments

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Kyoko:

Thanks for pulling together this great list of publications!

(Since you asked :) I would like to add that environmental justice advocates and the folks who document and study instances of environmental racism have produced some incredible work that is often hyper local in terms of geography but speaks to a much larger problem and the nexus of race, health, and place that you describe.

In 2009 IssueLab put together a special collection of nonprofit research on the topic of environmental justice that still has a lot of relevant research in it and may be of interest to you and your readers at PND. http://ej.issuelab.org/research
For a smaller subset of research addressing health impacts, simply select "health and medicine" from the list of issue areas.

Thanks again for covering this issue! It's one that is, sadly, only growing in importance.

Gabi

Gabi, thank you so much for bringing up the issue of environmental justice, which directly addresses the nexus of race, place, and health, and for the link to IssueLab's very extensive (60 reports!) special collection. The "This Week in PubHub" feature is limited to four reports published within the last year, but we did do one on the related topic of "green access" in April (http://pndblog.typepad.com/pndblog/2011/04/this-week-in-pubhub-environment-green-access.html). I hope the fact that efforts to address structural racism and its consequences are gaining attention is a good sign...

You can also check worldwide air pollution by going on the AirVisual website and having a look at the air quality map: https://www.airvisual.com/air-quality-map :)

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