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Krzyzanowski MC, Ives CL, Jones NL, Entwisle B, Fernandez A, Cullen TA, Darity WA, Fossett M, Remington PL, Taualii M, Wilkins CH, Pérez-Stable EJ, Rajapakse N, Breen N, Zhang X, Maiese DR, Hendershot TP, Mandal M, Hwang SY, Huggins W, Gridley L, Riley A, Ramos EM, Hamilton CM. The PhenX Toolkit: Measurement Protocols for Assessment of Social Determinants of Health. Am J Prev Med 2023; 65:534-542. [PMID: 36935055 PMCID: PMC10505248 DOI: 10.1016/j.amepre.2023.03.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 03/02/2023] [Accepted: 03/02/2023] [Indexed: 03/21/2023]
Abstract
INTRODUCTION Social determinants are structures and conditions in the biological, physical, built, and social environments that affect health, social and physical functioning, health risk, quality of life, and health outcomes. The adoption of recommended, standard measurement protocols for social determinants of health will advance the science of minority health and health disparities research and provide standard social determinants of health protocols for inclusion in all studies with human participants. METHODS A PhenX (consensus measures for Phenotypes and eXposures) Working Group of social determinants of health experts was convened from October 2018 to May 2020 and followed a well-established consensus process to identify and recommend social determinants of health measurement protocols. The PhenX Toolkit contains data collection protocols suitable for inclusion in a wide range of research studies. The recommended social determinants of health protocols were shared with the broader scientific community to invite review and feedback before being added to the Toolkit. RESULTS Nineteen social determinants of health protocols were released in the PhenX Toolkit (https://www.phenxtoolkit.org) in May 2020 to provide measures at the individual and structural levels for built and natural environments, structural racism, economic resources, employment status, occupational health and safety, education, environmental exposures, food environment, health and health care, and sociocultural community context. CONCLUSIONS Promoting the adoption of well-established social determinants of health protocols can enable consistent data collection and facilitate comparing and combining studies, with the potential to increase their scientific impact.
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Affiliation(s)
- Michelle C Krzyzanowski
- GenOmics, Bioinformatics, and Translation Research Center, RTI International, Research Triangle Park, North Carolina
| | - Cataia L Ives
- GenOmics, Bioinformatics, and Translation Research Center, RTI International, Research Triangle Park, North Carolina
| | - Nancy L Jones
- National Institute on Minority Health and Health Disparities, NIH, Bethesda, Maryland.
| | - Barbara Entwisle
- Department of Sociology, College of Arts and Sciences, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Alicia Fernandez
- Division of General Internal Medicine, Department of Medicine, University of California San Francisco, San Francisco, Carolina
| | | | - William A Darity
- Sanford School of Public Policy, Duke University, Durham, North Carolina
| | - Mark Fossett
- Department of Sociology, College of Arts & Sciences, Texas A&M University, College Station, Texas
| | - Patrick L Remington
- Department of Population Health Sciences, University of Wisconsin-Madison College of Medicine and Public Health, Madison, Wisconsin
| | - Maile Taualii
- Center for Integrated Health Care Research, Hawaii Permanente Medical Group, Honolulu, Hawaii
| | - Consuelo H Wilkins
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Eliseo J Pérez-Stable
- National Institute on Minority Health and Health Disparities, NIH, Bethesda, Maryland
| | - Nishadi Rajapakse
- Center for Translation Research & Implementation Science, National Heart, Lung, and Blood Institute, NIH, Bethesda, Maryland
| | - Nancy Breen
- National Institute on Minority Health and Health Disparities, NIH, Bethesda, Maryland
| | - Xinzhi Zhang
- Center for Translation Research & Implementation Science, National Heart, Lung, and Blood Institute, NIH, Bethesda, Maryland
| | - Deborah R Maiese
- Division for Research Services, RTI International, Research Triangle Park, North Carolina
| | - Tabitha P Hendershot
- GenOmics, Bioinformatics, and Translation Research Center, RTI International, Research Triangle Park, North Carolina
| | - Meisha Mandal
- GenOmics, Bioinformatics, and Translation Research Center, RTI International, Research Triangle Park, North Carolina
| | - Stephen Y Hwang
- GenOmics, Bioinformatics, and Translation Research Center, RTI International, Research Triangle Park, North Carolina
| | - Wayne Huggins
- GenOmics, Bioinformatics, and Translation Research Center, RTI International, Research Triangle Park, North Carolina
| | - Lauren Gridley
- GenOmics, Bioinformatics, and Translation Research Center, RTI International, Research Triangle Park, North Carolina
| | - Amanda Riley
- GenOmics, Bioinformatics, and Translation Research Center, RTI International, Research Triangle Park, North Carolina
| | - Erin M Ramos
- National Human Genome Research Institute, NIH, Bethesda, Maryland
| | - Carol M Hamilton
- GenOmics, Bioinformatics, and Translation Research Center, RTI International, Research Triangle Park, North Carolina
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Robbins PA, Bentley-Edwards KL, Blackman Carr LT, Conde E, Van Vliet R, Darity WA. Shades of Black: Gendered Denominational Variation in Depression Symptoms Among Black Christians. Psycholog Relig Spiritual 2022; 14:425-435. [PMID: 36861032 PMCID: PMC9970286 DOI: 10.1037/rel0000398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Religion and spirituality (R/S) play a central role in shaping the contextual experiences of many Black people in the United States. Blacks are among the most religiously engaged groups in the country. Levels and types of religious engagement, however, can vary by subcategories such as gender or denominational affiliation. Although R/S involvement has been linked to improved mental health outcomes for Black people in general, it is unclear whether these benefits extend to all Black people who claim R/S affiliation irrespective of denomination and gender. Data from the National Survey of American Life (NSAL) sought to determine whether there are differences in the odds of reporting elevated depressive symptomology among African American and Black Caribbean Christian adults across denominational affiliation and gender. Initial logistic regression analysis found similar odds of elevated depressive symptoms across gender and denominational affiliation, but further analysis revealed the presence of a denomination by gender interaction. Specifically, there was a significantly larger gender gap in the odds of reporting elevated depression symptoms for Methodists than for Baptists and Catholics. In addition, Presbyterian women had lower odds of reporting elevated symptoms than Methodist women. This study's findings highlight the importance of examining denominational disparities among Black Christians, and suggest that denomination and gender may work in tandem to shape the R/S experiences and mental health outcomes of Black people in the United States.
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Affiliation(s)
- Paul A. Robbins
- The Samuel DuBois Cook Center on Social Equity, Duke University
| | | | | | - Eugenia Conde
- The Samuel DuBois Cook Center on Social Equity, Duke University
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Himmelstein KEW, Lawrence JA, Jahn JL, Ceasar JN, Morse M, Bassett MT, Wispelwey BP, Darity WA, Venkataramani AS. Association Between Racial Wealth Inequities and Racial Disparities in Longevity Among US Adults and Role of Reparations Payments, 1992 to 2018. JAMA Netw Open 2022; 5:e2240519. [PMID: 36342718 PMCID: PMC9641537 DOI: 10.1001/jamanetworkopen.2022.40519] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
IMPORTANCE In the US, Black individuals die younger than White individuals and have less household wealth, a legacy of slavery, ongoing discrimination, and discriminatory public policies. The role of wealth inequality in mediating racial health inequities is unclear. OBJECTIVE To assess the contribution of wealth inequities to the longevity gap that exists between Black and White individuals in the US and to model the potential effects of reparations payments on this gap. DESIGN, SETTING, AND PARTICIPANTS This cohort study analyzed the association between wealth and survival among participants in the Health and Retirement Study, a nationally representative panel study of community-dwelling noninstitutionalized US adults 50 years or older that assessed data collected from April 1992 to July 2019. Participants included 7339 non-Hispanic Black (hereinafter Black) and 26 162 non-Hispanic White (hereinafter White) respondents. Data were analyzed from January 1 to September 17, 2022. EXPOSURES Household wealth, the sum of all assets (including real estate, vehicles, and investments), minus the value of debts. MAIN OUTCOMES AND MEASURES The primary outcome was all-cause mortality by the end of survey follow-up in 2018. Using parametric survival models, the associations among household wealth, race, and survival were evaluated, adjusting for age, sex, number of household members, and marital status. Additional models controlled for educational level and income. The survival effects of eliminating the current mean wealth gap with reparations payments ($828 055 per household) were simulated. RESULTS Of the 33 501 individuals in the sample, a weighted 50.1% were women, and weighted mean (SD) age at study entry was 59.3 (11.1) years. Black participants' median life expectancy was 77.5 (95% CI, 77.0-78.2) years, 4 years shorter than the median life expectancy for White participants (81.5 [95% CI, 81.2-81.8] years). Adjusting for demographic variables, Black participants had a hazard ratio for death of 1.26 (95% CI, 1.18-1.34) compared with White participants. After adjusting for differences in wealth, survival did not differ significantly by race (hazard ratio, 1.00 [95% CI, 0.92-1.08]). In simulations, reparations to close the mean racial wealth gap were associated with reductions in the longevity gap by 65.0% to 102.5%. CONCLUSIONS AND RELEVANCE The findings of this cohort study suggest that differences in wealth are associated with the longevity gap that exists between Black and White individuals in the US. Reparations payments to eliminate the racial wealth gap might substantially narrow racial inequities in mortality.
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Affiliation(s)
- Kathryn E. W. Himmelstein
- Division of Infectious Diseases, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Jourdyn A. Lawrence
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
- François-Xavier Bagnoud Center for Health and Human Rights, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Jaquelyn L. Jahn
- The Ubuntu Center on Racism, Global Movements, and Population Health Equity, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
| | - Joniqua N. Ceasar
- Department of Medicine, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Department of Pediatrics, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Michelle Morse
- Center for Health Equity and Community Wellness, New York City Department of Health and Mental Hygiene, New York, New York
- Division of Global Health Equity, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | | | - Bram P. Wispelwey
- Division of Global Health Equity, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - William A. Darity
- Sanford School of Public Policy, Duke University, Durham, North Carolina
| | - Atheendar S. Venkataramani
- Leonard Davis Institute of Health Economics, Division of Health Policy, Perelman School of Medicine at the University of Pennsylvania, Philadelphia
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Richardson ET, Malik MM, Darity WA, Mullen AK, Morse ME, Malik M, Maybank A, Bassett MT, Farmer PE, Worden L, Jones JH. Reparations for Black American descendants of persons enslaved in the U.S. and their potential impact on SARS-CoV-2 transmission. Soc Sci Med 2021; 276:113741. [PMID: 33640157 PMCID: PMC7871902 DOI: 10.1016/j.socscimed.2021.113741] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Revised: 12/17/2020] [Accepted: 01/31/2021] [Indexed: 12/15/2022]
Abstract
Background In the United States, Black Americans are suffering from a significantly disproportionate incidence of COVID-19. Going beyond mere epidemiological tallying, the potential for racial-justice interventions, including reparations payments, to ameliorate these disparities has not been adequately explored. Methods We compared the COVID-19 time-varying Rt curves of relatively disparate polities in terms of social equity (South Korea vs. Louisiana). Next, we considered a range of reproductive ratios to back-calculate the transmission rates βi→j for 4 cells of the simplified next-generation matrix (from which R0 is calculated for structured models) for the outbreak in Louisiana. Lastly, we considered the potential structural effects monetary payments as reparations for Black American descendants of persons enslaved in the U.S. would have had on pre-intervention βi→j and consequently R0. Results Once their respective epidemics begin to propagate, Louisiana displays Rt values with an absolute difference of 1.3–2.5 compared to South Korea. It also takes Louisiana more than twice as long to bring Rt below 1. Reasoning through the consequences of increased equity via matrix transmission models, we demonstrate how the benefits of a successful reparations program (reflected in the ratio βb→b/βw→w) could reduce R0 by 31–68%. Discussion While there are compelling moral and historical arguments for racial-injustice interventions such as reparations, our study considers potential health benefits in the form of reduced SARS-CoV-2 transmission risk. A restitutive program targeted towards Black individuals would not only decrease COVID-19 risk for recipients of the wealth redistribution; the mitigating effects would also be distributed across racial groups, benefiting the population at large.
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Affiliation(s)
- Eugene T Richardson
- Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA; Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA.
| | - Momin M Malik
- Berkman Klein Center for Internet & Society, Harvard University, Cambridge, MA, USA
| | - William A Darity
- Sanford School of Public Policy, Duke University, Durham, NC, USA
| | | | - Michelle E Morse
- Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA; Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - Maya Malik
- McGill University, School of Social Work, Montreal, Quebec, Canada
| | | | - Mary T Bassett
- François-Xavier Bagnoud (FXB) Center for Health and Human Rights, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Paul E Farmer
- Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA; Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - Lee Worden
- Proctor Foundation, University of California, San Francisco, USA
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Bentley-Edwards KL, Blackman Carr LT, Robbins PA, Conde E, Zaw K, Darity WA. Investigating Denominational and Church Attendance Differences in Obesity and Diabetes in Black Christian Men and Women. J Relig Health 2020; 59:3055-3070. [PMID: 31359241 PMCID: PMC6986996 DOI: 10.1007/s10943-019-00888-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Prior investigations of the relationships between religious denomination and diabetes and obesity do not consider the nuance within black faith traditions. This study used data from the National Survey of American Life (n = 4344) to identify denominational and religious attendance differences in obesity and diabetes among black Christian men and women. Key findings indicated that black Catholics and Presbyterians had lower odds of diabetes than Baptists. Black men that attended church almost daily were nearly twice as likely to be obese than those that never attend services. These results indicate that denomination and gender should inform faith-based and placed health promotion approaches.
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Affiliation(s)
- Keisha L Bentley-Edwards
- Samuel DuBois Cook Center on Social Equity, Duke University, 2024 West Main Street, Box 104407, Durham, NC, 27705, USA
- General Internal Medicine, Duke University, Durham, NC, USA
| | - Loneke T Blackman Carr
- Samuel DuBois Cook Center on Social Equity, Duke University, 2024 West Main Street, Box 104407, Durham, NC, 27705, USA.
| | - Paul A Robbins
- Samuel DuBois Cook Center on Social Equity, Duke University, 2024 West Main Street, Box 104407, Durham, NC, 27705, USA
| | - Eugenia Conde
- Samuel DuBois Cook Center on Social Equity, Duke University, 2024 West Main Street, Box 104407, Durham, NC, 27705, USA
| | - Khaing Zaw
- Samuel DuBois Cook Center on Social Equity, Duke University, 2024 West Main Street, Box 104407, Durham, NC, 27705, USA
| | - William A Darity
- Samuel DuBois Cook Center on Social Equity, Duke University, 2024 West Main Street, Box 104407, Durham, NC, 27705, USA
- Samuel DuBois Cook Professor of Public Policy, African and African American Studies, and Economics, Duke University, Durham, NC, USA
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6
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Robbins PA, Scott MJ, Conde E, Daniel Y, Darity WA, Bentley-Edwards KL. Correction to: Denominational and Gender Differences in Hypertension Among African American Christian Young Adults. J Racial Ethn Health Disparities 2020; 8:1344. [PMID: 33159285 DOI: 10.1007/s40615-020-00919-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Paul A Robbins
- The Samuel DuBois Cook Center on Social Equity, Duke University, Durham, NC, USA.
| | - Melissa J Scott
- The Samuel DuBois Cook Center on Social Equity, Duke University, Durham, NC, USA
| | - Eugenia Conde
- The Samuel DuBois Cook Center on Social Equity, Duke University, Durham, NC, USA
| | - Yannet Daniel
- The Samuel DuBois Cook Center on Social Equity, Duke University, Durham, NC, USA
| | - William A Darity
- The Samuel DuBois Cook Center on Social Equity, Duke University, Durham, NC, USA.,Sanford School of Public Policy, Duke University, Durham, NC, USA
| | - Keisha L Bentley-Edwards
- The Samuel DuBois Cook Center on Social Equity, Duke University, Durham, NC, USA.,Department of Medicine, Duke University, Durham, NC, USA
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Richardson ET, Malik MM, Darity WA, Mullen AK, Malik M, Benton A, Bassett MT, Farmer PE, Worden L, Jones JH. Reparations for Black American Descendants of Persons Enslaved in the U.S. and Their Estimated Impact on SARS-CoV-2 Transmission. medRxiv 2020:2020.06.04.20112011. [PMID: 32577701 PMCID: PMC7302310 DOI: 10.1101/2020.06.04.20112011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Background In the United States, Black Americans are suffering from significantly disproportionate incidence and mortality rates of COVID-19. The potential for racial-justice interventions, including reparations payments, to ameliorate these disparities has not been adequately explored. Methods We compared the COVID-19 time-varying R t curves of relatively disparate polities in terms of social equity (South Korea vs. Louisiana). Next, we considered a range of reproductive ratios to back-calculate the transmission rates β i→j for 4 cells of the simplified next-generation matrix (from which R 0 is calculated for structured models) for the outbreak in Louisiana. Lastly, we modeled the effect that monetary payments as reparations for Black American descendants of persons enslaved in the U.S. would have had on pre-intervention β i→j . Results Once their respective epidemics begin to propagate, Louisiana displays R t values with an absolute difference of 1.3 to 2.5 compared to South Korea. It also takes Louisiana more than twice as long to bring R t below 1. We estimate that increased equity in transmission consistent with the benefits of a successful reparations program (reflected in the ratio β b→b / β w→w ) could reduce R 0 by 31 to 68%. Discussion While there are compelling moral and historical arguments for racial injustice interventions such as reparations, our study describes potential health benefits in the form of reduced SARS-CoV-2 transmission risk. As we demonstrate, a restitutive program targeted towards Black individuals would not only decrease COVID-19 risk for recipients of the wealth redistribution; the mitigating effects would be distributed across racial groups, benefitting the population at large.
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Abstract
Female family headship has strong implications for endemic poverty in the United States. Consequently, it is imperative to explore the chief factors that contribute to this problem. Departing from prior literature that places significant weight on welfare-incentive effects, our study highlights the role of male marriageability in explaining the prevalence of never-married female family headship for blacks and whites. Specifically, we examine racial differences in the effect of male marriageability on never-married female headship from 1980 to 2010. By exploiting data from IPUMS-USA (N = 4,958,722) and exogenous variation from state-level sentencing reforms, the study finds that the decline in the relative supply of marriageable males significantly increases the incidence of never-married female family headship for blacks but not for whites.
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Affiliation(s)
- Terry-Ann Craigie
- Department of Economics, Connecticut College, 270 Mohegan Avenue, New London, CT 06320, (860) 439-2638
| | - Samuel L Myers
- Humphrey School of Public Affairs, University of Minnesota, 301 19th Avenue South, Minneapolis, MN 55455
| | - William A Darity
- Sanford School of Public Policy, Duke University, 238 Sanford Inst Bldg. Durham, NC 27708
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Abstract
Although the health status of Americans has improved, particularly decreases in incidence and prevalence rates of diseases, these improvements are not consistent and equally distributed within all population groups — particularly black Americans. To describe the relative differences, an analytical procedure of calculating the differential deficit ratio (DDR) was developed. It was observed that for males the death rate from all causes increased in 1950 from a .426 to a .473 DDR or 47.3 percent in 1982 with black males dying at a much higher rate than white males. For females there was a closing of the gap. In 1950 the rate was .703, higher in black females than white females, but in 1982 the ratio was .431. These trends were also observed for deaths due to heart disease, cerebrovascular, malignant neoplasms, diabetes mellitus, pneumonia and influenza and chronic liver disease and cirrhosis. An epidemic in homicide exists among black males. The rate among black Americans is more than 5 times higher than among white. Infant mortality DDR in 1950 was .638 and in 1982 it was .949, the highest in more than 32 years. Also the infant mortality rate among blacks was higher than in any other ethnic or racial group. Indices show that there is a direct correlation between level of poverty, income level, education and infant mortality. Future directions indicate a need for overall change in the health care system, re-education for the consuming public, rebasing health care in the community and correlating health care with other social problems which impact on health.
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Affiliation(s)
- William A. Darity
- Professor of Public Health, Dean, School of Health Sciences, University of Massachusetts, Amherst
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Cernada GP, Darity WA, Chen TTL, Winder AE, Benn S, Jackson R, Tolbert J. Mass Media Usage among Black Smokers: A First Look. Int Q Community Health Educ 2016; 10:347-64. [DOI: 10.2190/t87w-7j7t-xf8h-dbrg] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This article discusses preliminary results of a National Cancer Institute-sponsored pilot baseline survey in 1989 of smoking knowledge, attitude and habits among black smokers in four major U.S. cities: two in the North (Springfield, Massachusetts and Hartford, Connecticut) and two in the South (Durham, North Carolina and Columbia, South Carolina). It focuses on mass media readership, viewing and listening habits and a preliminary discussion of their application to practice.
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Abstract
This special edition of the Review of Black Political Economics provides a contribution to the growing, vital and intellectually rich field of stratification economics. Stratification economics is an emerging field in economics that seeks to expand the boundaries of the analysis of how economists analyze intergroup differences. It examines the competitive, and sometimes collaborative, interplay between members of social groups animated by their collective self-interest to attain or maintain relative group position in a social hierarchy. The collection of articles in this volume span both quantitative and qualitative approaches, geographical distances (Bangladesh, Brazil, the Dominican Republic, Kenya, and the U.S.), types of intergroup disparity (class, race, ethnicity, tribe, gender, and phenotype), and outcomes associated with social stratification (property rights in identity, human capital, financial capital, consumer surplus, health, and labor market outcomes).
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Affiliation(s)
| | - Darrick Hamilton
- The Milano Graduate School of International Affairs, Management and Urban Policy, The New School, 72 Fifth Ave, New York, NY 10011, USA
| | - James B. Stewart
- Labor Studies and Employment Relations, Penn State University, 8101 Palomino Drive, Bridgeville, PA 15017, USA
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Price GN, Darity WA. The economics of race and eugenic sterilization in North Carolina: 1958-1968. Econ Hum Biol 2010; 8:261-72. [PMID: 20188639 DOI: 10.1016/j.ehb.2010.01.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2009] [Revised: 01/20/2010] [Accepted: 01/24/2010] [Indexed: 05/23/2023]
Abstract
Theoretical justifications for state-sanctioned sterilization of individuals provided by Irving Fisher rationalized its racialization on grounds that certain non-white racial groups, particularly blacks due to their dysgenic biological and behavioral traits, retarded economic growth and should be bred out of existence. Fisher's rationale suggests that national or state level eugenic policies that sterilized the so-called biological and genetically unfit could have been racist in both design and effect by disproportionately targeting black Americans. We empirically explore this with data on eugenic sterilizations in the State of North Carolina between 1958 and 1968. Count data parameter estimates from a cross-county population allocation model of sterilization reveal that the probability of non-institutional and total sterilizations increased with a county's black population share-an effect not found for any other racial group in the population. Our results suggest that in North Carolina, eugenic sterilization policies were racially biased and genocidal.
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Affiliation(s)
- Gregory N Price
- Department of Economics, Morehouse College, 830 Westview Dr. SW, Atlanta, GA 30314, USA.
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Green TL, Darity WA. Under the skin: using theories from biology and the social sciences to explore the mechanisms behind the black-white health gap. Am J Public Health 2010; 100 Suppl 1:S36-40. [PMID: 20147678 DOI: 10.2105/ajph.2009.171140] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Equity and social well-being considerations make Black-White health disparities an area of important concern. Although previous research suggests that discrimination- and poverty-related stressors play a role in African American health outcomes, the mechanisms are unclear. Allostatic load is a concept that can be employed to demonstrate how environmental stressors, including psychosocial ones, may lead to a cumulative physiological toll on the body. We discuss both the usefulness of this framework for understanding how discrimination can lead to worse health among African Americans, and the challenges for conceptualizing biological risk with existing data and methods. We also contrast allostatic load with theories of historical trauma such as posttraumatic slavery syndrome. Finally, we offer our suggestions for future interdisciplinary research on health disparities.
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Affiliation(s)
- Tiffany L Green
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, USA.
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Darity WA, Chen TTL, Tuthill RW, Buchanan DR, Winder AE, Stanek E, Cernada GP, Pastides H. A multi-city community based smoking research intervention project in the African-American population. Int Q Community Health Educ 2008; 26:323-36. [PMID: 17890179 DOI: 10.2190/iq.26.4.b] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To carry out a community-based research approach to determine the most effective educational interventions to reduce smoking among African-American smokers. The intervention included preparation of the community, planning and developing a model of change, and developing a community-based intervention. The study population consisted of 2,544 randomly selected adult African-American smokers residing in four sites in the northeastern and southeastern parts of the United States. The research design provided a comparison of active intervention sites with passive control sites as well as low income and moderate income areas. MAJOR OUTCOME MEASURES Point prevalence of non-smoking at the time of interview; Period prevalence of non-smoking at the time of interview; Period prevalence of quit attempts in the prior six months; Number of smoke-free days in the prior six months; Number of cigarettes smoked daily at the time of interview. RESULTS Based upon a survey eighteen months after baseline data was collected, all four measures of cigarette smoking behavior showed a strong statistically significant reduction of personal smoking behavior among those receiving active interventions versus the passive group. On the basis of process variable analysis, direct contact with the project staff in the prior six months was significantly higher in the active intervention areas. There was only a small non-significant increase in personal smoking behavior in moderate income groups as opposed to low income groups. CONCLUSION An analysis of process variables strongly suggests that, within this African-American Community, "hands on" or "face to face" approaches along with mass media, mailings, and other less personal approaches were more effective in reducing personal smoking behavior than media, mailings, and other impersonal approaches alone addressed to large audiences.
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Affiliation(s)
- William A Darity
- School of Public Health, University of Massachusetts, Amherst, MA, USA
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Abstract
The author examines available evidence on the effects of exposure to joblessness on emotional well-being according to race and sex. The impact of racism on general health outcomes also is considered, particularly racism in the specific form of wage discrimination. Perceptions of racism and measured exposures to racism may be distinct triggers for adverse health outcomes. Whether the effects of racism are best evaluated on the basis of self-classification or social classification of racial identity is unclear. Some research sorts between the effects of race and socioeconomic status on health. The development of a new longitudinal database will facilitate more accurate identification of connections between racism and negative health effects.
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Affiliation(s)
- William A Darity
- Department of Economics, University of North Carolina at Chapel Hill, 27599, USA.
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Darity WA. End of Race? Transforming Anthropology 2001. [DOI: 10.1525/tran.2001.10.1.39] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Darity WA, Tuthill RW, Winder AE, Cernada GP, Chen TTL, Buchanan DR, Stanek E, Pastides H. A Multi-City Community Based Smoking Research Intervention Project in the African-American Population. Int Q Community Health Educ 1998; 17:117-30. [DOI: 10.2190/cexy-wg7c-gl3e-a2bp] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Objective: To carry out a community-based research approach to determine the most effective educational interventions to reduce smoking among African-American smokers. The intervention included preparation of the community, planning and developing a model of change, and developing a community-based intervention. The study population consisted of 2,544 randomly selected adult African-American smokers residing in four sites in the northeastern and southeastern parts of the United States. The research design provided a comparison of active intervention sites with passive control sites as well as low income and moderate income areas. Major Outcome Measures: Point prevalence of non-smoking at the time of interview; Period prevalence of non-smoking at the time of interview; Period prevalence of quit attempts in the prior six months; Number of smoke-free days in the prior six months; Number of cigarettes smoked daily at the time of interview. Results: Based upon a survey eighteen months after baseline data was collected, all four measures of cigarette smoking behavior showed a strong statistically significant reduction of personal smoking behavior among those receiving active interventions versus the passive group. On the basis of process variable analysis, direct contact with the project staff in the prior six months was significantly higher in the active intervention areas. There was only a small non-significant increase in personal smoking behavior in moderate income groups as opposed to low income groups. Conclusion: An analysis of process variables strongly suggests that, within this African-American Community, “hands on” or “face to face” approaches along with mass media, mailings, and other less personal approaches were more effective in reducing personal smoking behavior than media, mailings, and other impersonal approaches alone addressed to large audiences.
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Affiliation(s)
| | | | - Alvin E. Winder
- School of Public Health, University of Massachusetts, Amherst
| | | | - Ted T. L. Chen
- School of Public Health, University of Massachusetts, Amherst
| | | | - Edward Stanek
- School of Public Health, University of Massachusetts, Amherst
| | - Harris Pastides
- School of Public Health, University of Massachusetts, Amherst
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Coates RJ, Click LA, Harlan LC, Robboy S, Barrett RJ, Eley JW, Reynolds P, Chen VW, Darity WA, Blacklow RS, Edwards BK. Differences between black and white patients with cancer of the uterine corpus in interval from symptom recognition to initial medical consultation (United States). Cancer Causes Control 1996; 7:328-36. [PMID: 8734826 DOI: 10.1007/bf00052938] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
To determine whether Black women with symptoms of uterine corpus cancer had longer times from symptom recognition to initial medical consultation than did White women in the United States, 331 newly diagnosed patients living in Atlanta (GA), New Orleans (LA), and San Francisco/Oakland (CA) during 1985-87 were interviewed to collect information on symptoms, dates of recognition and consultation, and other factors that might affect the interval. Data were analyzed to estimate medical consultation rates and rate ratios following symptom recognition. Median recalled times between symptom recognition and consultation were 16 days for Black women and 14 days for White women. Although poverty, having no usual source of healthcare, and other factors were associated with lower consultation rates, the adjusted rate among Black women was only somewhat lower (0.87) than among White women, and the 95 percent confidence interval (CI = 0.58-1.31) was consistent with no true difference between the races. In addition, the median time to consultation for women with stage IV cancer was only 15 days longer than the time (14 days) for the women with stage I cancer. These results suggest that time from symptom recognition to initial medical consultation does not contribute importantly to the more advanced stage cancer of the uterine corpus commonly found among Black women.
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Affiliation(s)
- R J Coates
- Department of Epidemiology, Rollins School of Public Health of Emory University, Atlanta, GA 30322, USA
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Abstract
Commercial directories and governmental lists of dwelling units in low income urban Black communities in four eastern cities were evaluated for completeness. With rare exceptions, less than 90 percent of dwelling units were included in any one list and no list adequately identified multiple dwelling unit structures. Since household income is likely to be lower among households in such structures, all lists tend to miss the very poor, i.e., those who may be at highest health risk.
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Affiliation(s)
- E J Stanek
- Division of Public Health, University of Massachusetts, Amherst 01003
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Turner CB, Darity WA. Education and Family Planning among Black American Women. Int Q Community Health Educ 1987; 8:117-28. [DOI: 10.2190/e5np-cwrb-ardu-y6kn] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The factors which relate to family planning and fertility-related attitudes and practices among black Americans are not well understood. This study evaluates the importance of three demographic factors (level of education, age, and region) in predicting such fertility related variables. Black women between the ages of fifteen and forty-five ( N = 1,074) living in either a northern or a southern city were interviewed. The fertility-related variables included knowledge of, attitudes toward, and usage of various family planning methods; desired, ideal, and actual family size; and fears of race genocide. Using a three-factor (education, age, and region) Analysis of Variance for each of the dependent variables, education emerged as the most powerful and the only consistent predictor of the several fertility-related variables. Only desired number of children was unrelated to level of education. Such findings provide support for the contention that black fertility levels would be the same as that among whites, if access to equal educational opportunity were available to Blacks.
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Deveaux AM, Darity WA. Perceptions of Health Education of Selected Health and Social Service Providers in the Bahamas. Int Q Community Health Educ 1982; 3:279-90. [DOI: 10.2190/thkk-bc1m-5qe3-8p8r] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Health education is a new component of the health care delivery system in the Bahamas. In the past, confusion and uncertainty was expressed regarding the contribution of health education to the health care services. The intention of this study was to investigate the perceptions of selected health and social service providers to health problems, their most likely solutions, and to health education and health education related issues in the Bahamas. A questionnaire was either mailed or hand delivered to 412 selected health and social service providers in New Providence and the Family Islands in the Bahamas. Of these 127 (31%) usable questionnaires were returned. A discussion of the study findings, study limitations, implications for health education and suggestions for future research are presented. The survey results showed that a majority of respondents indicated consistent support for health education and health education related issues. This support was evident even when responses were crosstabulated with such variables as age, profession, and years of experience in present occupation.
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Turner CB, Darity WA. Black Couples and Birth Control: Knowledge, Attitudes, and Reported Practices. Int Q Community Health Educ 1980. [DOI: 10.2190/fj8y-gan4-m90a-qlmh] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
A research project aimed at understanding the process of birth control among black couples is described. This focus has been lacking in the research literature, if not in the theoretical literature. Knowledge, attitudes, and reported practices of matched pairs of black couples in a northern and a southern city were compared. Female partners were found to have more knowledge about birth control methods, more positive attitudes toward specific birth control methods, and reported more usage of birth control methods. When age, education and marital status were controlled, these findings remained essentially the same. The findings are discussed in terms of their relevance to family planning programs and community health education programs among black couples.
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Affiliation(s)
| | - William A. Darity
- Professor of Public Health and Dean, School of Health Sciences, University of Massachusetts at Amherst
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Darity WA. Health manpower and the black community. Urban Health 1977; 6:4. [PMID: 10305900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Darity WA, Piedmont EB, McBride TC, Romanella AE. Some implications of a pregnancy on campus: a research study. J Am Coll Health Assoc 1968; 16:253-9. [PMID: 5639437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Darity WA. Some considerations in developing family planning services. Public Health Rep (1896) 1967; 82:667-72. [PMID: 4962114 PMCID: PMC1920054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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