Search results

The authors' review of the health services literature since the release of the landmark Report of the Secretary's Task Force Report of Black and Minority Health in 1985 revealed significant differences in access to medical care by race and ethnicity within certain disease categories and types of health services. The differences are not explained by such factors as socioeconomic status (SES), insurance coverage, stage or severity of disease, comorbidities, type and availability of health care services, and patient preferences. Under certain circumstances when important variables are controlled, racial and ethnic disparities in access are reduced and may disappear. Nonetheless, the literature shows that racial and ethnic disparities persist in significant measure for several disease categories and service types. The complex challenge facing current and future researchers is to understand the basis for such disparities and to determine why disparities are apparent in some but not other disease categories and service types.

Abstract
Background
Exposure to air pollutants and other environmental factors increases the risk of adverse pregnancy outcomes. There is growing evidence that adverse outcomes related to air pollution disproportionately affect racial and ethnic minorities. The objective of this paper is to explore the importance of race as a risk factor for air pollution-related poor pregnancy outcomes.

Methods
Studies investigating the effects of exposure to air pollution on pregnancy outcomes by race were reviewed. A manual search was conducted to identify missing studies. Studies that did not compare pregnancy outcomes among two or more racial groups were excluded. Pregnancy outcomes included preterm births, small for gestational age, low birth weight, and stillbirths.

Results
A total of 124 articles explored race and air pollution as risk factors for poor pregnancy outcome. Thirteen percent of these (n=16) specifically compared pregnancy outcomes among two or more racial groups. Findings across all reviewed articles showed more adverse pregnancy outcomes (preterm birth, small for gestational age, low birth weight, and stillbirths) related to exposure to air pollution among Blacks and Hispanics than among non-Hispanic Whites.

Conclusion
Evidence support our general understanding of the impact of air pollution on birth outcomes and, specifically, of disparities in exposure to air pollution and birth outcomes for infants born to Black and Hispanic mothers. The factors driving these disparities are multifactorial, mostly social, and economic factors. Reducing or eliminating these disparities require interventions at individual, community, state, and national level.

Research suggests children from non-White and Hispanic/Latinx communities are at higher risk for child maltreatment. This study identified in which states children from specific non-White communities were overrepresented in child protective services reports for child physical, sexual, and emotional/psychological abuse through exploratory mapping. Reports on child maltreatment originated from the 2018 National Child Abuse and Neglect Data System and state-level population estimates from the U.S. Census Bureau. Racial disparities were identified in states with unequal proportions of reported child maltreatment among a non-White child population compared to the proportion among the White child population. We found disparities for children from non-White communities in many states, especially for Black communities (Disparity Ratio [DR]: 15.10 for child physical abuse, DR: 12.77 for child sexual abuse in Washington DC, and DR: 5.25 for child emotional/psychological abuse in California). The ability to identify high disparities among Pacific Islanders highlights one of the study's strengths, given we separately examined Asian Americans, Pacific Islanders and multiracial communities. Results from our exploratory mapping provide insight into how preventive resources might be differentially allocated to non-White communities with higher child protective services reporting compared with White communities, and manifest states with multiple non-White communities overrepresented across maltreatment types.

For decades, lawyers and legal scholars have disagreed over how much resource redistribution to expect from federal courts and Congress in satisfaction of the Fourteenth Amendment's promise of equal protection. Of particular importance to this debate and to the nation given its kaleidoscopic history of inequality, is the question of racial redistribution of resources. A key dimension of that question is whether to accept the Supreme Court's limitation of equal protection to public actors' disparate treatment of members of different races or instead demand constitutional remedies for the racially disparate impact of public action. For a substantial segment of the nation's population as well as its judiciary and legal culture, governmentally mandated redistribution, and particularly racial redistribution, of resources to remedy the disparate results of public action is anathema to our constitutional order – so much so that such redistribution may provoke violence that horribly magnifies inequality. Avoiding that prospect leads us to propose a new constitutional understanding of the relationship between disparate impact and treatment to serve as an alternative to racial redistribution – or, should our legal culture change sufficiently in reaction to current events, as a necessary supplement to redistribution. While acknowledging the need to mind the racial and other gaps that public action persistently creates and tolerates, our strategy calls upon public actors and oversight bodies to mine the gaps for dispositive evidence of disparate treatment. Compared with how federal courts and our legal culture currently understand disparate treatment, our approach is more honest about the existence and meaning of centuries of unrelenting racial disparities and more insistent on transparency about why disparities keep occurring and whether they are innocent. Yet, the proposal also is moderated by its continuing prioritization of disparate treatment over disparate impact per se; by the extent to which it remains constitutionally and culturally precedented; by its objective of reform but not necessarily outright racial redistribution; and by its effort to avoid rowing upstream against the nation's individualistic current or being swept by it over treacherous and violent falls. In offering this approach, we recognize the need constantly to calibrate the breadth of the concession being made to liberty over equality and community, in order to keep the voracious appetite of the nation's individualism from consuming all hope of equity and social solidarity among diverse populations.

Die Zunahme ethnischer Konflikte ist auf eine Reihe von Ursachen zurückzuführen. Zum Teil sind sie historisch begründet. So wurden beispielsweise im Zuge der Entkolonialisierung bestehende Diskriminierungen aufrechterhalten. Ob ethnische Unterscheide in einen Konflikt münden, hängt maßgeblich vom jeweiligen politischen System und dessen Führung ab. Denn trotz aller Probleme in den europäischen Staaten erreichen hier ethnische Konflikte nicht das Ausmaß an Gewalt wie in der Dritten Welt. (SWP-Krh)

Causes of interethnic conflicts, and strategies adopted by countries to manage them. Success of policies of inclusion and power-sharing in easing ethnic conflict.

One of the arguments in support of the legalization of cannabis is that it would help alleviate racial disparities in the criminal justice system. Using UCR data from Colorado and Washington, we explore trends in cannabis arrests disaggregated by rates using interrupted time-series analysis, linear mixed models, and data visualizations. The results demonstrate a general decline in cannabis arrests for nearly all racial groups, yet these declines were not consistent across racial groups or even across states. Moreover, substantial racial disparities persist following legalization, especially in Colorado. Overall, evidence suggests that while legalization has likely had a net positive effect on overrepresented populations by decreasing criminal justice contact, it is not a panacea and may only be minimally important for addressing disparities.

We propose the politics hypothesis—i.e., the hypothesis that political forces comprise either a powerful predecessor of the social determinants of health or are essential social determinants of health themselves. We examine the hypothesis that political actors like presidents, their ideology, and institutions like the political parties they represent shape overall and race-specific health outcomes. Using census and Vital Statistics data among many other sources, we apply both theory- and data-driven statistical methods to assess the role of the president's party and the president's political ideology as predictors of overall and race-specific infant mortality in the United States, 1965–2010. We find that, net of trend, Republican presidencies and socially-conservative ideology of U.S. presidents are strongly associated with slower declines of infant mortality rates, overall and for white and black infants, compared to Democratic and socially-liberal presidents in the U.S. Approximately half (46%) of the white-black infant mortality gap, about 20,000 additional infant deaths, and most if not all the infant mortality rate gap between the U.S. and the rest of the developed world, can be attributed to the 28 years of Republican administrations during the study period. These findings are consistent with the politicization of public health and the conceptualization of politics as a powerful predecessor, in the causal chain, of the social determinants of health. Understanding the political ideological and institutional contexts in which health policies and healthcare and welfare programs are implemented, as well as how governments construct culture and social psychology, provide a more comprehensive framework for understanding and improving population patterns of disease, mortality, and entrenched racial disparities in health in the U.S.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a betacoronavirus that causes the novel coronavirus disease 2019 (COVID-19), is highly transmissible and pathogenic for humans and may cause life-threatening disease and mortality, especially in individuals with underlying comorbidities. First identified in an outbreak in Wuhan, China, COVID-19 is affecting more than 185 countries and territories around the world, with more than 15,754,651 confirmed cases and more than 640,029 deaths. Since December 2019, SARS-CoV-2 transmission has become a global threat, which includes confirmed cases in all 50 states within the United States (US). As of 25 July 2020, the Johns Hopkins Whiting School of Engineering Center for Systems Science and Engineering reports more than 4,112,651 cases and 145,546 deaths. To date, health disparities are associated with COVID-19 mortality among underserved populations. Here, the author explores potential underlying reasons for reported disproportionate, increased risks of mortality among African Americans and Hispanics/Latinos with COVID-19 compared with non-Hispanic Whites. The author examines the underlying clinical implications that may predispose minority populations and the adverse clinical outcomes that may contribute to increased risk of mortality. Government and community-based strategies to safeguard minority populations at risk for increased morbidity and mortality are essential. Underserved populations living in poverty with limited access to social services across the US are more likely to have underlying medical conditions and are among the most vulnerable. Societal and cultural barriers for ethnic minorities to achieve health equity are systemic issues that may be addressed only through shifts in governmental policies, producing long-overdue, substantive changes to end health care inequities.