Soon after Allan Pinkerton established his legendary detective agency in the United States, Canadians began seeking their services. Call in Pinkerton's is the history of the agency's work on behalf of Canadian governments and police forces. During the late nineteenth century and early twentieth century, Pinkerton's operatives hunted legendary train robber Bill Miner in the woods of British Columbia, infiltrated German spy rings during World War I, and helped future prime minister John A. Macdonald to fend off the Fenian raids. They tracked down the Reno Brothers in Windsor, Ontario, and investi.
This paper provides an overview of the scientific evidence pointing to critically needed steps to reduce racial inequities in health. First, it argues that communities of opportunity should be developed to minimize some of the adverse impacts of systemic racism. These are communities that provide early childhood development resources, implement policies to reduce childhood poverty, provide work and income support opportunities for adults, and ensure healthy housing and neighborhood conditions. Second, the healthcare system needs new emphases on ensuring access to high quality care for all, strengthening preventive health care approaches, addressing patients' social needs as part of healthcare delivery, and diversifying the healthcare work force to more closely reflect the demographic composition of the patient population. Finally, new research is needed to identify the optimal strategies to build political will and support to address social inequities in health. This will include initiatives to raise awareness levels of the pervasiveness of inequities in health, build empathy and support for addressing inequities, enhance the capacity of individuals and communities to actively participate in intervention efforts and implement large scale efforts to reduce racial prejudice, ideologies, and stereotypes in the larger culture that undergird policy preferences that initiate and sustain inequities.
This article reviews the empirical evidence that suggests that there is a solid foundation for more systematic research attention to the ways in which interventions that seek to reduce the multiple dimensions of racism can improve health and reduce disparities in health. First, research reveals that policies and procedures that seek to reduce institutional racism by improving neighborhood and educational quality and enhancing access to additional income, employment opportunities, and other desirable resources can improve health. Second, research is reviewed that shows that there is the potential to improve health through interventions that can reduce cultural racism at the societal and individual level. Finally, research is presented that suggests that the adverse consequences of racism on health can be reduced through policies that maximize the health-enhancing capacities of medical care, address the social factors that initiate and sustain risk behaviors, and empower individuals and communities to take control of their lives and health. Directions for future research are outlined.
Black-White differences in health are large, persistent, and in some cases, worsening over time. Racial segregation is a central determinant of Black-White differences in health. The physical separation of the races in residential areas is an institutional mechanism of racism that remains a primary determinant of racial differences in economic circumstances. These differences in social and economic conditions are largely responsible for racial differences in health status. Reparations are a potentially effective strategy to rebuild the infrastructure of disadvantaged, segregated communities. Such investment would enhance the economic circumstances of African American families and communities and also improve their health.
This chapter reviews recent studies of socioeconomic status (SES) and racial differences in health. It traces patterns of the social distribution of disease over time and describes the evidence for both a widening SES differential in health status and an increasing racial gap in health between blacks and whites due, in part, to the worsening health status of the African American population. We also describe variations in health status within and between other racial populations. The interactions between SES and race are examined, and we explore the link between health inequalities and socioeconomic inequality both by examining the nature of the SES gradient and by identifying the determinants of the magnitude of SES disparities over time. We consider the ways in which major social structures and processes such as racism, acculturation, work, migration, and childhood SES produce inequalities in health. We also attend to the ways in which other intervening factors and resources are constrained by social structure. Measurement issues are addressed, and implications for health policy and future research are described.
The allegory of the orchard : The political determinants of health inequities -- Setting the precedent : America's attempts to address the political determinants of health inequities -- The political determinants of health model -- How the game Is played : successful employment of the political determinants of health -- Winning the game that never ends -- Growing pains : tackling the political determinants of health inequities during a regressive period -- The future of health equity begins and ends with the political determinants of health.
Over one hundred years ago, W. E. B. Du Bois (1899) documented large, pervasive, and persistent racial inequities in health. While the current demography of racial groups in the United States is radically different compared to the times when Du Bois first discussed issues of race and health, many of the significant developments in research on racial differences in health in the last century can be traced to his seminal work (Williams and Sternthal, 2010). Du Bois recognized that the limited access to economic resources and the social marginalization of some racial groups could have dire social, physical, and psychological consequences for them. Current research studies continue to document that racial groups with a long history characterized by economic exploitation and geographic marginalization—Blacks or African Americans, American Indians, and Native Hawaiians and other Pacific Islanders—have markedly poor health outcomes compared to the dominant White population. Immigrant Asians and Hispanics tend to have better health than the U.S. average, but their health tends to worsen over time and across subsequent generations. Despite Du Bois's prescience and the advances made by contemporary researchers, there are many substantive theoretical and methodological challenges confronting scholars who study the health of diverse racial and ethnic groups. This special issue of the Du Bois Review provides a state-of-the-art overview of some of these unanswered questions and critical research directions for the study of racial inequality in health.
