This chapter provides an introduction to the volume along with a very brief review of literature on underserved and socially disadvantaged groups and health and health care…
Abstract
Purpose
This chapter provides an introduction to the volume along with a very brief review of literature on underserved and socially disadvantaged groups and health and health care differentials.
Methodology/Approach
This chapter uses the approach of a literature review.
Findings
The chapter argues for the importance of greater examination of underserved and socially disadvantaged groups in consideration of health and health care differentials.
Originality/Value of Paper
The author reviews the issues of underserved and socially disadvantaged groups in consideration of health and health care differentials and previews this book.
Details
Keywords
Neale R. Chumbler, Samir P. Desai, Justin B. Ingels and Kevin K. Dobbin
As the new Patient Protection and Affordable Care Act (ACA) achieves full implementation in 2014–2015, public perceptions regarding improvement in access and quality of care due…
Abstract
Purpose
As the new Patient Protection and Affordable Care Act (ACA) achieves full implementation in 2014–2015, public perceptions regarding improvement in access and quality of care due to the ACA provide a fertile area for sociological research. The aim of this chapter is to determine if race is independently associated with perceptions of quality of care and access to care after ACA implementation. And, secondarily, we examined if such a relationship remained stable after considering SES (education and income) alone and SES with other relevant individual characteristics.
Methodology/approach
Data come from a telephone survey of a representative sample of Georgia residents aged 18 years or older. For each domain of the dependent variables (quality of care and access to care), three models were fitted with a nested design. The first model included only race. The second model included only race and SES. Model 3 included race, SES, and the following individual characteristics: (1) self-rated health status; (2) sense of coherence (SOC; a construct used to explain why some people are more disposed than others to illness after stressful situations); (3) travel time to doctor’s office; (4) importance of short wait times as doctor’s office; (5) political affiliation; and (6) geographic location (rural/non-rural).
Findings
Race was significantly associated with both the quality of care and the access to care. Non-White respondents were more likely to perceive improvements to both as a result of the ACA. Likewise, respondents with either higher education or income were also more likely to perceive improvements in quality and access as a result of the ACA. However, these associations were partly explained by respondents’ self-reported political affiliations.
Originality/value
Results of this study show that public perceptions toward the ACA and its impact on quality and access to care seem to differ based on an individuals’ race, income level and political affiliation. This may be a reflection of the media blitzkrieg that surrounds the ACA rather than a direct consequence of the policy itself. A concerted effort to develop communication strategies and outreach efforts by race and SES that can better educate the general population on the ACA may alleviate some of the reservations that are inherent to any major policy implementation, especially in terms of healthcare quality and access.
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Keywords
Christopher R. Freed, Shantisha T. Hansberry and Martha I. Arrieta
To examine a local primary health care infrastructure and the reality of primary health care from the perspective of residents of a small, urban community in the southern United…
Abstract
Purpose
To examine a local primary health care infrastructure and the reality of primary health care from the perspective of residents of a small, urban community in the southern United States.
Methodology/approach
Data were derived from 13 semistructured focus groups, plus three semistructured interviews, and were analyzed inductively consistent with a grounded theory approach.
Findings
Structural barriers to the local primary health care infrastructure include transportation, clinic and appointment wait time, and co-payments and health insurance. Hidden barriers consist of knowledge about local health care services, nonphysician gatekeepers, and fear of medical care. Community residents have used home remedies and the emergency department at the local academic medical center to manage these structural and hidden barriers.
Research limitations/implications
Findings might not generalize to primary health care infrastructures in other communities, respondent perspectives can be biased, and the data are subject to various interpretations and conceptual and thematic frameworks. Nevertheless, the structural and hidden barriers to the local primary health care infrastructure have considerably diminished the autonomy community residents have been able to exercise over their decisions about primary health care, ultimately suggesting that efforts concerned with increasing the access of medically underserved groups to primary health care in local communities should recognize the centrality and significance of power.
Originality/value
This study addresses a gap in the sociological literature regarding the impact of specific barriers to primary health care among medically underserved groups.
Details
Keywords
This chapter provides an introduction to the volume along with a brief review of literature on gender, women’s health concerns, and other social factors in health and health care…
Abstract
Purpose
This chapter provides an introduction to the volume along with a brief review of literature on gender, women’s health concerns, and other social factors in health and health care services.
Methodology/approach
Literature review.
Findings
The chapter argues for the importance of greater examination of gender, women’s health concerns, and social factors in health and health care services.
Originality/value
Reviews the issues of gender, women, and social factors and previews this book.
Details
Keywords
This chapter provides both an introduction to the volume and a brief review of literature on technology, communications, and health disparities.
Abstract
Purpose
This chapter provides both an introduction to the volume and a brief review of literature on technology, communications, and health disparities.
Methodology/approach
Literature review.
Findings
The chapter argues for the importance of greater examination of technology, communications, and their linkages to health disparities and other related factors.
Originality/value of chapter
Reviews the topic of technology, communication, and health disparities and previews this book.
Details
Keywords
This chapter provides both an introduction to the volume and a review of literature on health disparities and social determinants.
Abstract
Purpose
This chapter provides both an introduction to the volume and a review of literature on health disparities and social determinants.
Methodology/approach
Literature Review.
Findings
The chapter argues for the importance of greater consideration of social determinants of health disparities. This includes a consideration of race/ethnicity and socioeconomic status factors, geographic and place factors, and disparities especially linked to particular diseases.
Originality/value of paper
Reviews the topic of health disparities and social determinants and previews this book.
Details
Keywords
James W Grimm, Zachary W Brewster and D.Clayton Smith
Community household survey data tested the intervening role (between education and reported health outcomes) of adaptations of Antonovsky’s (1987) tripartite sense of coherence…
Abstract
Community household survey data tested the intervening role (between education and reported health outcomes) of adaptations of Antonovsky’s (1987) tripartite sense of coherence (SOC). Comprehensibility was indexed by clarity and responsiveness of insurance representatives, manageability was measured by problems reported with physician office visits, and meaningfulness was assessed with household members’ community health activities. SOC measures did not link education to either impairments or to health lifestyle scores. Comprehensibility and manageability linked education with self-reported well-being. Education and manageability each reduced impairments, while education, manageability, and meaningfulness increased lifestyle totals. Results help elucidate the influence of education on health.
Existing knowledge about differences in well-being is still incomplete. Based on the previous research, we hypothesize that there is a positive relationship between the use of…
Abstract
Purpose
Existing knowledge about differences in well-being is still incomplete. Based on the previous research, we hypothesize that there is a positive relationship between the use of health information from the media and well-being, and that the strength of this relationship increases with the number of years of schooling.
Methodology/approach
To test the hypotheses we used the data (n = 14,835) from the Eurobarometer survey which was conducted in several European countries (Austria, Belgium, Denmark, Finland, France, Germany, Greece, Ireland, Italy, the Netherlands, Luxembourg, Portugal, Spain, Sweden, and the United Kingdom). We analyzed the data by applying hierarchical multiple regression analysis.
Findings
The findings indicate cross-national differences in the relationship between the use of health information from the media and well-being. Moreover, they suggest that the extent of education matters for this relationship, however its influence differs across countries.
Research limitations/implications
Further research is needed to explain the differences found between the countries. The research results offer some suggestions for further research and for social policy initiatives to reduce educational differences in the relationship between the use of media information on health issues and well-being.
Originality/value
This chapter draws attention to the interrelationship between education, use of media information on health issues and well-being, as knowledge about this is scarce.
Details
Keywords
Marcia Texler Segal, Vasilikie Demos and Jennie Jacobs Kronenfeld
This is a volume about gender, health and medicine broadly defined. It is based on the now widely-held assumption in the sociology of medicine that medicine and health are social…
Abstract
This is a volume about gender, health and medicine broadly defined. It is based on the now widely-held assumption in the sociology of medicine that medicine and health are social constructions and that gender is an embedded part of them (see Lorber, 1997). The essays reveal that embedded with gender in the institution of medicine are race, class, and sexuality. Taken as a whole, the volume offers a critique of exclusively biomedical approaches to personal and public health and calls for more sociological input and qualitative research to help us understand aspects of health and illness. Among the recurrent themes in the seven essays are the medicalization of personal and social problems, the commodification of healthcare, and questions of agency, responsibility and control.
Emily Walton and Denise L. Anthony
Racial and ethnic minorities utilize less healthcare than their similarly situated white counterparts in the United States, resulting in speculation that these actions may stem in…
Abstract
Racial and ethnic minorities utilize less healthcare than their similarly situated white counterparts in the United States, resulting in speculation that these actions may stem in part from less desire for care. In order to adequately understand the role of care-seeking for racial and ethnic disparities in healthcare, we must fully and systematically consider the complex set of social factors that influence healthcare seeking and use.
Data for this study come from a 2005 national survey of community-dwelling Medicare beneficiaries (N = 2,138). We examine racial and ethnic variation in intentions to seek care, grounding our analyses in the behavioral model of healthcare utilization. Our analysis consists of a series of nested multivariate logistic regression models that follow the sequencing of the behavioral model while including additional social factors.
We find that Latino, Black, and Native American older adults express greater preferences for seeking healthcare compared to whites. Worrying about one’s health, having skepticism toward doctors in general, and living in a small city rather than a Metropolitan Area, but not health need, socioeconomic status, or healthcare system characteristics, explain some of the racial and ethnic variation in care-seeking preferences. Overall, we show that even after comprehensively accounting for factors known to influence disparities in utilization, elderly racial and ethnic minorities express greater desire to seek care than whites.
We suggest that future research examine social factors such as unmeasured wealth differences, cultural frameworks, and role identities in healthcare interactions in order to understand differences in care-seeking and, importantly, the relationship between care-seeking and disparities in utilization.
This study represents a systematic analysis of the ways individual, social, and structural context may account for racial and ethnic differences in seeking medical care. We build on healthcare seeking literature by including more comprehensive measures of social relationships, healthcare and system-level characteristics, and exploring a wide variety of health beliefs and expectations. Further, our study investigates care seeking among multiple understudied racial and ethnic groups. We find that racial and ethnic minorities are more likely to say they would seek healthcare than whites, suggesting that guidelines promoting the elicitation and understanding of patient preferences in the context of the clinical interaction is an important step toward reducing utilization disparities. These findings also underscore the notion that health policy should go further to address the broader social factors relating to care-seeking in the first place.