The New Destination Disadvantage: Disparities in Hispanic Health Insurance Coverage Rates in Metropolitan and Nonmetropolitan New and Established Destinations

Hispanics have the lowest health insurance rates of any racial or ethnic group, but rates vary significantly across the United States. The unprecedented growth of the Hispanic population since 1990 in rural areas with previously small or nonexistent Hispanic populations raises questions about disparities in access to health insurance coverage. Identifying spatial disparities in Hispanic health insurance rates can illuminate the specific contexts within which Hispanics are least likely to have health care access and inform policy approaches for increasing coverage in different spatial contexts. Using county‐level data from the 2009–13 American Community Survey, I find that early new destinations (i.e., those that experienced rapid Hispanic population growth during the 1990s) have the lowest Hispanic adult health insurance coverage rates, with little variation by metropolitan status. Conversely, among the most recent new destinations that experienced significant Hispanic population growth during the first decade of the 2000s, metropolitan counties have Hispanic health insurance rates that are similar to established destinations, but rural counties have Hispanic health insurance rates that are significantly lower than those in established destinations. Findings demonstrate that the new destination disadvantage is driven entirely by higher concentrations of immigrant noncitizen Hispanics in these counties, but labor market conditions were salient drivers of the spatially uneven distribution of foreign‐born noncitizen Hispanics to new destinations, particularly in rural areas.     

Becoming Overweight without Gaining a Pound: Weight Evaluations and the Social Integration of Mexicans in the United States

Mexican women gain weight with increasing duration in the United States. In the United States, body dissatisfaction tends to be associated with depression, disordered eating, and incongruent weight evaluations, particularly among white women and women of higher socioeconomic status. However, it remains unclear how being overweight and obesity are interpreted by Mexican women. Using comparable data of women aged 20–64 from both Mexico (the 2006 Encuesta Nacional de Salud y Nutricion; N = 17,012) and the United States (the 1999–2009 National Health and Nutrition Examination Surveys; N = 8,487), we compare weight status evaluations among Mexican nationals, Mexican immigrants, US‐born Mexicans, US‐born non‐Hispanic whites, and US‐born non‐Hispanic blacks. Logistic regression analyses, which control for demographic and socioeconomic variables and measured body mass index and adjust for the likelihood of migration for Mexican nationals, indicate that the tendency to self‐evaluate as overweight among Mexicans converges with levels among non‐Hispanic whites and diverges from blacks over time in the United States. Overall, the results suggest a US integration process in which Mexican‐American women's less critical self‐evaluations originate in Mexico but fade with time in the United States as they gradually adopt US white norms for thinner body sizes. These results are discussed in light of prior research about social comparison and negative health assimilation.     

Educational differences in age-related patterns of disease: reconsidering the cumulative disadvantage and age-as-leveler hypotheses

Some studies suggest that the relationship between education and health strengthens with age (cumulative disadvantage hypothesis), while other studies find that it weakens (age-as-leveler hypothesis). This research addresses this inconsistency by differentiating individual-level changes in health from those occurring at the aggregate level due to selective mortality. Using retrospective and prospective data from a nationally representative sample of US. adults, I examine educational differences in age-specific rates of disease prevalence, incidence, and survival. At the aggregate level, I find that educational differences in disease prevalence are largest at mid-life and then decline. At the individual level, however, disease incidence and mortality increase with age at a greater rate for less-educated persons compared to the well educated. These findings suggest that the cumulative disadvantage hypothesis explains how education affects the health of individuals with increasing age, whereas the leveling hypothesis describes the aggregated by-product of these educational disparities in health decline.     

Gender and physical health: a study of African American and Caribbean black adults

Although gender disparities in health in the United States remain a primary concern among health professionals, less is known about this phenomenon within the black American population. Using the National Survey of American Life, the author examines gender differences in self-rated health, chronic illness, and functional limitations among African Americans (n = 3,330) and Caribbean blacks (n = 1,562) and the extent to which the availability of resources explains these differences. The results reveal a consistent disadvantage among African American women across indicators of health. The gender-health relationship among Caribbean blacks is somewhat weaker, but there is a health disadvantage for immigrant women and U.S.-born Caribbean men when certain resources are taken into account. These findings illustrate the importance of the intersections of race, ethnicity, and nativity in our understanding of gender differences in health.     

Assessing the Relationship Between Gender,Household Structure,and Net Worth in the United States

This paper examines wealth disparities by gender and household structure in the United States using data from the 1998–2013 Survey of Consumer Finances. Following studies of economic insecurity, we placed households at the center of our analysis to highlight the interconnected nature of wealth with multiple aspects of family structure. We investigated net worth by both gender and household structure, which includes variation by partnership status and the presence of other adult relatives and their roles within the household. We found that wealth disparities were largest among single adult households, but these varied by gender. Female single adult households held some of the lowest levels of net worth, but after accounting for key explanations of wealth inequality, single male households actually held greater wealth than two-adult partnered households. This relationship further depended on the presence of extended family members, where gender disparities were smaller among households with other relatives present.     

Latino Adolescent Reproductive and Sexual Health Behaviors and Outcomes: Research Informed Guidance for Agency-Based Practitioners

Latinos are the largest and fastest growing minority youth group in the United States. Currently, Latino adolescents experience higher rates of teen pregnancy compared to any other racial or ethnic group and have disproportionately high levels of sexually transmitted infections and HIV. Latino teens are also affected by a number of social problems such as school dropout, poverty, depression and limited access to healthcare, which contributes to disparities in reproductive health outcomes for this population. Relatively few intervention research studies and programs have been dedicated to reducing sexual risk among Latino youth, despite their particular vulnerabilities in experiencing negative reproductive health outcomes. We provide recommendations for identifying the unique reproductive health needs of Latino youth and specific applied strategies so that agency-based social workers and other providers can develop family-based interventions that improve adolescent Latino sexual and reproductive health.     

DISAGGREGATING THE EFFECTS OF RACIAL AND ECONOMIC INEQUALITY ON EARLY TWENTIETH-CENTURY EXECUTION RATES

This article examines how class inequality may have influenced the historical use of executions in the United States, both within the South and outside of the South. Specifically, this article asks whether executions acted as a mechanism to maintain an exploitative class system in the entire United States, just as lynching maintained a racial caste system in the South. Much of the literature on the historical determinants of macrolevel execution rates has examined these disparities in terms of racial inequality. This study demonstrates that racial inequality alone cannot account for the high number of executions that typified the early twentieth century United States and contends that it is important to expand our understanding of the effects of class inequality on both historical and contemporary trends in executions.     

The Homeownership Hierarchies of Canada and the United States: The Housing Patterns of White and Non‐White Immigrants of the Past Thirty Years1

In this paper two gaps in North American immigrant homeownership research are addressed. The first concerns the lack of studies (especially in Canada) that identify changes in homeownership rates by skin color over time, and the second relates to the shortage of comparative research between Canada and the United States on this topic. In this paper the homeownership levels and attainment rates of Black, Chinese, Filipino, White, and South Asian immigrants are compared in Canada and the United States for 1970/1971–2000/2001. For the most part, greater similarities than differences are found between the two countries. Both Canadian and U.S. Chinese and White immigrants have the highest adjusted homeownership rates of all groups, at times even exceeding comparably positioned native‐born households. Black immigrants, on the other hand, tend to have the lowest ownership rates of all groups, particularly in the United States, with Filipinos and South Asians situated between these extremes. Most of these differences stem from disparities that exist at arrival, however, and not from differential advancement into homeownership.     

Social Democratic Programs: What Is Worth Modeling (for the United States)

This article argues that the United States could improve social welfare outcomes by adopting effective and efficient elements from nations that excel in social welfare areas of employment, education, health care and income support. Using secondary data for comparison the article explores four foreign model programs that are worth modeling for the United States, which include employment in Norway, education in Finland, and health care and income support in Sweden. Each program is framed within its national context and is qualitatively described and linked to three essential social democratic values: universalism, equality and comprehensiveness     

DO MINIMUM WAGE INCREASES INFLUENCE WORKER HEALTH?

This study investigates whether minimum wage increases impact worker health in the United States. We consider self‐reported measures of general, mental, and physical health. We use data on lesser‐skilled workers from the 1993 to 2014 Behavioral Risk Factor Surveillance Survey. Among men, we find no evidence that minimum wage increases improve health; instead, we find that such increases lead to worse health outcomes, particularly among unemployed men. We find both worsening general health and improved mental health following minimum wage increases among women. These findings broaden our understanding of the full impacts of minimum wage increases on lesser‐skill workers. (JEL I1, I11, I18)     

Racialized Labour Market Incorporation? African Immigrants and the Role of Education‐Occupation Mismatch in Earnings

U.S. immigration policy debates increasingly center on attracting highly‐skilled immigrants. African immigrants, in particular, exhibit high levels of over‐education. But questions remain about whether African immigrants’ skills are appropriately utilized in the U.S. labour market. This paper uses U.S. Census and American Community Survey data to determine whether Africans’ over‐education leads to a corresponding wage disadvantage. I also investigate whether search and match, imperfect transferability, or queuing theory describes African immigrants’ wage outcomes. I find that, while African and Asian immigrants have similarly high rates of college education and over‐education, Africans experience significantly larger wage disadvantages due to over‐education. African immigrants’ low wages are closer to that of U.S. and Caribbean‐born blacks indicating that queuing theory describes their wage disadvantage. These findings suggest the need for policy addressing racial disparities in the labour market rather than new immigration policy.     

Are There Differing Patterns of Health Care Access and Utilization Among Male Sexual Minorities in the United States?

Disparities in health care access and utilization among male sexual minorities in the United States were explored using data from the National Survey of Family Growth (N = 8,846). Bisexual men had a small disadvantage in health insurance coverage but no differences were found in health insurance or consistency of coverage between gay and heterosexual men. Gay men were more likely to have a usual place of care, but were not more likely to utilize services. The current study provides inconclusive evidence for systematic disparities in health care access and utilization among gay and bisexual men in the United States.     

Effect of Educational Expansion on Educational Inequality in Post-industrialized Societies: A Cross-cultural Comparison of Japan and the United States of America

Abstract: This paper analyzes the relationship between educational expansion and educational inequality. I first reconsider the conceptual basis of educational expansion, noting that in post‐industrialized societies, people's educational attainment is no longer measurable in a simple temporal increase because of the recent leveling‐off in the younger generation. I then review the theoretical framework of educational inequality. After presenting a summary of related studies, I provide a multilevel regression model that examines the macro/cohort influence of educational expansion on educational inequality in Japan and the United States. The following propositions are derived from my analyses: Educational expansion has functioned to dissolve both the socio‐economic and the cultural‐educational reproduction processes in Japan; meanwhile, inequality in terms of micro coefficients remains. In the United States, both the magnitude of gender inequality and the influence of the socio‐economic reproduction process are smaller than in Japan. The macro/cohort effects of educational expansion are generally smaller in the United States. This is true despite the fact that educational expansion significantly dissolves gender inequality in the United States, while educational expansion has little to do with gender equalization in Japan. My comparison of the model's fit concludes that the trajectory of educational equalization follows the two‐fold consequence of educational expansion. In sum, these results show that in conjunction with the non‐linear sequence of educational attainment in the post‐industrialized phase of development, the macro/cohort influence of educational expansion as well as the micro structure of educational inequality undergo gradual transformations.     

Theorizing Inequality: Comparative Policy Regimes,Gender, and Everyday Lives

Sociological explanations of inequality are incomplete unless they fully recognize the importance of social policy regimes, the policy logics embedded within them, and how policy arrangements work to stratify and shape daily lives. In this address, I develop my arguments by examining two overlapping struggles of everyday life in the contemporary United States: balancing work and family on the one hand, and securing health‐care services, both formal medical care and informal family care, on the other. Both struggles involve care deficits that are significantly more serious in the United States than in other high‐income countries, in part because our policy regime contributes to rather than counters the gendered roots of work–family conflict. Comparative studies hold a key to better understanding the link between policy regimes and everyday lives, as illustrated by the author's own comparative research in Finland and in the United States In terms of policies and policy logics that promote gender equity, paid parental leave for fathers has received much recent attention from social science scholars. Sociologists are challenged to become aware of comparative social policy scholarship and to approach inequalities and the related daily conflicts and struggles—such as over care deficits—by including this work in their analyses.     

Race-Ethnicity and Health Trajectories: Tests of Three Hypotheses across Multiple Groups and Health Outcomes

Racial-ethnic disparities in static levels of health are well documented. Less is known about racial-ethnic differences in age trajectories of health. The few studies on this topic have examined only single health outcomes and focused on black-white disparities. This study extends prior research by using a life course perspective, panel data from the Health and Retirement Study, and multilevel growth curve models to investigate racial-ethnic differences in the trajectories of serious conditions and functional limitations among blacks, Mexican Americans, and whites. We test three hypotheses on the nature of racial-ethnic disparities in health across the life course (aging-as-leveler, persistent inequality, and cumulative disadvantage). Results controlling for mortality selection reveal that support for the hypotheses varies by health outcome, racial-ethnic group, and life stage. Controlling for childhood socioeconomic status, adult social and economic resources, and health behaviors reduces but does not eliminate racial-ethnic disparities in health trajectories.     

SOCIAL DYNAMICS OF OBESITY

We explain the recent increases in obesity in the United States with a model involving falling food prices, endogenous social body weight norms, and heterogeneous human metabolism. Calibrating an analytical choice model to American women in the 30- to 60-yr-old age bracket, we compare the predicted weight distributions to National Health and Nutrition Examination survey data spanning (intermittently) the years 1976–2000. The model, the first to describe explicitly complete weight distribution dynamics for this group, predicts average weights and obesity rates with considerable accuracy and captures a significant portion of the recent growth in upper quantile weights. ( JEL D11, I12, Z13)     

Drivers of change: Examining the effects of gender equality on child nutrition

India has the world's highest burden of child undernutrition. Lack of income is considered as one of its primary causes. However, evidence suggests that despite steady economic growth and investments in social services directed towards child welfare, undernutrition rates continue to rise. Thus indicating, that there are other societal factors impacting child undernutrition. Previous studies indicate that countries with higher gender inequality have worse health outcomes for women and children. India, particularly in the northern states, has deep-rooted gender biases, leading to disproportionately worse outcomes for women and children. This study uses cross sectional data from the India National Family Health Survey Round-3 (NFHS-3) to examine the immediate and underlying effect of gender inequality on child nutritional status. The sample includes urban married women between 15 and 49 years (N = 9092) who have at least one living child between 0 and 5 years. Findings highlight the significant effect of autonomy and health related awareness on child nutritional status, when the relationship is mediated by maternal health. Implications for policy and practice are provided.     

Women in India: The Context and Impact of HIV/AIDS

ABSTRACT

The response to the HIV/AIDS epidemic on the Indian subcontinent has been hampered by several factors, including societal stigma, lack of educational resources, lack of economic opportunities, and the competing priorities for a nation just growing and developing an infrastructure for education, industry, and health. In particular, Indian women are silent victims in this epidemic because they do not readily have a respected voice in decision making and priority setting for the government. The epidemic is increasingly affecting and infecting Indian women (e.g., female commercial sex workers, married women, and pregnant women). The status of Indian women has placed them at extreme disadvantage because India is a country with socially progressive laws but has been slow to change its social norms. The reported HIV prevalence is low although many researchers agree a large amount of underreporting occurs. For India to address this emerging epidemic among women appropriately, it should focus on three intervention areas: (1) short-term solutions such as treatment options for those already infected with HIV to prevent further infection to sexual partners and children; (2) intermediate solutions such as education for those who are uninfected but engaging in behaviors that may put them at risk, such as injection drug use, engaging in commercial sex work, engaging in extramarital sexual relations, and having sexual partners who are not monogamous; and 3) long-term solutions such as addressing the root causes of inequality (e.g., disparities in education and employment and unwillingness to change social norms).     

Missing Teeth: Reviewing the Sociology of Oral Health and Healthcare

Both the US Surgeon General and the World Health Organization have called for further social scientific research on the social determinants of oral health. Oral disease can have detrimental effects on quality of life, having been linked with physical, mental, and social impairments. This article reviews the recent literature pertaining to the sociology of oral health and healthcare. The purpose of this review is to summarize and revive a necessary field. In order to maintain a focus on the United States and expand into other social science disciplines, relevant anthropological works were also included. The review discusses five key areas in both the sociology and anthropology of oral health. Of the 25 included articles, research maintained a focus on the dental profession, the construction of oral health, the mouth and the social self, social factors in dental care, and cultural assumptions of oral health. While the reviewed studies have aided in closing the gap, much of the research has been conducted outside of the United States, has used oral health as a case study for larger arguments, and has not considered the role of social inequality. Future research is necessary to more fully frame oral health and healthcare in society.