Is doctor-patient race concordance associated with greater satisfaction with care?

We examined a national sample of African American, white, Hispanic, and Asian American respondents to test the hypothesis that doctor-patient race concordance is predictive of patient satisfaction. Our analysis examined racial/ethnic differences in patient satisfaction among patients in multiple combinations of doctor-patient race/ethnicity pairs. Additionally, we outline the determinants of doctor-patient race concordance. The analysis used the 1994 Commonwealth Fund Minority Health Survey to construct a series of multivariate models. We found that for respondents in each race/ethnic group, patients who had a choice in the selection of their physician were more likely to be race concordant. Whites were more likely to be race concordant with their physician compared to African American, Hispanic, and Asian American respondents. Among each race/ethnic group, respondents who were race concordant reported greater satisfaction with their physician compared with respondents who were not race concordant. These findings suggest support for the continuation of efforts to increase the number of minority physicians, while placing greater emphasis on improving the ability of physicians to interact with patients who are not of their own race.     

The race relations “Problematic” in American sociology: Revisiting Niemonen’s case study and critique

Using articles drawn from the years 1996-1999, this paper updates and expands Jack Niemonen’s 1997 TAS analysis of the articles dealing with race and ethnicity in the four core sociology journals. We found a greater rate of publication and several new substantive areas incorporating race and ethnicity, but many of the patterns Niemonen identified remain in place. These articles are highly quantitative, rely heavily on U.S. Census categories, tend to explain racial and ethnic phenomenon as by-products of broader social forces (such as class-based stratification), and subsume these analyses under the headings of alternative subfields. Niemonen used these findings to offer a powerful critique of the status of race and ethnicity in sociology, the under-development of the racial and ethnic relations “problematic,” and its marginalization within the discipline as a whole. To reassess these interpretations and conclusions, we examined the relationships between methodology and substance, and compared the main sample with a subset of more specialized articles focused on race and ethnicity. We found a close connection between quantitative methods and the use of Census definitions of race and ethnicity, but surprisingly few differences between the race and ethnic subset and the more inclusive main sample appeared. These findings allow us to offer support and some important qualifications to Niemonen’s original conclusions. We would like to thank Jordan Bartlett for serving as our research assistant on this project, and the members of the Fall 2000 Race Theory Seminar at the University of Minnesota (Sociology 8211) who participated in and gave commentary on a preliminary version of this study. Thanks also to Professor Jack Niemonen who communicated at length with us about his coding procedures and even consented to code a number of articles for us.     

THE UNRELENTING SIGNIFICANCE OF MINORITY STATUSES: GENDER,ETHNICITY, AND ECONOMIC ATTAINMENT SINCE AFFIRMATIVE ACTION

Using data from the National Longitudinal Survey of Youth and based on the split-class theory of racial and ethnic discrimination, this research examines the effects of gender, ethnicity, education, family characteristics, and geographic residence over time on economic attainment. While gender and family poverty status had greater impacts on overall economic attainment, results reveal that being an ethnic minority is significantly associated with lower wages. Moreover, results reveal that the disadvantage to racial and ethnic minorities has expanded over time or becomes more important at advanced ages. The results lend support to split-class theory and the arguments of Charles V. Willie that race/ethnicity has become a more important, rather than becoming less important indicator of poverty and income. Further, the results refute the notions that Affirmative Action has accomplished its goals or that it leads to reverse discrimination against White males.     

Examining the impact of gender, race/ethnicity, and family factors on mental health issues in a sample of court-involved youth

Faced with anywhere between one half and two thirds of its youth having a diagnosable mental illness, the identification and treatment of mental health concerns is a critically important endeavor for professionals working with youth who have contact with the juvenile justice system. In addition, the literature suggests that factors related to both the family and to the gender of the adolescent must be incorporated into any approach to assessment and intervention within this special population. Further, prior work that has documented the interaction of gender and family issues with adolescent race/ethnicity warrants further empirical attention, as does the intermediary role that the family may play in the development of both internalizing and externalizing behaviors. The present study extends this literature by examining factors related to gender, race/ethnicity, family factors, and mental health issues in a sample of 2,549 Caucasian and African American youth coming to the attention of juvenile courts. Multivariate analysis of variance results indicated significant main effects for gender and race/ethnicity, as well as a significant gender x race/ethnicity interaction for the family and externalizing variables. A multiple group structural equation modeling procedure was employed in order to test the hypothesis that family environment mediates the relationship between gender and mental health problems, as well as to test for potential differences in these relationships as a function of race/ethnicity. Results indicated support for the mediation model in the sample of African American youth but not in the sample of Caucasian youth.     

Life in the Corporation: A Multi-Method Study of the Experiences of Male and Female Asian,Black, Hispanic and White Employees

Organizational experiences of male and female Asian, Black, Hispanic and White managers in a Fortune 500 company were examined using both qualitative and quantitative methods. Oral histories were conducted to identify the antecedents to advancement within this organization. We used focus groups to expand our understanding of these antecedents and to determine differences among the racial/ethnic groups according to gender. Data from a follow-up survey of 1,645 employees were subjected to MANCOVA to determine race/ethnicity and gender effects, controlling for the effect of organizational tenure. Main effects for race/ethnicity were found on three measures and main effects for gender were found on eight measures. Follow-up size-of-effect tests (eta squared) revealed that the strength of the relationship was strong for two significant gender findings and one significant race finding.     

DOMINANT GROUP ETHNIC IDENTITY IN THE UNITED STATES:

This article explores several issues pertaining to the nature of dominant group ethnicity in the United States. Dominant group ethnic identity tends to be less visible and less salient as a result of dominant status. This "hidden' ethnicity has resulted in the systematic un-derdevelopment of the study of race and ethnic relations with regard to the analysis of the role of dominant group ethnicity. In addition, the taken-for-granted nature of dominant group identity has facilitated attempts by the dominant group to maintain its dominant position in the system of ethnic stratification. Finally, this article examines the process through which dominant group ethnicity has evolved and assesses the consequences of these changes for race and ethnic relations in the United States.     

Ethnic Community and Ethnic Boundaries in a “Sauce‐Scented Neighborhood”1

This article investigates the problem of ethnic boundary making in a changing context. Our case is Boston’s North End, a historically Italian neighborhood undergoing changes to its social and physical environment, making the ethnic definition of neighborhood identity and belonging more difficult though not less salient. Consequently, participants in the workings of the neighborhood—residents, business owners, politicians—face challenges of both boundary placement (who is Italian and who is not?), as well as cultural content (what does it mean to be “Italian”?). Rather than viewing Italian ethnicity as simply weakening over time, we argue that the North End shows ethnicity is in a stage of category divergence, where the still‐dominant ethnic identity is juxtaposed not against another ethnic out‐group, but at various times against boundaries of class and race, commercial and community values, even city political boundaries. Drawing on ethnographic research and in‐depth interviews, we describe three group identity frames that illustrate these processes and reveal how Italian ethnicity continues to animate discourse and action in the neighborhood.     

Ethnicity or race,area characteristics,and sexual partner choice among American adolescents

The aim of this paper is to examine the association of individual demographic variables and area characteristics with the characteristics of sexual partners of American adolescents. Data for the study were drawn from the National Longitudinal Study of Adolescent Health. The data indicate that the community characteristics of ethnic or racial composition of the population and region were most strongly related to the ethnicity or race of the partner. Regional differences in the ethnicity or race of partners were significant even after controlling for the ethnic or racial composition of the community. Differences in partner s age, grade, neighborhood, and school or residence were not related to school and community characteristics. In addition, the individual characteristics of age, gender, and race or ethnicity were also related to ethnicity or race of partner.     

Ethnicity or race,area characteristics,and sexual partner choice among American adolescents

The aim of this paper is to examine the association of individual demographic variables and area characteristics with the characteristics of sexual partners of American adolescents. Data for the study were drawn from the National Longitudinal Study of Adolescent Health. The data indicate that the community characteristics of ethnic or racial composition of the population and region were most strongly related to the ethnicity or race of the partner. Regional differences in the ethnicity or race of partners were significant even after controlling for the ethnic or racial composition of the community. Differences in partner's age, grade, neighborhood, and school or residence were not related to school and community characteristics. In addition, the individual characteristics of age, gender, and race or ethnicity were also related to ethnicity or race of partner.     

Structural Influences on Racial and Ethnic Disparities in Women's Health Care

This paper summarizes recent research about several structural influences on racial and ethnic disparities in women's health care. While disparities in women's health care access and quality emanate from a number of sources, this paper focuses on the intersection between race/ethnicity and several structural factors (access to insurance coverage, discrimination, neighborhood characteristics, and social isolation). We identify gaps in the literature and suggest directions for future research. Particularly needed are gender studies of the impact of race/ethnicity that transcend the black–white dichotomy, that attend to location, that examine variation in social networks, and that clarify the impact of discrimination on women's health care.     

THE IMPLICATIONS OF CHOOSING "NO RACE" ON THE SALIENCE OF HISPANIC IDENTITY: How Racial and Ethnic Backgrounds Intersect among Hispanic Adolescents

Using data from the National Longitudinal Study of Adolescent Health (Add Health), a nationally representative sample of youth from 7th to 12th grades, we examined how racial and ethnic identification overlap among Hispanic adolescents. We evaluated the relative proximity between race and ethnic identifiers among Hispanics. Empirical analyses suggest that the racial identification of other students at school has a significant impact on the odds of choosing particular racial identifiers. Both Hispanic and non-Hispanic schoolmates' racial identification is related to the racial identification of Hispanic adolescents. We also find evidence that both ethnicity and race are distinct stratifiers among Hispanics. Overall, our findings support the notion that Hispanic may be a more meaningful "racial" identity than black, white, or other, but we also find that racial identification and ethnic background are still important and meaningful dividers among Hispanic youth.     

Acceptance of International Students: Host and Sojourner Characteristics

This study was designed to investigate how both characteristics of the sojourner and of the host affect how American students regard and treat international students in the United States. Undergraduates (N=198) evaluated college admission applications. All applicant information was held constant except for gender, race, and nationality. After they completed a questionnaire evaluating the foreign applicant, they volunteered to offer various levels of hospitality to foreign students. In terms of host characteristics, the results indicate that women were more favorable than men in their ratings of foreign students, and Minorities (48% of the sample) were more favorable than Whites in their volunteerism. Regarding characteristics of the foreigner, American students responded equally to male and female foreigners; equally to White and Black foreigners; but they evaluated Canadian foreigners more favorably than Algerian ones. There was an interaction between gender of the host and foreigner in a few instances, and several instances of an interaction between race of the host and race of the foreigner. These results partially support the hypotheses and suggest that what makes a difference in how Americans respond to foreigners is cultural similarity and shared ethnic minority status.     

The material and the symbolic in theorizing social stratification: issues of gender, ethnicity and class

Within most approaches to stratification gender and ethnicity are seen to pertain primarily to the symbolic or cultural realms, whilst class is regarded as pertaining to material inequality. This constructs gender and ethnic positioning as entailing honour, deference, worth, value and differential treatment (sometimes expressed through the notion of 'status'), but the social relations around these are themselves not seen as constitutive of social stratification. In this paper I will rethink social stratification away from the polarity between the material and the symbolic, and argue that material inequality, as a set of outcomes relating to life conditions, life chances and solidary processes, is informed by claims and struggles over resources of different types, undertaken in terms of gender, ethnicity/race and class. This formulation allows us to include these categorial formations, alongside class, as important elements of social stratification i.e. as determining the allocation of socially valued resources and social places/locations.     

Coping with perceived discrimination: does ethnic identity protect mental health?

Using data (N = 2,109) from a large-scale epidemiological study of Filipino Americans, this study examines whether ethnic identity is linked to mental health and reduces the stress of discrimination. The strength of identification with an ethnic group is found to be directly associated with fewer depressive symptoms. In other words, having a sense of ethnic pride, involvement in ethinic practices, and cultural commitment to one's racial/ethnic group may protect mental health. Self-reports of racial/ethnic discrimination over a lifetime and everyday discrimination in the past month not due to race/ethnicity are associated with increased levels of depressive symptoms. Yet ethnic identity buffers the stress of racial/ethnic discrimination. This suggests that ethnic identity is a coping resource for racial/ethnic minorities that should not be overlooked. The strong link between ethnic identity and better mental health has implications for social-psychological theories on race/ethnicity and assimilation in the United States.     

Grandfather caregivers: race and ethnic differences in poverty

We use data from the 2006 American Community Survey to examine race and ethnic differences in the effects of marital status and co-residence of the middle generation on the likelihood of poverty among grandfathers who have primary responsibility for co-resident grandchildren (N = 3,379). Logistic regression results indicate that race/ethnicity and household composition are significant predictors of poverty for grandfather caregivers: non-Hispanic white grandfathers, those who are married, and those with a co-resident middle generation are the least likely to be poor. The effects of race/ethnicity, marital status, and the presence of a middle generation are, however, contingent upon one another. Specifically, the negative effect of being married is lower among grandfathers who are Hispanic, African American, non-Hispanic, and non-Hispanics of other race/ethnic groups compared to whites. In addition, having a middle generation in the home has a larger negative effect on poverty for race/ethnic minority grandfathers than for non-Hispanic whites. Finally, the combined effects of marriage and a middle generation vary across race/ethnic group and are associated with lower chances of poverty among some groups compared with others. We use the theory of cumulative disadvantage to interpret these findings and suggest that race/ethnicity and household composition are synergistically related to economic resources for grandfather caregivers.     

Becoming culturally competent in ethnic psychopharmacology

People from minority backgrounds who have a mental illness experience double discrimination associated with both mental illness and race. In 2001, the Surgeon General's landmark report on race, culture, ethnicity, and mental health compellingly documented racial and ethnic disparities in mental heath care related to issues of misdiagnosis, underuse, overrepresentation, and improper treatment. The report called for sound research, including investigation into the area of psychopharmacology, to determine the extent to which the variability of an individual's response to medications is accounted for by factors related to race, ethnicity, age, gender, family history, or lifestyle. This article will focus on the realm of ethnic psychopharmacology and propose a practice model for nurses to become culturally competent in the area of ethnic psychopharmacology.     

The cost of caregiving: wage loss among caregivers of elderly and disabled adults and children with special needs

Sixty-one percent of the adults caring for elderly and disabled family members and 53% of parents of children with special needs are employed. Yet studies examining the experience of employed caregivers of children with special needs and elderly or disabled adult family members have not examined the impact on earnings or the workplace policies that might help reduce the conflicts between work and caregiving. This study begins to fill this gap using data from a nationally representative US survey of American adults. We find that employees who live with a child with a health problem are 48% more likely to have lost wages. Each adult with health issues that an employee is responsible for raises the chances of wage loss by 29%. At the same time, access to paid leave for family health needs reduces the likelihood of wage loss by 30%, and having a supportive supervisor reduces the odds of experiencing wage loss by 37%. Implications for employers and US policy-makers are discussed.     

Racial,Ethnic, and National Boundaries: Sexual Intersections and Symbolic Interactions

Sex and race are strained, if not strange, bedfellows. Sexual depictions and denigrations of racial, ethnic, and national “others” and the regulation of in‐group sexual behavior are important mechanisms by which ethnic boundaries are constructed, maintained, and defended. Race, ethnicity, and the nation are sexualized, and sexuality is racialized, ethnicized, and nationalized. The sexual systems that prop up ethnic boundaries and define ethnic identities and communities tend to be inherently conservative blueprints for ethnosexual living. These systems stress endogamy, heterosexuality and reproduction under the rubric of traditional, often patriarchal family life for ethnic group members and tend to demonize and denigrate the sexuality of those outside ethnic boundaries or of those within ethnic communities who do not conform to heteronormative, heteroconventional models of sexuality. I present several examples of the intersections of race, ethnicity, nationalism, and sexuality/ies from U.S. and international settings, and I argue that the symbolic interaction between ethnicity and sexuality is central to their mutual constitution.     

Analyzing Cultural Models in Adolescent Accounts of Romantic Relationships

Research on academic achievement has led the way in demonstrating how culturally constructed meanings shape adolescent scholastic behavior. The aim of this research is to move this standpoint of analysis more centrally into the area of adolescent dating and sexuality by focusing on the cultural components of adolescent romantic relationships. This study examines cultural models of romantic relationships in Vernacular Term Interviews of 68 African American and 59 Mexican American 11th‐ and 12th‐grade female and male high school students. A subset of interviews was analyzed first qualitatively to identify the models. The models then were committed to a manual and 4 analytic coders established reliability before coding all interviews blind as to race/ethnicity and gender of the adolescent. The resultant data were summarized by a principal components analysis that yielded 5 interpretable factors. Factor scores were computed and compared for gender and race/ethnicity differences. The results demonstrated clear differences in factors by race/ethnicity but not by gender. Results are discussed in relation to cultural differences described in the literature for these 2 populations.     

Hispanic Immigration and Black Violence at the Macro‐Level: Examining the Conditioning Effect of Victim Race/Ethnicity

Much attention has been devoted to the relationship between Hispanic immigration and violent offending at the macro‐level, including how it varies across racial and ethnic groups. Unfortunately, little attention has been paid to the conditioning effect of the race/ethnicity of the victim, or how Hispanic immigration is associated with crime by one racial/ethnic group against members of the same or different groups. Using National Incident‐Based Reporting System offending estimates and American Community Survey data, we examine the association between Hispanic immigration and black intra‐ and intergroup (black‐on‐white and black‐on‐Hispanic) homicide, robbery, and serious index violence in over 350 U.S. communities. We employ advanced imputation methods to address missing data that have constrained much prior research, as well as utilize crime measures adjusted for the likelihood of random contact between groups. Findings suggest that (1) Hispanic immigration has a positive association with black violence on the whole, but that (2) this association is conditioned by the race/ethnicity of the victim. Our results reinforce the importance of distinguishing across offender–victim dyads in research on the immigration–crime nexus, particularly in light of competing theoretical expectations. Directions for future research and policy are discussed.