Therapist Effects on Disparities Experienced by Minorities Receiving Services for Mental Illness

OBJECTIVES: The authors examine if some of the reason clients from racial and ethnic minority groups experience outcome disparities is explained by their therapists. METHOD: Data from 98 clients (19% minority) and 14 therapists at two community mental health agencies where clients from racial and ethnic minority groups were experiencing outcome disparities were analyzed using hierarchical linear modeling with treatment outcomes at Level 1, client factors at Level 2, and therapists at Level 3. RESULTS: There were substantial therapist effects that moderated the relationship between clients' race and treatment outcomes (outcome disparities). Therapists accounted for 28.7% of the variability in outcome disparities. CONCLUSIONS: Therapists are linked to outcome disparities and appear to play a substantial role in why disparities occur.     

The Impact of Social Capital on Labor Force Participation: Evidence from the 2000 Social Capital Benchmark Survey

Objectives . Few studies apply the concept of social capital to labor force participation. In this research, I study the relationship between friendship networks and labor force participation as represented by employment and hours worked. Methods . I test five hypotheses representing social capital with network structure, network quality, and network diversity using nationally representative data from the 2000 Social Capital Benchmark Survey. Since this survey enables comparisons across racial/ethnic and gender groups, I am also able to specify how social capital interacts with race/ethnicity and gender to influence labor force participation, while controlling for other prominent theoretical concerns such as human capital theory. Results . I find that friendship networks are generally positively related with increased labor force participation. Further, I find significant social capital differences based on race/ethnicity and gender. Conclusions . I illustrate that social capital can be applied across a broader racial/ethnic/gender spectrum. The findings suggest that programs that attempt to bring valuable labor market information to individuals and communities lacking employment–related information are likely to be effective in reducing inequality, especially if combined with programs for developing human capital.     

The Greater Complexity of Lived Race: An Extension of Harris and Sim*

Objectives. Harris and Sim (2002) recently demonstrated the complexity of lived race by exploring patterns of racial self‐identification. They raised important sociological questions about the role of context in racial self‐identification, but offered an incomplete picture of ethnic fluidity by excluding Hispanics from their analyses. We address this limitation with data on Hispanics from the National Longitudinal Study of Adolescent Health (Add Health). Methods. Our social‐psychological approach, using compositional analysis, focuses on the lived experience of race and ethnicity as qualitatively similar conceptual categories. Results. Informed by the cognitive process of social categorization, we find that considerably more individuals show fluidity in racial and ethnic self‐identification across contexts than suggested by Harris and Sim. Conclusions. Harris and Sim's thesis is even more strongly supported by these findings than in their original analysis, and our findings reinforce their challenge to the assumed stability of racial and ethnic measurement in sociology. We conclude by proposing a change in the measurement of race/ethnicity in America.     

Do Hispanic and Asian Adolescents Practice Panethnicity in Friendship Choices?*

Objectives. Using data from the National Longitudinal Study of Adolescent Health (Add Health), we investigate whether Asian and Latino youth value racial boundaries more than ethnic boundaries. We evaluate the relative preferences of same‐ethnic, same‐race (but different‐ethnic), and different‐race friends. Methods. We use multilevel multinomial logistic regression models to examine the odds of choosing same‐ethnic, different‐ethnic (but same‐race), and different‐race friends net of the opportunity to interact. Results. We find strong effects of school racial and ethnic composition, immigrant status, and parental education on the likelihood of crossing boundaries in the selection of friends. In addition, we develop a new scale of panethnicity and find substantial ethnic group variation in panethnic sentiment. Conclusion. We find an overwhelming preference for same‐ethnic peers over same‐race (different‐ethnic) and different‐race peers.     

Options: Racial/Ethnic Identification of Children of Intermarried Couples*

Objective. Whites of various European ethnic backgrounds usually have weak ethnic attachment and have options to identify their ethnic identity ( Waters, 1990 ). What about children born to interracially married couples? Methods. I use 1990 Census data—the last census in which only one race could be chosen—to examine how African American‐white, Latino‐white, Asian American‐white, and American Indian‐white couples identify their children's race/ethnicity. Results. Children of African American‐white couples are least likely to be identified as white, while children of Asian American‐white couples are most likely to be identified as white. Intermarried couples in which the minority spouse is male, native born, or has no white ancestry are more likely to identify their children as minorities than are those in which the minority spouse is female, foreign born, or has part white ancestry. In addition, neighborhood minority concentration increases the likelihood that biracial children are identified as minorities. Conclusion. This study shows that choices of racial and ethnic identification of multiracial children are not as optional as for whites of various European ethnic backgrounds. They are influenced by race/ethnicity of the minority parent, intermarried couples' characteristics, and neighborhood compositions.     

Racial Diversity,Representative Bureaucracy,and Equity in Multiracial School Districts*

Objective. This study examines the conditions under which minorities will face policy inequity within the educational system. It turns to the theory of representative bureaucracy as one possible explanation, and extends the literature by considering whether African‐American students benefit from the presence of Latinos on teaching faculties and vice versa. This study also tests competing theories of how racial context influences minority educational policy outcomes. Methods. This study combines original survey data with data gathered by the U.S. Census to predict levels of academic grouping in U.S. school districts as reported by the Office of Civil Rights. Results. Minority teachers lower levels of discrimination among all minority students, not just co‐ethnics. Moreover, minority teachers do so consistently and with a substantive impact that occasionally rivals that of co‐ethnic teachers. The findings also suggest that greater levels of racial/ethnic diversity within a district are associated with lower levels of discrimination. Conclusion. Theories of race relations must move beyond black‐Anglo or Latino‐Anglo relations to consider how multiple racial/ethnic groups interact, and how such interactions affect the lives of minority groups differently.     

The Influence of Sociodemographic and Psychosocial Factors on Advance Care Planning

This study investigated sociodemographic and psychosocial factors that enhance or impede the completion of advance care planning, analyzing data from the Health and Retirement Study. The analytic subsample included the panel participants who died between 2006 and 2010 and who had answered the psychosocial and lifestyle questionnaire when they were alive. Multinomial logistic regression was executed to answer the research question (N = 1,056). The study found that persons who were older, who were women, who identified themselves as White, and who had higher levels of income and education were more likely to be motivated to complete advance care planning. Having greater sense of control was found to weaken the adverse relationship between being African American and the completion of advance directives. Having cancer, suffering from the illnesses for longer periods of time, and having experience of nursing home institutionalization also predicted the completion of advance care planning. Implications include incorporating a culturally tailored approach for racial/ethnic minorities and using advance directives that are clear and easily understood. In addition, future research needs to include a larger minority population and examine the extent to which variations between racial/ethnic groups exist in relation to advance care planning.     

School context and American Indian substance use

The present study extends prior research exploring the role of school contextual factors in predicting individual adolescent substance use by examining how a school’s racial composition is associated with American Indian adolescent tobacco and marijuana use. Using a subsample of 523 American Indian students from the restricted use Add Health data, we consider both individual and school contextual factors across 99 schools. Our results suggest that a school’s racial composition is associated with individual tobacco and marijuana use among American Indian youth, but in different ways depending upon the substance. Our findings illustrate the importance of extending research on the correlates of substance use for racial and ethnic minorities beyond studies examining African-Americans and/or Hispanics.     

Home Modifications among Community-Dwelling Older Adults: A Closer Look at Race and Ethnicity

ABSTRACT

This study investigated racial and ethnic differences in home modification use. Data from the 2011 National Health and Aging Trends Study were used (n=6,764). Compared with non-Hispanic Whites, Hispanics were less likely to have a grab bar (odds ratio (OR) = 0.6), bath seat (OR = 0.8), or raised toilet (OR = 0.6). Non-Hispanic Blacks were less likely to have a grab bar (OR = 0.7) or bath seat (OR = 0.7) than non-Hispanic Whites, but more likely to have a raised toilet (OR = 1.3). English proficiency largely explained ethnic differences, while health status partially accounted for racial disparities.     

The inclusion of minority groups in clinical trials: problems of under representation and under reporting of data

Objective: To evaluate the representation of minority groups in randomized control trials (RCTs), and the frequency with which this information is reported. Study Design: Reviewers collected data on the racial/ethnic composition of study samples from all RCTs published in six leading medical journals in 1999. Results: Of the 280 RCTs, most (204, 71.3%) provided no information on the race/ethnicity of participants. Of the 89 U.S.-based RCTs, 50 (56.1%) reported their minority distribution. Relative to other trials, those funded by the National Institute of Health (NIH) (n = 52) were more likely to report race/ethnicity data (55.8% vs. 23.7%; x2 = 20.9, p <_0.001) and to include nonwhite participants (13.5 % vs. 12.5%; x2=22.7, p<_0.001). Conclusion: Minority groups are currently under-represented in clinical trials. Information on the race and ethnicity of clinical trial participants is currently underreported in six leading medical journals. Reporting of minority group information was significantly better only in NIH funded trials, which also were more likely to include nonwhite participants. This suggests that mandatory reporting policies may have a positive effect on both reporting and representation.     

The role of social desirability bias and racial/ethnic composition on the relation between education and attitude toward immigration restrictionism

Social scientists note individuals tend to respond favorably to sensitive topics in surveys, but few consider factors triggering these responses. This study uses unique data to examine respondents’ racial/ethnic attitude under direct and indirect modes of elicitation. In particular, the list experiment provides a cloak of anonymity to a random subsample of individuals that allows them to respond truthfully about their racial/ethnic attitudes. By comparing responses between administration modes, this study evaluates whether social desirability pressures mediate, and racial/ethnic composition moderate, the relation between education and racial/ethnic attitudes. Findings indicate an initial positive relation between education and racial/ethnic attitudes, but desirability bias mainly drives this relation. Furthermore, there is some support racial/ethnic composition moderates the influence of social desirability on education.     

Is it racism? Skepticism and resistance towards ethnic minority care workers among older care recipients

The study investigates the occurrence and character of skepticism and resistance towards ethnic minority care workers among older care recipients in a municipality in Sweden. Twelve representatives of caregiver organizations were interviewed about their experience of this phenomenon. Three additional interviews were conducted with ethnic minority care workers. Representatives described the problem as rare and mostly occurring as language difficulties or as a temporary problem characterized as a fear of the unknown among some care recipients. They tended to apply a pragmatic or pathologizing approach when talking about causes of and solutions to the problem. These approaches enabled care providers to comply with "potential racism" without challenging an official ideology of anti-racism. In contrast, staff of foreign descent described the problem as more frequent and severe, particularly for short-term employees who experience many first-time encounters with care recipients.     

Age,autos, and the value of a statistical life

The value of a statistical life (VSL) is used to assign a dollar value to the benefits of health and safety regulations. Many of those regulations disproportionately benefit older people, but most estimates of the VSL come from hedonic wage regressions with few older workers and no retirees. Using automobile purchase decisions, I estimate a VSL for individuals from the age of 18 up to the age of 85. Combining information on vehicle holdings and use, household attributes, used vehicle prices, crash test results, and yearly fatal accidents for each make, model, and vintage automobile, I calculate a separate willingness to pay for reduced mortality for different age groups. I find a significant inverted-U shape to the age-VSL function that ranges from $1.5 to $19.2 million (in 2009 dollars). The shape and magnitude of the vehicle-based age-VSL relationship corroborate labor market estimates and extend the age range of revealed preference evidence on the relationship between age and the VSL.     

College,Jobs, or the Military? Enlistment During a Time of War*

Objective. This article questions what factors are associated with joining the military after high school rather than attending college, joining the civilian labor force, or doing some other activity. Three areas of influence on military enlistment are highlighted: educational goals, the institutional presence of the military in communities, and race and socioeconomic status. Method. The analysis uses data from a recent cohort of high school graduates from the State of Texas in 2002, when the United States was at war, and employs multinomial logistic regression to model the correlates of post‐high‐school choice of activity in this cohort. Results. Results confirm the hypothesis that a higher military institutional presence increases the odds of enlisting in the military relative to enrolling in college, becoming employed, or doing some other activity after high school. Additionally, college aspirations are clearly associated with the decision to enroll in college versus enlist and also increase the odds of joining the military rather than the civilian labor market, or remaining idle. Unlike previous studies, few racial and ethnic differences are found. Conclusion. Voluntary military enlistment during wartime is associated college aspirations, lower socioeconomic status, and living in an area with a high military presence.     

Ethno-religious identities and persisting penalties in the UK labor market

Most studies of minority group penalties in the UK labor market have focused on groups classified by their self-assessed ethnicity only, without taking into account major divisions within such groups, notably by religion. Using a large sample taken from the quarterly Labor Force Survey, this paper analyze levels of both unemployment and obtaining posts within the salariat for fourteen separate ethno-religious groups. Estimates of both gross and net penalties are derived, the latter taking the individuals’ human capital resources into account. They show that most non-White groups face an employment penalty, but Muslim groups – both men and women – experienced the greatest penalties. These penalties are exacerbated when searching for any job turns into searching for a managerial or a professional job suggesting that inequality is preserved through mechanisms of color and cultural racism which intensifies as minority workers seek jobs at the more lucrative end of the labor market – which, if persistent, could have long-term implications for the cohesion of the UK's multi-ethnic, multi-cultural society.     

The Inclusion of Minority Groups in Clinical Trials: Problems of Under Representation and Under Reporting of Data

Objective: To evaluate the representation of minority groups in randomized control trials (RCTs), and the frequency with which this information is reported.

Study Design: Reviewers collected data on the racial/ethnic composition of study samples from all RCTs published in six leading medical journals in 1999.

Results: Of the 280 RCTs, most (204, 71.3%) provided no information on the race/ethnicity of participants. Of the 89 U.S.-based RCTs, 50 (56.1%) reported their minority distribution. Relative to other trials, those funded by the National Institute of Health (NIH) (n = 52) were more likely to report race/ethnicity data (55.8% vs. 23.7%; χ² = 20.9, p ≤ 0.001) and to include nonwhite participants (13.5% vs. 12.5%; χ² = 22.7, p ≤ 0.001).

Conclusion: Minority groups are currently under-represented in clinical trials. Information on the race and ethnicity of clinical trial participants is currently underreported in six leading medical journals. Reporting of minority group information was significantly better only in NIH funded trials, which also were more likely to include nonwhite participants. This suggests that mandatory reporting policies may have a positive effect on both reporting and representation.     

Categorical Imperatives: The Interaction of Latino and Racial Identification*

Objective. Most large data sets solicit “ethnic” identification and “racial” identification in separate questions. We test the relative salience of these two identifications by exploring whether individuals who chose both a Latino “ethnic” label and a “racial” label on separate survey questions still chose both of these labels when they were given a single combined question about their racial and ethnic origins. Methods. Using the May 1995 Race and Ethnicity Supplement to the Current Population Survey, we estimate a multinomial logit model of identification choices. Results. We find that most individuals who chose a Latino label and a racial label chose a Latino‐only identification. Selection of multiple labels was more common for Latinos than non‐Latinos, however. Language use, local ethnic context, national origin, and age were all significantly related to these identification choices. Conclusion. The format of “race” and “ethnicity” questions on surveys has significant implications for the identification patterns of Latinos.     

Job Skill and Black Male Wage Discrimination*

Objective. Debate over the causes of wage inequality have raised suggestions that, rather than discrimination, skill differences may be the reason for racial wage disparities. The purpose of this research is to examine what impact on‐the‐job skill differences have on wage inequality. Method. I regress the log wage onto race and a measure of skill. The Multi‐City Study of Urban Inequality Employer Survey is particularly useful in this analysis because it contains the employer's evaluation of the worker's relative skill against other workers. Result. When white and black men have the same employer's competitive performance rating, rather than decreasing racial wage differences, the differences actually increase. Conclusion. The wage gap is not a skills gap, but evidence of racial discrimination in the labor market.