Race and Gender Concordance: Strategy to Reduce Healthcare Disparities or Red Herring? Evidence from a Qualitative Study

Healthcare treatment differences persist for African Americans even after controlling for socioeconomic status (van Ryn and Burke 2000). Although blacks represent a sizable percentage of the middle class, most disparities research does not address class heterogeneity. Furthermore, research indicates patient–provider race concordance may mitigate racial disparities in health care (Laveist and Neru-jeter in J Health Soc Behav 43(3):296–306, 2002; IOM in Unequal treatment: confronting racial and ethnic disparities in health care. National Academies Press, Washington, 2002). This study explores race and gender preference for black middle-class women in healthcare settings. The study uses in-depth interviews and focus groups to explore the experiences of thirty African American women between 38 and 67 in a large urban area. The majority of respondents expressed a strong preference for a female OB/GYN (of any race) while 9 preferred a female primary care provider (of any race). Although the women did not express an explicit race preference, they had a strong affinity for black female providers. Importantly, respondents complicated the idea of provider-level race preference by noting that other site-level factors like wait times and the site’s racial composition affected their racial preferences. Although increasing racial diversity among providers is generally positive, respondents suggest that alone will not ameliorate racial disparities. The complexities of the healthcare encounter, including time pressure, clinical uncertainty, and the patient’s desire for expertise regardless of race or gender, all impinge on respondents’ race preferences. Lastly, women noted that site-level factors may be conflated with the race of provider such that having a black provider does not necessarily lead to better care or protect women from discrimination or bias.     

Predictors of Posttraumatic Stress and Growth Among Black and White Survivors of Hurricane Katrina: Does Perceived Quality of the Governmental Response Matter?

Data from the Baseline Survey of the Hurricane Katrina Community Advisory Group Study (Kessler 2009) were used to explore the predictors of posttraumatic growth and posttraumatic stress among black (n?=?265) and white (n?=?715) adult survivors of Hurricane Katrina. We focus on the perceived quality of the governmental response and cognitive processing related to the response on posttraumatic outcomes, and whether there were racial group differences. We also consider the impact of demographic factors and severity of stress. Results of hierarchical linear regression showed that being black, older, having lower educational attainment, and experiencing greater perceived stress and loss during Katrina positively predicted greater posttraumatic growth. Being female, living below the poverty line, and experiencing greater perceived stress and loss positively predicted posttraumatic stress symptoms. More positive views of the governmental response were associated with greater posttraumatic growth and more negative views with greater posttraumatic stress symptomology. Moreover, it was found that race significantly moderated the effect between perceived quality of the response and posttraumatic stress. Subgroup analysis corroborated the interaction effect and showed that while perceived quality of the governmental response significantly predicted posttraumatic stress for black survivors, it was not a significant predictor for white survivors. This study sheds light on some of the factors and conditions under which positive and negative post-trauma outcomes occurred after Katrina. We propose that racial group differences in the impact of perceived quality of the response on posttraumatic stress may be related to views among some black survivors that the emergency response was discriminatory.     

A “Subterranean Agenda”? Racial Attitudes, Presidential Evaluations, and Tea Party Membership

Recent research suggests that fiscally conservative policy preferences and disapproval of President Obama are significant predictors of Tea Party membership (Maxwell and Parent 2012). Unfortunately, however, we know very little about the reasons why Tea Party members so aggressively disapprove of President Obama. While Tea Party members adamantly deny that President Obama’s race plays any role in their motivations, their critics argue that racial attitudes are a primary reason why individuals choose to join the movement. In this article, using national survey data conducted by Knowledge Networks (n = 1649), we explore the possibility that three unique racial attitudes have been influential in the establishment of the Tea Party. Specifically, we investigate the role of symbolic racism, racial stereotypes, and ethnocentrism as predictors of self-identified Tea Party membership among whites.     

The What,the Why,and the How: A Review of Racial Microaggressions Research in Psychology

Since the publication of Sue et al. (Am Psychol 62:271–286, 2007a, b) seminal article, there has been an enormous scholarly interest in psychology on this construct of racial microaggressions—subtle everyday experiences of racism. In this paper, we provide a review of racial microaggressions research literature in psychology since 2007, following the publication of the first comprehensive taxonomy of racial microaggressions, which provided a conceptual framework and directions for research related to racial microaggressions. However, our review suggests that important conceptual and methodological issues remain to be addressed in the three domains: (1) what are racial microaggressions and who do they impact; (2) why are racial microaggressions important to examine; and (3) how are racial microaggressions currently studied and how might we improve the methodologies used to study racial microaggressions. We propose recommendations to further facilitate racial microaggressions research, improve the scientific rigor of racial microaggressions research, and contribute toward a more complete and sophisticated understanding of the concept and consequences of racial microaggressions—a construct that is undoubtedly salient and psychologically relevant among many members of racial minority groups.     

The Stigma of Privilege: Racial Identity and Stigma Consciousness Among Biracial Individuals

Racial identification is a complex and dynamic process for multiracial individuals, who as members of multiple racial groups have been shown to self-identify or be identified by others differently, depending on the social context. For biracial individuals who have white and minority ancestry, such identity shifting (e.g., from minority to white, or vice versa) may be a way to cope with the threats to their racial identity that can be signaled by the presence or absence of whites and/or minorities in their social environment. We examine whether stigma consciousness (Pinel in J Pers Soc Psychol 76(1):114–128, 1999; i.e., the chronic awareness of the stereotyping and prejudice that minorities face) interacts with the sociocultural context to predict social identity threat, belonging, and racial identification. Using experience sampling methodology, minority/white biracial individuals (27 Asian/white, 22 black/white, and 26 Latino/white) reported the racial composition of their environment, social identity threat for their component racial identities, overall feelings of belonging, and racial identification over a 1-week period. Results suggest that stigma consciousness predicts the extent to which biracial people identify with their white background and experience belonging in different racial contexts. We discuss racial identity shifting in response to context-based threats as a protective strategy for biracial people, and identity where participants’ sociocultural contexts and experiences with racial identity and threat differ as a result of their minority racial group or ascribed race.     

Wealth Mobility of Families Raising Children in the Twenty-First Century

Wealth inequality between the top and bottom deciles has grown over the last 20 years (Piketty and Zucman in Wealth and inheritance in the long run, Centre for Economic Policy Research, London, 2014), as has the racial wealth gap (Shapiro et al. in The roots of the widening racial wealth gap: explaining the black–white economic divide. Institute on Assets and Social Policy, Brandeis University, Waltham, 2013. http://iasp.brandeis.edu/pdfs/Author/shapiro-thomas-m/racialwealthgapbrief.pdf). Within these broad trends of inequality, some families are able to get ahead and grow their wealth, while others are not. Yet we do not understand well the critical variables that increase the likelihood of wealth mobility across the life course—within the same generation. This paper addresses this gap and investigates the following questions: What accounts for intra-generational relative and absolute wealth mobility for families with children in the first decade of the twenty-first century? And how does it differ by race? The paper draws on two longitudinal data sets—the Panel Study of Income Dynamics household survey data matched with neighborhood-level US Census data (1999–2011), and the IASP Leveraging Mobility (LM) study (1998–2011). Applying an integrated mixed methods design, analyses are conducted in three stages: (1) A grounded theory analytic approach of the LM data determines key variables of wealth mobility: homeownership, income, employment characteristics, extended family wealth, negative life events, and neighborhood factors; (2) regression analyses test these indicators for absolute and relative wealth mobility; and (3) recontextualization through further analyses of LM data deepen the regression results by illustrating the pathways of significant wealth mobility predictors. Results reveal that increasing family income, larger family transfers, consistent long-term homeownership, and in some cases white-collar occupations increase the likelihood of upward relative wealth mobility. Negative life events, higher rates of neighborhood poverty, and black race are negatively correlated with the amount of wealth growth. These key drivers of wealth mobility highlight the need for targeted policies that reinforce and expand opportunities for all families to build wealth over the life course.     

The Harki Identity: A Product of Marginalisation and Resistance to Symbolic Violence?

This paper seeks to demonstrate that since their arrival in France in 1962, the Harkis – the Algerians who fought with rather than for the French side against the Algerian independence movement (1954–1962) – have been the victims of symbolic violence. They have been assigned by the French state to the periphery of French towns, French history and French identity. As, since 25 September 2001 (the first national Harki remembrance day) and 5 December 2002 (when President Chirac inaugurated the Algerian war memorial in Paris), the Harkis ceased to epitomise ‘the archetype of official non memory’ (Rosello, 1998 Rosello, M. 1998. Declining the stereotype- Ethnicity and representations in French cultures, Hanover: University Press of New England.  [Google Scholar], p. 170), this paper ultimately asks whether the end of a certain form of symbolic violence may not result in the ‘delegitimisation’ of the Harkis’ main (historical) claims and, consequently, in the weakening of the Harki identity.     

Did the Difference Between Black and White Americans in Anger-Out Decrease During the First Decade of the Twenty-First Century?

Studies have found blacks in the USA report lower levels of anger-out and higher levels of anger-in than whites. However, most of the research on anger expression has been based on data from limited samples. The current study investigates the black–white difference in anger-in and anger-out in a sample representative of Americans aged 40 and older. Data are from the two most recent waves of the Americans’ Changing Lives (ACL) surveys. In 2001, the ACL assessed both outcomes, with anger-out re-assessed in 2011. Thus, individual-level change in anger-out can be investigated. Drawing on literature on “anger privilege,” civility, the politicization of anger, and related topics, we develop and evaluate hypotheses about: (1) the race difference in anger-out over time, (2) race as a moderator of the gender difference in both forms of anger expression, and (3) the impact of controlling for perceived discrimination on anger expression. We find blacks to report greater expressive reticence with regard to their anger (i.e., anger-in) than whites in 2001. That race difference became nonsignificant when discrimination was controlled. The race difference in anger-out was of borderline significance in 2001 and became significant after discrimination was controlled. Longitudinal analyses show that the race difference in anger-out decreased over time. The rate that anger-out decreased by did not significantly differ by race. We discuss processes that that could contribute to our results. We also speculate about how current trends in political anger expression might be related to the patterns we observe.     

Sounding Like Your Race in the Employment Process: An Experiment on Speaker Voice,Race Identification,and Stereotyping

Research has shown that listeners can identify black and white speakers with high accuracy rates from voice alone, but few studies have investigated whether individuals can identify Asian American native English speakers. In a three-part hypothetical employment process experiment, recordings of white, black, and US-born Asian American voices are used to test participants’ (N = 49) race identification of unseen speakers, evaluations of speakers’ employability, and accuracy of race identification with the introduction of headshots. Key findings show the following: judges demonstrate high accuracy rates of identifying white and black speakers based on voice alone, judges rated the black speaker at least eight times less likely to be hired than the white and Asian American speakers, and accuracy rates of race identification for the Asian American speaker rose dramatically with the introduction of headshots. The study contributes to research on Asian American English speech and extends work on stereotyping and employment discrimination.     

Racial Discrimination in the U.S. Housing and Mortgage Lending Markets: A Quantitative Review of Trends, 1976–2016

We examine trends in racial and ethnic discrimination in U.S. housing and mortgage lending markets through a quantitative review of studies. We code and analyze as a time series results from 16 field experiments of housing discrimination and 19 observational studies of mortgage lending discrimination. Consistent with prior research, we find evidence of a decline in housing discrimination from the late 1970s to the present. Our results show that this trend holds in both the national audits sponsored by the U.S. Department of Housing and Urban Development (HUD) and in non-HUD studies. The decline in discrimination is strongest for discrimination that involves direct denial of housing availability, for which discrimination has declined to low levels. The downward trend in discrimination is weaker for measures reflecting the number of units recommended and inspected, and significant discrimination remains for these outcomes. In the mortgage market, we find that racial gaps in loan denial have declined only slightly, and racial gaps in mortgage cost have not declined at all, suggesting persistent racial discrimination. We discuss the implications of these trends for housing inequality, racial segregation, and racial disparities in household wealth.

     

Perceived Racial Discrimination in Health Care and Race Differences in Physician Trust

Racial discrimination in health care is more often perceived by racial minority patients than by whites. In this study, we explored whether two types of perceived racial discrimination, perceptions that the healthcare system is racially biased in general (perceived institutional racial discrimination) and perceptions that one has personally encountered racial discrimination while seeking health care (perceived interpersonal racial discrimination), mediated racial differences in patients’ trust in physicians. We examined this in a sample of black (N = 127) and white (N = 303) patients being treated in two Veterans Affairs orthopedic clinics for advanced osteoarthritis. Patients completed measures of perceived institutional and interpersonal racial discrimination in health care before meeting with an orthopedic surgeon and a measure of physician trust after the visit. Using a multiple mediator bootstrapping procedure, we tested whether perceived institutional and/or interpersonal racial discrimination mediated the association between race and trust. Compared to whites, blacks reported lower physician trust (M = 4.00 vs. 4.17, β = ?0.15, 95 % CI = ?0.25, ?0.05), more perceived institutional racial discrimination (M = 3.13 vs. 2.60, β = 0.43, 95 % CI = 0.25, 0.61), and more perceived interpersonal racial discrimination (M = 1.94 vs. 1.21, β = 0.60, 95 % CI = 0.47, 0.74). Perceived interpersonal, but not institutional, racial discrimination mediated the race difference in physician trust and accounted for 55 % of the variance. Our finding that lower physician trust among black patients than white patients was explained by perceptions of interpersonal racial discrimination in health care suggests that issues of racial discrimination may need to be addressed in order to foster minority patients’ trust in physicians.     

Immigrant Group Differences in Job Satisfaction

Despite the large number of immigrants in Canada’s labor force, studies of immigrants to Canada have devoted insufficient attention to how country of birth and race are related to job satisfaction. Using data from a general population telephone survey of English-speaking workers in Toronto (n = 659), we investigate job satisfaction differences between white Canadian-born workers and immigrants born in the Caribbean, the Philippines, South Asia, China, Portugal, the United States, and the UK. Each of the immigrant groups is racially homogenous, and most of the groups are composed of (non-white) visible minorities. We find that the contrasts between Canadian-born whites and workers born in the Philippines and China remain substantial, and statistically significant under one-tailed tests, after age, gender, job type, income, job demands, job control, job support, workplace discrimination, job-related stress, and perceived unfairness at work are all controlled. We argue that social comparison theory offers the most compelling explanation for the persistence of group differences in job satisfaction after controls.     

The militarisation of English schools: Troops to Teaching and the implications for Initial Teacher Education and race equality

This article considers the implications of the Troops to Teaching (TtT) programme, to be introduced in England in autumn 2013, for Initial Teacher Education (ITE) and race equality. TtT will fast-track ex-armed service members to teach in schools, without necessarily the requirement of a university degree. Employing theories of white supremacy, and Althusser’s (1971 Althusser, Louis. 1971. “Ideology and Ideological State Apparatuses.” In Lenin and Philosophy and Other Essays, edited by, Althusser Louis, New York: Monthly Review Press. Accessed September 10. http://www.marxists.org/reference/archive/althusser/1970/ideology.htm [Google Scholar]) concept of Ideological and Repressive State Apparatus, I argue that this initiative both stems from, and contributes to, a system of social privilege and oppression in education. Despite appearing to be aimed at all young people, the planned TtT initiative is actually aimed at poor and racially subordinated youth. This is likely to further entrench polarisation in a system which already provides two tier educational provision: TtT will be a programme for the inner-city disadvantaged, whilst wealthier, whiter schools will mostly continue to get highly qualified teachers. Moreover, TtT contributes to a wider devaluing of current ITE; ITE itself is rendered virtually irrelevant, as it seems TtT teachers will not be subject specialists, rather will be expected to provide military-style discipline, the skills for which they will be expected to bring with them. More sinister, I argue that TtT is part of the wider militarisation of education. This military-industrial-education complex seeks to contain and police young people who are marginalised along lines of race and class, and contributes to a wider move to increase ideological support for foreign wars - both aims ultimately in the service of neoliberal objectives which will feed social inequalities.     

Race and Unemployment Amidst the New Diversity: More Evidence of a Black/Non-Black Divide

The fact that the United States is more racially and ethnically diverse now than in the past has led scholars to dismiss dichotomous—black/white—conceptions of race as antiquated. However, some others have noted the emergence of a black/non-black divide that is manifest in patterns of residential segregation and intermarriage. This study attempts to determine whether such a dichotomous conception is sufficient to capture the effects of race and ethnicity on unemployment patterns among entry-level workers in the United States. Findings suggest that more than 80% of the effects of race and ethnicity on unemployment can be captured simply by knowing who is black and who is not. The most elaborate conception tested here acknowledges 20 different racial and ethnic groups; it adds significantly but not commensurately to the explanatory power of the models. Despite the increasingly diverse racial and ethnic composition of entry-level labor markets in the United States, it is black exclusion that seems to drive the effects of race and ethnicity on unemployment.     

Racial Disproportionality in Juvenile Justice: The Interaction of Race and Geography in Pretrial Detention for Violent and Serious Offenses

Youth of color, particularly black youth, are overrepresented at every stage of processing in the juvenile justice system. This paper presents an analysis of racial differentials at an early stage—pretrial detention among youth charged with violent and serious offenses. It contributes to work in this area by exploring police decision making, which has been understudied in comparison with decision making by court actors. Contrary to prior studies suggesting that race differences in police treatment are found primarily in the handling of youth suspected of minor offenses, we find that black youth are three times as likely as white youth to be detained, controlling for other demographic and legal factors, including offense type and severity. This paper also contributes to efforts to understand how racial disproportionality occurs, by including an analysis of how geography affects detention decisions differentially by race. Using data from an urban county in Michigan, we find that geography and race interact, such that white youth from the suburbs are much less likely to be detained than white youth from the city and black youth from the city or suburbs.     

Linking gender,class and race in Brazil1

This article examines the socio‐historical effects of the intersection of representations of gender, race, and the nation which determine black Brazilian women's subaltern social position and inform their self‐representations. This intersection is presented from two perspectives: analysis of quantitative data and a case study. Through the examination of socio‐economic data on black women participation in the labour market, it show that, when compared with white women and black men, black women are unequally concentrated in certain low paid jobs in the service industry, such as for instance domestic work. Through a brief case study, basically interviews with women from different colours and social classes — i.e. domestic workers and their employers — it shows how the particularities of domestic work inform black women's race and gender self‐definitions.     

Does a Self-Affirmation Intervention Reduce Stereotype Threat in Black and Hispanic High Schools?

The risk of confirming negative stereotypes about one’s social group, known as stereotype threat, depresses academic achievement among students of color and contributes to racial gaps in achievement. Some work finds that stereotype threat may be alleviated through self-affirmation exercises, translating into improved performance among students vulnerable to threat. However, this work has been conducted primarily in settings where students of color represent a relatively small segment of the student population. The current study explores whether this intervention is efficacious in schools where students of color are the majority. Through a randomized controlled trial of 886 students in three high schools (one predominantly black, one predominantly Hispanic, and one mixed race school), we administered self-affirmation exercises over the course of an academic year. We find no clear evidence that self-affirmation promoted higher standardized test scores or higher grades within the sample. The null findings highlight the complex nature of academic challenges in segregated contexts and raise important questions about the nature of stereotype thereat in such contexts. Importantly, this suggests that solely enhancing self-integrity may not be sufficient to close academic race-based gaps.     

Low Social Status Markers: Do They Predict Depressive Symptoms in Adolescence?

Some markers of social disadvantage are associated robustly with depressive symptoms among adolescents: female gender and lower socioeconomic status (SES), respectively. Others are associated equivocally, notably black v. white race/ethnicity. Few studies examine whether markers of social disadvantage by gender, SES, and race/ethnicity jointly predict self-reported depressive symptoms during adolescence; this was our goal. Secondary analyses were conducted on data from a socioeconomically diverse community-based cohort study of non-Hispanic black and white adolescents (N = 1,263, 50.4% female). Multivariable general linear models tested whether female gender, black race/ethnicity, and lower SES (assessed by parent education and household income) and their interactions predicted greater depressive symptoms reported on the Center for Epidemiological Studies Depression Scale. Models adjusted for age and pubertal status. Univariate analyses revealed more depressive symptoms in females, blacks, and participants with lower SES. Multivariable models showed females across both racial/ethnic groups reported greater depressive symptoms; blacks demonstrated more depressive symptoms than did whites, but when SES was included this association disappeared. Exploratory analyses suggested blacks gained less mental health benefit from increased SES. However, there were no statistically significant interactions among gender, race/ethnicity, or SES. Taken together, we conclude that complex patterning among low social status domains within gender, race/ethnicity, and SES predicts depressive symptoms among adolescents.