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.     

Race,SES, and Obesity Among Men

Over the last decade, obesity has increased significantly among men but few national studies have empirically examined racial and socioeconomic differences in obesity among men. In this paper, we utilized logistic regression to evaluate the potential associations that race and socioeconomic status may have with obesity among men in the National Survey of American Life: an in-person household survey of non-institutionalized U.S. blacks and whites who lived in communities where at least 10% of the community residents were black Americans. A greater proportion of black men were likely to be obese than white men, but no interaction among race, SES, and obesity was detected when potential confounding variables were included. There was not a relationship between SES and obesity for white men, but there was an apparent positive relationship between SES and obesity for black men that did not remain significant in adjusted models. No relationship was found between age and obesity among black men, though white men who were 55 and older were more likely than those 18–34 to be obese in confounder adjusted models. Among white men, no relationships were found between obesity and education, household income, or marital status. Black men in the lowest income category were less likely to be obese than those in the highest income category, in bivariate but not adjusted models. These findings suggest that the way racial, economic, stress and behavioral factors combine to affect obesity in black and white men may be different.     

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.     

Understanding Differences in College Enrollment: Race,Class and Cultural Capital

Scholarship on race and class differences in educational outcomes has identified cultural capital, or cultural resources that can be utilized to increase educational success, as important mechanisms of educational inequality. However, despite substantial interest, the role of cultural capital in producing inequalities among American students remains unclear. In this research, we use nationally representative data from the Educational Longitudinal Study to clarify the relationships among race, social class, cultural capital and 4-year college enrollment. Using a theoretically based approach to operationalizing social class and measures of both cultural capital possession and activation, this research finds that while black students tend to possess fewer resources than their white counterparts at any class level, they activate cultural capital to a greater degree than white students. Results also show that while cultural capital can explain differences between low-income and middle-income students, a persistent middle-class advantage remains for both black and white students. Additionally, results indicate that at any class level, black students are more likely than their white counterparts to attend a 4-year university. Finally, results show that measures of cultural capital possession and activation have generally independent effects on college enrollment.     

Racist nativist microaggressions and the professional resistance of racialized English language teachers in Toronto

English language teaching upholds racist nativist notions that competent teachers are white native speakers of English born in majority-white countries. These notions manifest when international students, expecting to be taught by these speakers, are skeptical about having a racialized instructor, who may be seen as non-native to English and the nation where it is natively spoken. Rather than overt, this skepticism may appear in the form of microaggressions. Informed by critical race and resistance theories, this article uses interviews with 10 racialized teachers in Toronto, Canada to detail the racist nativist microaggressions that they experience at work and their professional resistance strategies that combat these microaggressions. The findings describe the following microaggressions: interrogations of the teachers’ nativeness, insinuations of their foreignness to English, and behavioral indications that they are ‘invading’ the classroom. Their professional resistance either conformed to or sought to transform notions of the supremacy of white (Canadian) teachers.     

Immigration and Economic Conditions Among Older Asian Americans

This study compares native-immigrant gaps in economic conditions among older Asian Americans to those in other racial groups. This study uses the American Community Survey data collected from 2006 to 2010. The sample consists of Asians, whites, blacks, and Hispanics, who are 65 years old or older (N = 2,205,148). The dependent variables are per capita income, poverty, asset income, homeownership, and vehicle ownership. This study employs linear and logit regressions. Analysis results show that older native Asian Americans’ economic statuses are comparable to or better than older native whites. Older immigrant Asian Americans’ economic situations are worse off than older immigrant whites but better off than their black and Hispanic counterparts. Regression analyses indicate that native-immigrant gaps among older Asian Americans are significantly larger than those among other racial groups. These findings suggest that the public perception of economically successful immigrant Asians is not consistent with the economic reality of older immigrant Asian Americans. Analysis results call for further research on native-immigrant gaps among older Asian Americans and policy interventions to enhance economic security among older minority groups, including older immigrant Asian Americans.     

Marital Dissolution and Formation for Interracial Couples: Evidence from Parents of Biracial Children

There is a large amount of literature on whether interracial relationships are more unstable than same-race relationships. This study utilizes data on the race of respondents’ children and examines how marital dissolution and formation differ for those who mate interracially. Contrary to several previous studies, this study finds that some interracial couples are more likely to proceed to marriage and have more stable marriage than same-race couples. White men with Asian biracial children are more likely to be married than other white male parents, black women with white biracial children are more likely to be married than other black female parents, and Asian women with white biracial children are more likely to get married (but more likely to get divorced or separated once married) than other Asian female parents.     

Race and Ethnic Self-Identification Influences on Physical and Mental Health Statuses Among Blacks

We examine if commonly used distress measures, rates of psychiatric disorders, and chronic health conditions are affected by alternate measures of race-ethnicity for African Americans and Caribbean blacks. We examined two alternative self-identification measures to investigate if their influence might differ. A study on national household probability sample of non-institutionalized African Americans (n = 3,570) and blacks from Caribbean countries, who now live in the United States (n = 1,621), was conducted between February 2001 and June 2003, using a slightly modified version of the Composite International Diagnostic Interview. The method used to measure black race and ethnicity has influence on physical and mental health outcomes. The distributions of depressive symptoms are not affected, while the distributions of DSM IV disorders and chronic health conditions vary by race and ethnic self-identifications among the African American and Caribbean black populations. There are serious implications of using alternate measures of race-ethnicity on the distribution of physical and mental health morbidity among African Americans and Caribbean blacks. The conceptualization and assessment of race-ethnicity should be carefully considered when studying mental and physical health statuses and service needs in the American black population.     

Explaining Race and Ethnic Variation in Marriage: Directions for Future Research

Racial and ethnic differentials in marriage are large and may contribute to maintaining inequalities. Previous research identifies economic factors, particularly low levels of employment stability and earnings, as important contributors to depressed marriage rates among blacks. Yet group differences in employment and earnings do not offer sufficient explanations for race and ethnic variation in marriage patterns—a fact which is not surprising given that marriage represents far more than an economic relationship. Future research in this area should consider other factors that distinguish marriage from other couple relationships, such as commitment, sexual fidelity, and trust. Moreover, it should recognize that marriage is a social institution that shapes social interactions ranging from informal relationships with family members to eligibility for formal benefits such as health insurance. We argue that taking a broader view of marriage will help identify new approaches to understanding race and ethnic variation in marriage patterns.     

Convergence and Disadvantage in Poverty Trends (1980–2010): What is Driving the Relative Socioeconomic Position of Hispanics and Whites?

The gap between white and Hispanic poverty has remained stable for decades despite dramatic changes in the size and composition of the two groups. The gap, however, conceals crucial differences within the Hispanic population whereby some leverage education and smaller families to stave off poverty while others facing barriers to citizenship and English language acquisition face particularly high rates. In this paper, we use Decennial Census and American Community Survey data to examine poverty rates between Hispanic and non-Hispanic, white heads of household. We find the usual suspects stratify poverty risks: gender, age, employment, education, marital status, family size, and metro area status. In addition, Hispanic ethnicity has become a weaker indicator of poverty. We then decompose trends in poverty gaps between racial and ethnic groups. Between 1980 and 2010, poverty gaps persisted between whites and Hispanics. We find support for a convergence of advantages hypothesis and only partial support (among Hispanic noncitizens and Hispanics with limited English language proficiency) for a rising disadvantages hypothesis. Poverty-reducing gains in educational attainment alongside smaller families kept white–Hispanic poverty gaps from rising. If educational attainment continues to rise and family size drops further, poverty rates could fall, particularly for Hispanics who still have lower education and larger families, on average. Gains toward citizenship and greater English language proficiency would also serve to reduce the Hispanic–white poverty gap.     

Understanding the role of schools in the Asian-white gap: a seasonal comparison approach

Asian Americans are the most highly educated racial group in the United States and are commonly heralded as the model minority for their high academic success. Nevertheless, previous research suggests that Asian Americans may face certain disadvantages in school settings. For example, Asian Americans’ academic advantage over non-Hispanic white students diminishes between kindergarten entry and the next several years of schooling. This study provides a closer examination of the educational progress of Asian American students compared to white students through a seasonal comparison approach. Using the Northwest Evaluation Association, we analyze reading and math scores for over 130,000 Asian American and white students in grades K-7 in approximately 675 public schools across the US. We find that Asian Americans have higher academic achievement than white students in general, but that these advantages are maintained primarily through faster rates of learning during the summer months. When school is in session, the Asian advantage either remains unchanged or shrinks, consistent with the view that some school processes undermine the educational progress of Asian American students relative to white students.     

Teacher-Based Racial Discrimination: The Role of Racial Pride and Religiosity Among African American and Caribbean Black Adolescents

This study explored the extent to which private regard and religiosity beliefs serve as protective factors for school bonding among African American and Caribbean black adolescents who experience racial discrimination in school. Findings are drawn from a nationally representative sample of (n = 810) African American and (n = 360) Caribbean black adolescents (52% girls) aged 13–17 (M_age = 15, SD = 1.42) years. Results suggest that perceiving racial discrimination from teachers was associated with lower levels of school bonding for African American and Caribbean black adolescents. For African American adolescents, perceiving more racial discrimination from teachers and reporting lower private regard beliefs was associated with less school bonding. The findings for Caribbean black adolescents revealed that endorsing moderate levels of religiosity and perceiving higher rates of teacher discrimination was associated with less school bonding. The developmental significance and implications for future research are discussed.     

The Joint Effects of Offender Race/Ethnicity and Sex on Sentence Length Decisions in Federal Courts

The current study examined the main and interactive effects of offender race/ethnicity and sex on sentence length decisions for drug offenders convicted in three federal courts located in Iowa, Minnesota, and Nebraska. The additive model showed that females received shorter prison sentences than similarly situated male offenders, but there were no differences between white offenders and minority offenders. However, when the data were partitioned by sex, black males were found to receive lengthier prison terms than white males. There were no differences between white males and Hispanic males, and white females were treated no differently than either black or Hispanic females. Moreover, when the data were partitioned by race/ethnicity, white females were treated no differently than white males. However, black females received shorter sentences than black males and Hispanic females received shorter sentences than Hispanic males. Further analyses showed that black and Hispanic males also received longer sentences than white females and that black males received longer sentences than all other offenders (with the exception of Hispanic male offenders). These findings mesh with those gleaned from other sentencing studies, although they are at odds with theoretical notions that leniency at the sentencing stage is reserved only for white women.     

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.     

Diverging Fortunes: Racial/Ethnic Inequality in Wealth Trajectories in Middle and Late Life

The primary aim of this study is to examine whether racial/ethnic inequality in wealth dissipates or increases between middle and late life, and by how much. To address this aim, this study draws on critical race and life course perspectives as well as 10 waves of panel data from the Health and Retirement Study and growth curve models to understand racial/ethnic inequality in wealth trajectories among whites, blacks, and Mexican Americans (N = 8337). Findings show that, by midlife, significant inequalities in net worth emerge between whites and their black and Mexican American counterparts. On average, white households have amassed a net worth of $105k by midlife, compared to less than $5k and $39k among black and Mexican American families, respectively. Moreover, whites experience much more rapid rates of wealth accumulation during their 50s and 60s than their minority counterparts, resulting in increasing wealth disparities with age, consistent with a process of cumulative disadvantage. At the peak of their wealth trajectory (at age 66), whites have approximately $245k more than blacks and $219k more than Mexican Americans. A wide range of socioeconomic, behavioral, and health factors account for a portion, but not all, of racial/ethnic inequality in wealth, suggesting that unobserved factors such as parental wealth, segregation, and discrimination may play a role in the production and maintenance of wealth inequality.     

Fabulachia: urban,black female experiences and higher education in Appalachia

Abstract

This article draws on focus group conversations with black female college students attending a small, liberal arts institution in Kentucky. Based primarily on group interviews and discussions, as well as observations and analysis – a theoretical domain (referred to throughout the article as ‘Fabulachia’) emerged as a site-specific outcome of events and ideas regarding race, gender and identity experienced by the research participants. Specifically, ‘Fabulachia’ functions as a theoretical hybrid space in which urban (e.g. ‘ghetto fabulous’) black college student-voices find a sense of empowerment as they construct their own narratives of leaving ‘the hood’ to attend college in rural Appalachia. This project revises and updates previous research on race and rural identity/ies in order to situate the urban black female experience into an Appalachian context. Drawing on hip hop feminism and urban education based theoretical paradigms, the Fabulachia study seeks to give voice to black females in contemporary Appalachia, with attention to their self-proclaimed ‘ghetto fabulous’ identities honed in and through their urban upbringings. The unique experiences of (Fabulachian) black females are an important and largely absent part of larger conversations of the growing body of Urban education research that seeks to situate the black student/black youth and schooling experience in the US. In the Fabulachia study, a group of black female students shared personal narratives (part-oral history and part direct response) to prompts and queries about the role of hip hop culture, race and gender identity in their lives. They also discussed and debated what it means to be a black female in contemporary (often racist) Appalachia, and about how their families and urban surroundings influenced their processes of being and becoming in the context of higher educational achievement.     

The Color of Debt: An Examination of Social Networks,Sanctions, and Child Support Enforcement Policy

This article is based on face-to-face interviews with 20 randomly selected fathers of black and white children receiving temporary assistance for needy families benefits, followed, when possible, by an interview with the mother of one of the father’s children in Dane County, Wisconsin. The primary purpose of this research was to explore the sample’s level of knowledge about child support enforcement program policy. The informants shared information on their knowledge of child support enforcement program policy and procedures, but also their access or lack of access to social networks for employment to pay their child support order, and experiences with various imposed sanctions for non-payment of their child support order. The data provided an opportunity to conduct comparisons across and within races on their experiences with the child support enforcement program. Results from an analysis of the qualitative data provided an insight into their “lived” experiences with law enforcement by race when their child support was in arrears. In addition, quantitative data obtained from the Wisconsin kids information data system administrative records highlighted the stark racial differences in fathers’ annual (UI) earnings and debt owed in child support to the state and the mother of their child (ren). Further analysis highlights the limited social networks for referrals to employment among black noncustodial fathers and the accumulated debt of child support for black men, which hampers their ability to maintain a minimal level of economic security.     

College as an Investment: The Role of Graduation Rates in Changing Occupational Inequality by Race, Ethnicity, and Gender

In this paper, we examine whether investments in higher education have contributed to changes in occupational inequality by focusing on the impact of college completion rates on movement into desirable occupations between 1983 and 2002. Since forces generating inequality vary by gender, race, and ethnicity, we examine trends for white, black, and Hispanic men and women in our study. Utilizing Ordinary Least Squares Regression on data from 20 Current Population Surveys, we find a modest decrease in both gender and racial inequality in access to desirable occupations and an increase in inequality between Hispanics and members of the other groups. College completion accounts for the progress made by white women and for the declines among Hispanic men. It does not explain changes for African Americans, either between men and women or when compared to whites.     

‘I’m a different kind of biracial’: how black/white biracial Americans with immigrant parents negotiate race

Increasingly, multiracial families have garnered scholarly attention. However, the roles of ethnicity and immigrant ties are largely absent in bi/multiracial studies. Drawing on 17 in-depth interviews with black/white biracial Americans with at least one immigrant parent, this study analyzes the dynamic interplay of race, ethnicity, and immigrant roots in the bi/multiracial community. Our findings show that participants struggle to articulate the meaning of race, and they assert specific racial/ethnic identities to circumvent stereotypical connotations of whiteness and blackness. We highlight how biracial Americans with immigrant ties – those who we might assume would have a limited understanding of race – voice clear understandings of racial superiority and inferiority, racial relations, and racial stereotypes. Emphasizing their ethnic roots is not only an attempt to accurately describe their ancestry; it also allows them to avoid the social consequences (i.e. stereotypes, discrimination, etc.) of being (half) white or (half) black.     

Environmental affects: NASCAR,place and white American cultural citizenship

Attempts to grapple with the complicated tangle of race and memory are more prominent than ever in the public discourse of the United States. In 2006, public intellectual Henry Louis Gates sought to popularize the search for roots and meaning with his project African American Lives, and in 2007 the black and white descendants of the landmark Plessy v. Ferguson case met in New Orleans to discuss the past and present significance of their ancestors’ lives. As the crafting of identities around increasingly fluid notions of ‘race’ proceeds apace, the activities of family historians provide a useful entrée into struggles over race, identity, and collective memory in the United States. The research reported here illustrates how the shared history of the multi-racial descendants of eighteenth and nineteenth century St Domingue/Haiti in Louisiana is encountered in racially distinct ways. Participant observation is used to examine how race is dealt with in the activities of two groups: 1) a mainly European American genealogical society, called the St Domingue Special Interest Group; and 2) the LA Creole cultural and genealogy group, made up primarily of Louisiana creoles of color. Preliminary findings indicate that while the process of engaging in family history research provides an opening for some participants to better understand others across racial and ethnic divides, this kind of cross-racial dialogue was limited by the organization of family history activities into racially distinct social networks. As the popularity of genealogy increases, the findings here point to the need to recognize the public significance of these private histories.