In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.

This book shows the important links between social conditions and health and begins to describe the processes through which these health inequalities may be generated. It reviews a range of methodologies that could be used by health researchers in this field and proposes innovative future research directions.

Stigma leads to poorer health. In The Oxford Handbook of Stigma, Discrimination, and Health, leading scholars identify stigma mechanisms that operate at multiple levels to erode the health of stigmatized individuals and, collectively, produce health disparities. This book provides unique insights concerning the link between stigma and health across various types of stigma and groups.

Estimates indicate that as many as 1 in 4 Americans will experience a mental health problem or will misuse alcohol or drugs in their lifetimes. These disorders are among the most highly stigmatized health conditions in the United States, and they remain barriers to full participation in society in areas as basic as education, housing, and employment. Improving the lives of people with mental health and substance abuse disorders has been a priority in the United States for more than 50 years. The Community Mental Health Act of 1963 is considered a major turning point in America's efforts to improve behavioral healthcare. It ushered in an era of optimism and hope and laid the groundwork for the consumer movement and new models of recovery. The consumer movement gave voice to people with mental and substance use disorders and brought their perspectives and experience into national discussions about mental health. However over the same 50-year period, positive change in American public attitudes and beliefs about mental and substance use disorders has lagged behind these advances. Stigma is a complex social phenomenon based on a relationship between an attribute and a stereotype that assigns undesirable labels, qualities, and behaviors to a person with that attribute. Labeled individuals are then socially devalued, which leads to inequality and discrimination. This report contributes to national efforts to understand and change attitudes, beliefs and behaviors that can lead to stigma and discrimination. Changing stigma in a lasting way will require coordinated efforts, which are based on the best possible evidence, supported at the national level with multiyear funding, and planned and implemented by an effective coalition of representative stakeholders. Ending Discrimination Against People with Mental and Substance Use Disorders: The Evidence for Stigma Change explores stigma and discrimination faced by individuals with mental or substance use disorders and recommends effective strategies for reducing stigma and encouraging people to seek treatment and other supportive services. It offers a set of conclusions and recommendations about successful stigma change strategies and the research needed to inform and evaluate these efforts in the United States.

As the population of older Americans grows, it is becoming more racially and ethnically diverse. Differences in health by racial and ethnic status could be increasingly consequential for health policy and programs. Such differences are not simply a matter of education or ability to pay for health care. For instance, Asian Americans and Hispanics appear to be in better health, on a number of indicators, than White Americans, despite, on average, lower socioeconomic status. The reasons are complex, including possible roles for such factors as selective migration, risk behaviors, exposure to various stressors, patient attitudes, and geographic variation in health care. This volume, produced by a multidisciplinary panel, considers such possible explanations for racial and ethnic health differentials within an integrated framework. It provides a concise summary of available research and lays out a research agenda to address the many uncertainties in current knowledge. It recommends, for instance, looking at health differentials across the life course and deciphering the links between factors presumably producing differentials and biopsychosocial mechanisms that lead to impaired health.

Racial and ethnic disparities in health care are known to reflect access to care and other issues that arise from differing socioeconomic conditions. There is, however, increasing evidence that even after such differences are accounted for, race and ethnicity remain significant predictors of the quality of health care received. In Unequal Treatment, a panel of experts documents this evidence and explores how persons of color experience the health care environment. The book examines how disparities in treatment may arise in health care systems and looks at aspects of the clinical encounter that may contribute to such disparities. Patients' and providers' attitudes, expectations, and behavior are analyzed. How to intervene? Unequal Treatment offers recommendations for improvements in medical care financing, allocation of care, availability of language translation, community-based care, and other arenas. The committee highlights the potential of cross-cultural education to improve provider-patient communication and offers a detailed look at how to integrate cross-cultural learning within the health professions. The book concludes with recommendations for data collection and research initiatives. Unequal Treatment will be vitally important to health care policymakers, administrators, providers, educators, and students as well as advocates for people of color.

People with mental illness commonly describe the stigma and discrimination they face as being worse than their main condition. Discrimination can pervade every part of their daily life - their personal life, working life, sense of citizenship, their ability to maintain even a basic standard ofliving. Though things have certainly improved in the past 50 years, discrimination against the mentally ill is still a major problem throughout the world. It can manifest itself in subtle ways, such as the terminology used to describe the person or their illness, or in more obvious ways - by the waythe mentally ill might be treated and deprived of basic human rights. Should we just accept such discrimination as deeply rooted and resistant to change, or is this something that we can collectively change if we understand and commit ourselves to tackling the problem?Shunned presents clearly for a wide readership information about the nature and severity of discrimination against people with mental illness and what can be done to reduce this. The book features many quotations from people with mental illness showing how this has affected their home, personal,social, and working life. After showing, both from personal accounts and from a thorough review of the literature, the nature of discrimination, the book sets out a clear manifesto for change.Written by a leading figure in mental health in a lively and accessible manner, the book presents a fascinating and humane portrayal of the problem of stigma and discrimination, and shows how we can work to reduce it.

The two main sections of the book comprise chapters on 10 specific illnesses and conditions and chapters relating to broader issues (stigma and family, overcoming stigma, stigma across cultures and future directions). The book concludes with observations on what has not worked in overcoming stigma as well as possible future directions. (Psychology)

Up until now, many articles have been written to portray stigma and discrimination which occur with people living with HIV/AIDS (PLWHA) in many parts of the world. But this is the first book which attempts to put together results from empirical research relating to stigma, discrimination and living with HIV/AIDS. The focus of this book is on issues relevant to stigma and discrimination which have occurred to individuals and groups in different parts of the globe, as well as how these individuals and groups attempt to deal with HIV/AIDS. The book comprises chapters written by researchers who carry out their projects in different parts of the world and each chapter contains empirical information based on real life situations. This can be used as an evidence for health care providers to implement socially and culturally appropriate services to assist individuals and groups who are living with HIV/AIDS in many societies. The book is of interest to health care providers who have their interests in working with individuals and groups who are living with HIV/AIDS from a cross-cultural perspective. It will be useful for students and lecturers in courses such as anthropology, sociology, social work, nursing, public health and medicine. In particular, it will assist health workers in community health centres and hospitals in understanding issues related to HIV/AIDS and hence provide culturally sensitive health care to people living with HIV/AIDS from different social and cultural backgrounds. The book is useful for anyone who is interested in HIV/AIDS-related stigma and discrimination in diverse social and cultural settings.

PULITZER PRIZE FINALIST • "A stunning exposé of why Black people in our society 'live sicker and die quicker'—an eye-opening game changer."—Oprah Daily From an award-winning writer at the New York Times Magazine and a contributor to the 1619 Project comes a landmark book that tells the full story of racial health disparities in America, revealing the toll racism takes on individuals and the health of our nation. In 2018, Linda Villarosa's New York Times Magazine article on maternal and infant mortality among black mothers and babies in America caused an awakening. Hundreds of studies had previously established a link between racial discrimination and the health of Black Americans, with little progress toward solutions. But Villarosa's article exposing that a Black woman with a college education is as likely to die or nearly die in childbirth as a white woman with an eighth grade education made racial disparities in health care impossible to ignore. Now, in Under the Skin, Linda Villarosa lays bare the forces in the American health-care system and in American society that cause Black people to “live sicker and die quicker” compared to their white counterparts. Today's medical texts and instruments still carry fallacious slavery-era assumptions that Black bodies are fundamentally different from white bodies. Study after study of medical settings show worse treatment and outcomes for Black patients. Black people live in dirtier, more polluted communities due to environmental racism and neglect from all levels of government. And, most powerfully, Villarosa describes the new understanding that coping with the daily scourge of racism ages Black people prematurely. Anchored by unforgettable human stories and offering incontrovertible proof, Under the Skin is dramatic, tragic, and necessary reading.