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.

In their later years, Americans of different racial and ethnic backgrounds are not in equally good-or equally poor-health. There is wide variation, but on average older Whites are healthier than older Blacks and tend to outlive them. But Whites tend to be in poorer health than Hispanics and Asian Americans. This volume documents the differentials and considers possible explanations. Selection processes play a role: selective migration, for instance, or selective survival to advanced ages. Health differentials originate early in life, possibly even before birth, and are affected by events and experiences throughout the life course. Differences in socioeconomic status, risk behavior, social relations, and health care all play a role. Separate chapters consider the contribution of such factors and the biopsychosocial mechanisms that link them to health. This volume provides the empirical evidence for the research agenda provided in the separate report of the Panel on Race, Ethnicity, and Health in Later Life.

If you're the only person from your ethnic background in your organization or team, you probably know what it's like to be misunderstood or marginalized. Organizational consultant Adrian Pei describes key challenges ethnic minorities face in majority-culture organizations, unpacking the historical forces at play and what both minority and majority cultures need to know in order to work together fruitfully.

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.

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.

A guide to the latest research on how young people can develop positive ethnic-racial identities and strong interracial relations Today’s young people are growing up in an increasingly ethnically and racially diverse society. How do we help them navigate this world productively, given some of the seemingly intractable conflicts we constantly hear about? In Below the Surface, Deborah Rivas-Drake and Adriana Umaña-Taylor explore the latest research in ethnic and racial identity and interracial relations among diverse youth in the United States. Drawing from multiple disciplines, including developmental psychology, social psychology, education, and sociology, the authors demonstrate that young people can have a strong ethnic-racial identity and still view other groups positively, and that in fact, possessing a solid ethnic-racial identity makes it possible to have a more genuine understanding of other groups. During adolescence, teens reexamine, redefine, and consolidate their ethnic-racial identities in the context of family, schools, peers, communities, and the media. The authors explore each of these areas and the ways that ideas of ethnicity and race are implicitly and explicitly taught. They provide convincing evidence that all young people—ethnic majority and minority alike—benefit from engaging in meaningful dialogues about race and ethnicity with caring adults in their lives, which help them build a better perspective about their identity and a foundation for engaging in positive relationships with those who are different from them. Timely and accessible, Below the Surface is an ideal resource for parents, teachers, educators, school administrators, clergy, and all who want to help young people navigate their growth and development successfully.

The classic, New York Times-bestselling book on the psychology of racism that shows us how to talk about race in America. Walk into any racially mixed high school and you will see Black, White, and Latino youth clustered in their own groups. Is this self-segregation a problem to address or a coping strategy? How can we get past our reluctance to discuss racial issues? Beverly Daniel Tatum, a renowned authority on the psychology of racism, argues that straight talk about our racial identities is essential if we are serious about communicating across racial and ethnic divides and pursuing antiracism. These topics have only become more urgent as the national conversation about race is increasingly acrimonious. This fully revised edition is essential reading for anyone seeking to understand dynamics of race and racial inequality in America.

Amidst discontent over America's growing diversity, many white Americans now view the political world through the lens of a racial identity. Whiteness was once thought to be invisible because of whites' dominant position and ability to claim the mainstream, but today a large portion of whites actively identify with their racial group and support policies and candidates that they view as protecting whites' power and status. In White Identity Politics, Ashley Jardina offers a landmark analysis of emerging patterns of white identity and collective political behavior, drawing on sweeping data. Where past research on whites' racial attitudes emphasized out-group hostility, Jardina brings into focus the significance of in-group identity and favoritism. White Identity Politics shows that disaffected whites are not just found among the working class; they make up a broad proportion of the American public - with profound implications for political behavior and the future of racial conflict in America.