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Understanding Associations between Race, Socioeconomic Status, and Health: Patterns and Prospects

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The Social Medicine Reader, Volume II, Third Edition
This chapter is in the book The Social Medicine Reader, Volume II, Third Edition
Understanding Associations between Race, Socioeconomic Status, and HealthPatterns and ProspectsDavid R. Williams, Naomi Priest, and Norman AndersonRacial and ethnic stigmatized peoples experience higher rates of illness, impairment, and death than the average of their societies in the U.S. and glob-ally (Williams 2012). Across multiple health outcomes, these disparities are also seen in the earlier onset of illness, more severe disease, and poorer quality of care for racial/ethnic minorities compared to their majority peers. Socio-economic status (ses), whether measured by income, education, or occupa-tional status, is among the most robust determinants of variations in health outcomes in virtually every society throughout the world (who Health Com-mission 2008). Understanding the complex ways in which race, ethnicity, and ses, uniquely and in combination, influence health outcomes is thus a critical task in addressing disparities across the socioeconomic spectrum and among racial/ethnic groups (Williams, Mohammed et  al. 2010). This commentary considers empirical evidence regarding these complexities and argues for greater attention to understanding risks and resources in the social environ-ment that are linked to race, ethnicity, and ses, and to how they combine and accumulate together with innate and acquired biological factors across the life course, to influence cardiovascular disease and other health outcomes.Historically, the categorization of social groups into races has reflected oppression, exploitation, and social inequality (American Sociological David  R. Williams, Naomi Priest, and Norman Anderson, “Understanding Associations between Race, Socioeconomic Status and Health: Patterns and Prospects,” from Health Psychology 35, no. 4 (2016): 407–411. Copyright © 2016 by American Psychological Association. Reprinted by permission.
© 2020 Duke University Press, Durham, USA

Understanding Associations between Race, Socioeconomic Status, and HealthPatterns and ProspectsDavid R. Williams, Naomi Priest, and Norman AndersonRacial and ethnic stigmatized peoples experience higher rates of illness, impairment, and death than the average of their societies in the U.S. and glob-ally (Williams 2012). Across multiple health outcomes, these disparities are also seen in the earlier onset of illness, more severe disease, and poorer quality of care for racial/ethnic minorities compared to their majority peers. Socio-economic status (ses), whether measured by income, education, or occupa-tional status, is among the most robust determinants of variations in health outcomes in virtually every society throughout the world (who Health Com-mission 2008). Understanding the complex ways in which race, ethnicity, and ses, uniquely and in combination, influence health outcomes is thus a critical task in addressing disparities across the socioeconomic spectrum and among racial/ethnic groups (Williams, Mohammed et  al. 2010). This commentary considers empirical evidence regarding these complexities and argues for greater attention to understanding risks and resources in the social environ-ment that are linked to race, ethnicity, and ses, and to how they combine and accumulate together with innate and acquired biological factors across the life course, to influence cardiovascular disease and other health outcomes.Historically, the categorization of social groups into races has reflected oppression, exploitation, and social inequality (American Sociological David  R. Williams, Naomi Priest, and Norman Anderson, “Understanding Associations between Race, Socioeconomic Status and Health: Patterns and Prospects,” from Health Psychology 35, no. 4 (2016): 407–411. Copyright © 2016 by American Psychological Association. Reprinted by permission.
© 2020 Duke University Press, Durham, USA

Chapters in this book

  1. Frontmatter i
  2. Contents v
  3. Preface to the Third Edition ix
  4. Introduction 1
  5. Social and Cultural Contributions to Health, Differences, and Inequalities 3
  6. Part I. Defining and Experiencing Differences
  7. Beyond Medicalisation 31
  8. On Being a Cripple 37
  9. What You Mourn 48
  10. Physicians’ Juries for Defective Babies 50
  11. Blind, Deaf, and Pro-Eugenics: Helen Keller’s Advice in Context 52
  12. Tell Me, Tell Me 54
  13. Instructions to Hearing Persons Desiring a Deaf Man 61
  14. I Have Diabetes. Am I to Blame? 62
  15. Part II. Sickness amid Relationships
  16. Twisted Lies: My Journey in an Imperfect Body 67
  17. Raising a Woman 78
  18. The Sick Wife 83
  19. The Loneliness of the Long-Term Care Giver 84
  20. Fathers and Sons 92
  21. Parents Support Group 93
  22. Part III. Social Factors and Inequalities
  23. “Doctors Don’t Know Anything”: The Clinical Gaze in Migrant Health 97
  24. Anthropology in the Clinic: The Problem of Cultural Competency and How to Fix It 116
  25. Beyond Cultural Competence: Applying Humility to Clinical Settings 127
  26. The Racist Patient 132
  27. The Social Determinants of Health: Coming of Age 134
  28. Structural Violence and Clinical Medicine 156
  29. Structural Competency Meets Structural Racism: Race, Politics, and the Structure of Medical Knowledge 170
  30. Racial Categories in Medical Practice: How Useful Are They? 188
  31. Taking Race Out of Human Genetics: Engaging a Century-Long Debate about the Role of Race in Science 204
  32. Structural Racism and Health Inequities in the United States of America: Evidence and Interventions 209
  33. America’s Hidden HIV Epidemic 235
  34. Is the Prescription Opioid Epidemic a White Problem? 254
  35. Understanding Associations between Race, Socioeconomic Status, and Health: Patterns and Prospects 258
  36. Can Disparities Be Deadly? Controversial Research Explores Whether Living in an Unequal Society Can Make People Sick 268
  37. Religion and Global Health 275
  38. Part IV. Politics, Institutions, and Care
  39. Thinking through the Pain 297
  40. Unfinished Journey: The Struggle over Universal Health Insurance in the United States 305
  41. On Incarceration and Health: Reframing the Discussion 314
  42. Bioexpectations: Life Technologies as Humanitarian Goods 318
  43. About the Editors 341
  44. Index 343
Readers are also interested in:
https://doi.org/10.1515/9781478004363-030

Chapters in this book

  1. Frontmatter i
  2. Contents v
  3. Preface to the Third Edition ix
  4. Introduction 1
  5. Social and Cultural Contributions to Health, Differences, and Inequalities 3
  6. Part I. Defining and Experiencing Differences
  7. Beyond Medicalisation 31
  8. On Being a Cripple 37
  9. What You Mourn 48
  10. Physicians’ Juries for Defective Babies 50
  11. Blind, Deaf, and Pro-Eugenics: Helen Keller’s Advice in Context 52
  12. Tell Me, Tell Me 54
  13. Instructions to Hearing Persons Desiring a Deaf Man 61
  14. I Have Diabetes. Am I to Blame? 62
  15. Part II. Sickness amid Relationships
  16. Twisted Lies: My Journey in an Imperfect Body 67
  17. Raising a Woman 78
  18. The Sick Wife 83
  19. The Loneliness of the Long-Term Care Giver 84
  20. Fathers and Sons 92
  21. Parents Support Group 93
  22. Part III. Social Factors and Inequalities
  23. “Doctors Don’t Know Anything”: The Clinical Gaze in Migrant Health 97
  24. Anthropology in the Clinic: The Problem of Cultural Competency and How to Fix It 116
  25. Beyond Cultural Competence: Applying Humility to Clinical Settings 127
  26. The Racist Patient 132
  27. The Social Determinants of Health: Coming of Age 134
  28. Structural Violence and Clinical Medicine 156
  29. Structural Competency Meets Structural Racism: Race, Politics, and the Structure of Medical Knowledge 170
  30. Racial Categories in Medical Practice: How Useful Are They? 188
  31. Taking Race Out of Human Genetics: Engaging a Century-Long Debate about the Role of Race in Science 204
  32. Structural Racism and Health Inequities in the United States of America: Evidence and Interventions 209
  33. America’s Hidden HIV Epidemic 235
  34. Is the Prescription Opioid Epidemic a White Problem? 254
  35. Understanding Associations between Race, Socioeconomic Status, and Health: Patterns and Prospects 258
  36. Can Disparities Be Deadly? Controversial Research Explores Whether Living in an Unequal Society Can Make People Sick 268
  37. Religion and Global Health 275
  38. Part IV. Politics, Institutions, and Care
  39. Thinking through the Pain 297
  40. Unfinished Journey: The Struggle over Universal Health Insurance in the United States 305
  41. On Incarceration and Health: Reframing the Discussion 314
  42. Bioexpectations: Life Technologies as Humanitarian Goods 318
  43. About the Editors 341
  44. Index 343
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