Search

The large and persistent differences in health outcomes between African Americans and whites have sometimes been attributed to differences in the quality of the facilities in which they receive care. A large body of literature documents systematically worse performance by facilities which serve a larger share of black patients. However, these estimates may be biased by unobserved variables which correlate with the racial profile of the clinic and also affect outcomes. This paper uses a unique dataset from the Department of Veterans' Affairs system to examine the relationship between the quality of health care and the racial profile of the patient population in an equal-access health care system. An instrumental variable is used to overcome the omitted variable bias in the Ordinary Least Squares (OLS) estimates. Both the OLS and IV estimates show that increasing the proportion of visits by African-American patients results in improved outcomes for all patients treated at the clinic. The OLS results significantly underestimate the effect of increasing the proportion of black patients. Holding the overall clinic load constant and adding one hundred outpatient visits by African Americans in a year would result in a 0.5 percentage point decrease in 1-year mortality for the average patient in the clinic. Thus, contrary to results from the private health care sector, increasing clinic racial integration in an equal access system would benefit all patients. Keywords Racial segregation. Health and health care markets. Discrimination JEL 100, Introduction Research over the last 20 years has shown persistent racial differences in health care access, utilization, and outcomes. Numerous studies have documented that minorities, particularly African Americans, experience higher [...]

Nursing homes serve many severely ill poor people, including large numbers of racial/ethnic minority residents. Previous research indicates that blacks tend to receive care from lower quality nursing homes. Using the Institute of Medicine (IOM) definition of racial-ethnic disparities, this study decomposes nursing home disparities into within and across facility components. Using detailed person-level nursing home data, we find meaningful black-white disparities for one of the four risk-adjusted quality measures, with both within and across nursing home components of the disparity. The IOM approach, which recognizes mediation through payer status and education, has a small effect on measured disparities in this setting. Although we did not find disparities across the majority of quality measures and alternate disparity definitions, this approach can be applied to other health care services in an effort to disentangle the role of across and within facility variation and the role of potential mediators on racial/ethnic disparities. Keywords Racial disparities * Long-term care * Decomposition methods JEL I10 * J15, Introduction A great deal of recent policy interest focuses on racial and ethnic disparities in health care settings (Institute of Medicine 2002). Nursing home quality has been a serious concern [...]

Obesity among U.S. adolescents ages 12-19 rose from 4.6% in 1963-1965 to 17.4% in 2003-2004. This paper contributes to the literature on the impact of unhealthy body mass index (BMI) on health (e.g., obesity) and human capital (e.g., schooling) investments of adolescents. We use the propensity score method to study 8,388 individuals who responded to survey Waves I through III of the National Longitudinal Study of Adolescent Health (Add Health), for students in grades 7-12. We estimate an economic model that captures longer-term effects of BMI categories (obesity and overweight separately) on on-time (dichotomous) high school graduation. We control for characteristics at the individual, household, and community levels. Baseline probit regression estimates were improved upon by using matching estimators (propensity scores yield consistent estimate of the average treatment on the treated) based on the nearest neighbor and the more robust kernel density weighting schemes. Results from both full and reduced models suggest no adverse impact of overweight or obesity on timely high school completion for males, but a significant average negative effect on females. Investigating disparities in effects across both gender and race, we isolate the adverse effects primarily to white and Asian females. No significant effects were found for African-Americans. One of the novel contributions of our research is that the significant effects of gender- and race- specific adolescent obesity and overweight conditions reach beyond high school GPA standing to also impact on-time high school graduation status. Keywords Adolescents * Obesity * Overweight * BMI * On-time high school graduation * Propensity scores * Add Health JEL 100, Introduction Obesity among US adolescents ages 12 to 19 has increased from an estimated 4.6% in 1963-1965 to an estimated 17.4% in 2003-2004 (Ogden et al. 2008). Most past research [...]

Much research on the issue of health disparities in the United States has been produced by health services researchers across disciplines, particularly medical care providers, public health workers and sociologists. Many economists have also studied health disparities. This special issue of Atlantic Economic Journal highlights in particular the role of economic scholarship in this important national debate. This article, introducing the special issue, categorizes the contribution of many economists to the literature on health disparity. The literature reviewed ultimately includes 107 articles published between 1998 and 2008. Articles by any of the 932 economists that were members of the American Society of Health Economists in 2006 publishing about racial/ethnic health disparities as found in Medline, articles related to racial/ethnic health disparities published in Health Economics or the Journal of Health Economics or through searches in EconLit were reviewed for inclusion. Keywords Health disparities. Health policy. Literature review JEL I-Health. Education. Welfare, Introduction Throughout US history health status gaps between the majority white population and numerous racial/ethnic subpopulations have been observed and have persisted. Life expectancy at birth, a gross measure of [...]

Abstract Sport is a social institution that is rife with raced and gendered discursive fields, creating structural and power relations that may influence the leadership experiences of Black women there-in. [...]

Address by GEORGE FRASER, Author Delivered to The Commonwealth Club of California, San Francisco, California, December 12, 1997 Good evening and thank you so much for taking some time to [...]

In the U.S.A., government action to combat workplace discrimination against minorities faces growing criticism The civil rights revolution in the United States was primarily a struggle for liberty, not equality. [...]

The authors examine the role that racial differences in access to high-paying occupations played in determining the racial wage gap in the 1980s. Analyzing data on black and white women aged 34-44 from the National Longitudinal Surveys for 1968-88, they estimate the effects of human capital characteristics and discrimination on segregation into high- and low-wage jobs by race. They find that differences in workers' measured characteristics explain little of either the observed occupational segregation by race or the racial wage gap in 1988. Further analysis suggests that several changes in the wage structure for women during the 1980s, notably a widening of occupational wage differentials and an increase in the returns to education, abetted direct discrimination in enlarging the racial wage gap among women., Between 1940 and 1980, black women experienced considerable improvement in their economic status relative to white women. In 1940, black women earned approximately 50% of the wages earned by white [...]

African American buyers spend more than anyone for new or used cars. Why are we getting 'shafted'? Here's how to fight back. IN THE MARKET FOR A NEW OR USED [...]

When Nelson Mandela called for the creation of a 'rainbow nation' in his May 10 inaugural speech as president of South Africa, there were echoes of Jesse Jackson's appeal for [...]

THE WASHINGTON POST marked Martin Luther King, Jr. Day on Jan. 18, 1993, with a front-page article headlined 'Few Blacks Reach Top in Private Sector, Census Finds.' The story said [...]

The northwestern Czech city of Usti nad Labem made international headlines less than two years ago when the local residents of one neighbourhood decided to build a concrete wall to [...]

The spectre must be exorcised Some readers' hearts and spirits will sink at this editorial, which marks the publication of a book on racism in medicine from the King's Fund, [...]

The recent civil unrest in Cincinnati over a policeman's fatal shooting of an unarmed Black man, Timothy Thomas (JET April, 30), is the latest in a series of growing incidents [...]

NEW YORK, FEBRUARY 20 For years and at different levels we've gotten fired up by the fear of creeping social estrangement. The 'quest for community' was one great expression of [...]

'Racial profiling' has become one of the shibboleths of our time. Anyone who wants a public career in the United States must place himself on record as being against it. [...]

A White surgeon recently came under fire for granting a White patient's request to keep Black men out of the operating room during her open-heart surgery. Dr. Michael R. Petracek, [...]

Bob J. Nash and Janis F. Kearney, a married couple who are two of President Clinton's highest-ranked White House aides, were recent victims of a terrifying case of 'Driving While [...]

Church prays in Face of rally against immigrants St. Julia Church in Siler City, N.C., responded to a local anti-immigration rally with the Eucharist and with prayer at a bilingual [...]

The UCLA forum last week had one of those nifty-sounding titles, 'Diversifying Hollywood,' that theoretically says it all. 'For the entertainment industry to be truly successful,' said Rep. Diane Watson [...]

FRATS AND SORORITIES The Greek Rites Of Exclusion My interest in fraternities began innocently, on abalmy night last fall, when a friend and I attempted to drive across the campus [...]

The black family and the urban public schools share more than their children. The 'plight' of each has been assayed in apocalyptic terms and chronicled in the reports of myriad [...]

Attorney General Janet Reno, accompanied by her underlings, strides to the podium at the Department of Justice and announces another settlement with a bank for alleged lending discrimination. Reno has [...]