Guest Editor's Introduction: Sociological Perspectives on Racial and Ethnic Inequality in Health and Health Care

Abstract

I am pleased to introduce this special issue of Sociobgical Focus, Sociological Perspectives on Racial and Ethnic Inequality in Health and Health Care. Although researchers from a broad set of discipli nes contribute to efforts to answer questions about racial inequality in health and health care, sociologists have the ability to add a vital perspective to this research. We have social theories and methodological approaches that lend insight into the mechanisms that lead to social inequality. The papers in this issue use a variety of theories and methods to illuminate several of the mechanisms associated with racial and ethnic inequality in health and health care. Racial and ethnic groups are socially created and recreated categorizations of people that serve to distribute material and symbolic resources unequally (Bonilla-Silva 1997; Lewis 2004; Orni and Winant 1994). Racial and ethnic inequality can be found on many measures of health status, with non-Hispanic whites having better health than blacks, Native Americans, and Hispanics. For example, Mexican Americans and Native Americans are more than two times more likely than whites to have diabetes. Blacks are 1 .6 times more likely than whites to have diabetes. Based on limited data, it appears that some Asian American subgroups have an increased risk of poor health, while other subgroups have a decreased risk (Centers for Disease Control 2005). Given documentation of inequality in health status, researchers have sought to uncover the sources of racial and ethnic differences in health status. Sociologists contribute to this work by examining how structural forces influence the resources available for health-promoting activities and the likelihood of experiencing health risks. Unequal health status results from a myriad of mechanisms that begin with the system of racial inequality and lead to inequities in many domains-from income inequality to stress associated with interpersonal racial discrimination (Williams and Collins 1995). Sources of inequality in health have often been investigated using large national data sets, which provide a vehicle for effectively assessing national-level inequality on specific measures of health status. In this volume, the research by Lisa A. Cubbins and Tom Buchanan follows this tradition by using the National Health Interview Survey to demonstrate the complex relationship among race, ethnicity, socioeconomic status, health behaviors, and health status. The/ report that socioeconomic status and health behaviors help to explain racial and ethnic inequality in health status, but that the benefits of some of these factors vary by race and ethnicity, with non-Hispanic whites garnering greater benefit. Their thoughtful analysis reflects the complexity of the system of racial, ethnic, and class inequality in the United States. One of the complexities of racial, ethnic, and class inequality can be found in the infant mortality rate. This rate is considered an excellent indicator of population health, because it provides an indication of the health of women as well as access to health care. In 2005, the infant mortality rate for babies born to black mothers was 2.4 times higher than for those born to non-Hispanic white women. In contrast, the infant mortality rate for babies born to Hispanic women is lower than that for white women (Mathews and MacDorman 2008). The low infant mortality rate among Hispanics has led to research on the of a socially and economically disadvantaged ethnic group with unexpectedly good health (e.g., de la Rosa 2002). Though, as Toni Terling Watt and Gloria Martinez-Ramos note in this issue, conclusions about an epidemiological paradox should be made cautiously. Watt and Martinez-Ramos challenge the low reported prevalence of development disorders among Hispanic children. They demonstrate that while the prevalence of diagnosis of development disorders is lower among Latinos than among whites, Latino parents are more likely to have concerns about their child's development. …