Class Disparities Research Articles

Boom Town: How Wal-Mart Transformed an All-American Town into an International Community by Marjorie Rosen

Boom Town: How Wal-Mart Transformed an All-American Town into an International Community by Marjorie Rosen

Degrees of inequality: culture, class, and gender in American higher education

Degrees of Inequality reveals the powerful patterns of social inequality in American higher education by analyzing how the social background of students shapes nearly every facet of the college experience. Even as the most prestigious institutions claim to open their doors to students from diverse backgrounds, class disparities remain. Just two miles apart stand two institutions that represent the stark class contrast in American higher education. Yale, an elite Ivy League university, boasts accomplished alumni, including national and world leaders in business and politics. Southern Connecticut State University graduates mostly commuter students seeking credential degrees in fields with good job prospects. Ann L. Mullen interviewed students from both universities and found that their college choices and experiences were strongly linked to social background and gender. Yale students, most having generations of family members with college degrees, are encouraged to approach their college years as an opportunity for intellectual and personal enrichment. Southern students, however, perceive a college degree as a path to a better career, and many work full- or part-time jobs to help fund their education. Moving interviews with 100 students at the two institutions highlight how American higher education reinforces the same inequities it has been aiming to transcend.

Help for All Parents?: Child-Rearing Advice in English Canada in the 1960s and 1970s

Changes occurring in Canadian society during the 1960s and 1970s were poorly reflected in the child-rearing advice directed to English-Canadian parents. Despite the rise in the number of women working outside the home and feminist calls for a more equitable division of child care, experts only sometimes modified their advice to acknowledge this reality. In addition, the creation of the welfare state seemed to encourage child-rearing advisors to ignore class disparities. Finally, experts in this period rarely acknowledged any racial diversity in the Canadian population, despite an increasingly multicultural society. They continued to presume as the norm a white, Anglo-Saxon, middle-class family in which mothers remained the primary caregivers.

Year 7 Pupils' Views of the Future

This paper reports findings from a study among 610 Year 7 (typically age 12) pupils at 27 nonselective secondary schools in three English regions: Cornwall and Devon, London, and Greater Manchester. Data was gathered in workshops, each with 15–25 pupils, who completed questionnaires and performed individual tasks, all related to their vocational and educational aims, their ideas on what counted as success, and the main influences on their forward thinking, then discussed their answers and results. The discussions were tape recorded. Most pupils expressed robust occupational aims, and most said that they wanted to go to university. Family class did not predict levels of educational or occupational aims, but was related to the importance attached to “the job that I want to do” in the pupils' forward thinking. SAT scores did predict levels of occupational aspiration, ideas on what counted as success, and by whom and what the pupils were most influenced. These findings are interpreted to challenge the view, on which a raft of current policies are based, that social class disparities in educational and labour market outcomes are due to the intergenerational transmission of low aspirations in lower-class families and neighbourhoods. The paper concludes with an alternative model of status transmission processes in which attainments during secondary education are posited as the key intervening variable.

The Ethics of Mechanical Restraints in Prisons and Jails: A Preliminary Inquiry from Psychological Jurisprudence

According to the American Correctional Association (ACA, 2008), mechanical restraint use is to be limited, preventing injury to self and/or to others when administered and certainly not applied to inmates as a punitive or protracted intervention. Regrettably, however, the ongoing use of control devices raises a number of thorny questions when deployed in prisons and jails. This article systematically reviews these concerns. Specifically, the health and mental health consequences for incarcerates are delineated, and the race, gender, class, and mental disability disparities that correspondingly attach are examined. Given these myriad concerns, the ethical justifications that serve as support for or opposition to this correctional practice are described. The article concludes by provisionally recommending how the philosophy of psychological jurisprudence, informed by insights derived from restorative justice and therapeutic jurisprudence, functions as a type of virtue ethics that re-conceives the problems posed by mechanical restraint use. The resultant strategy promotes healing, advances justice, and grows integrity for the kept and for their keepers, managers, and watchers.

Race, Class and Gender Disparities in Clara Barton's Late Nineteenth-Century Disaster Relief

Abstract This case study explores how civil society bodies developed to respond to US disasters in the context of the erratic nineteenth-century American state. It focuses on the American Red Cross, whose founder, Clara Barton, transplanted the Red Cross concept from its native Swiss soil to the US and changed the organisation's principal mission from assistance of wounded soldiers to disaster relief. Barton also transplanted the Geneva Conventions' ideal of 'neutrality' from the national fault lines of Europe to the social fault lines of the US. Just as the Conventions called for impartial medical assistance to wounded combatants regardless of national affiliation, Barton aimed to offer impartial medical and material aid to disaster sufferers regardless of race, gender or religion. This study comparatively examines the organisation's execution of these ideals in its response to two major US disasters, the 1889 Johnstown Flood in Pennsylvania, and the Sea Islands Hurricane in South Carolina. Late nineteenth-century social ideologies of class, race and gender shaped public perception of these events and consequently the degree and type of assistance offered to the survivors. While Barton's ideal of neutrality somewhat mitigated this disparity, she was unable to counter or escape the pervasive ideologies of difference that led to cruel inequalities in state and societal responses to disasters. This study suggests that civil society organisations cannot mitigate such inequalities when not supported by an egalitarian state, and that they work more effectively when supplementing rather than supplanting the state's emergency social welfare functions.

Shedding a new light on the HLA matching

Shedding a new light on the HLA matching

Health Care Reform and Health Disparities: Implications for Social Workers

Health disparities, or preventable differences in burden of disease, injury and violence, or opportunities ... experienced by socially disadvantaged racial, ethnic, and other populations groups and communities, remain a serious problem in United States (Centers for Disease Control and Prevention, 2008). The grim figures are well known to social workers (NASW, 2009). Compared with white Americans, African Americans have shorter life expectancies and higher rates of disease and death. Although Hispanic Americans, particularly those born in other countries, are in better than nonimmigrant white Americans for at least one generation after immigrating, they lag behind in some measures (Kimbro, Bzostek, Goldman, & Rodriquez, 2008; Russell, 2009; U.S. Department of Health and Human Services [HHS], 2010). Racial and ethnic minorities, including Hispanic Americans, also generally have less access to care than white Americans, and when they get it, it is often inferior (HHS, 2010). Much less is known about disparities from Asian Americans, Arab Americans, and other racial and ethnic groups. During presidential campaign, candidates Obama and Biden pledged to tackle root causes of disparities by addressing differences in access to coverage and promoting prevention and public health (Obama Biden, n.d.). The Obama administration has also pledged to take steps to address disparities (Council on Social Work Education, 2010). Yet, what has been done to date? Thus far, one feat has been enactment of Patient Protection and Affordable Care Act (PPACA) (EL. 111-148) by Congress in March 2010. This article examines potential impact of PPACA on two kinds of disparities: racial and ethnic disparities and class (as determined or influenced by socioeconomic status) disparities. PPACA AND RACIAL AND ETHNIC DISPARITIES A central issue facing many racial and ethnic minorities is lack of access to care. In 2008, 10.8 percent of non-Hispanic white Americans lacked insurance, whereas 19.l percent of African Americans and 30.7 percent of Hispanic Americans no coverage (these figures provide a rough measure of uninsured population at a point in time, not entire year) (U.S. Census Bureau, 2009). If implemented as planned, PPACA ameliorate this problem by providing tax credits and other subsidies to individuals and families earning less than 400 percent of poverty line to assist them in buying coverage through new exchanges (Kaiser Family Foundation, 2010). Because approximately 80 percent of nonelderly blacks, Hispanics, and American Indians and Alaska Natives (compared with 57 percent of white Americans) had incomes below 400 percent of poverty, new law should help reduce disparities in access (Families USA, 2010). The legislation also extend Medicaid coverage to children and adults with incomes below 133 percent of poverty line. PPACA also should decrease group differences in by expanding funding for community centers, which have played a critical role in effort to stem the nation's growing flood of uninsured (Iglehart, 2010, p. 343). Former president George W. Bush described these centers, which grew out of antipoverty efforts of 1960s, as integral part of a care system because they provide care for low-income, for newly arrived, and they take pressure off of our hospital emergency rooms (cited in Iglehart, 2010, p. 343). In 2008, 61 percent of 20 million people served by community were African American or Hispanic American (National Association of Community Health Centers, 2009). The legislation provide $11 billion over five years, an investment that will approximately double number of people seen in centers (Wakefield, 2010). Also, plans be required to offer free preventive and wellness coverage, which many African Americans, Hispanic Americans, and others with high rates of uninsurance often go without (Health Reform for African Americans, n. …

Beyond the Binary: Critical Feminisms in Social Work

Affilia has had 30 or more years of creating and holding space open for feminist social work scholars, activists, and poets to reflect on the nexus of their work and social justice. So why is Affilia publishing this special issue on critical feminisms and why is the journal’s corporate board organizing an upcoming conference on unsettling feminisms? Is there a need? Yes, we would answer emphatically. There is a need to open and broaden spaces for critical feminist work because much feminist social work research, practice, and education focus on ‘‘women’s issues’’ without critically exploring or analyzing structural issues and forces as they inform people’s lives. In this era of preemptive wars and increasingly globalized racial and class disparities, critical voices are systematically silenced or dismissed. Without critical feminist voices that highlight the ways in which inequalities in power and social structures distort gender, many people experience limited access to opportunities and a reduced potential for development. We join with Trevino, Harris, and Wallace (2008, p. 8) and paraphrase the much-needed contribution from critical scholarship:

Migrants’ Voices

The regional autonomy movement based in Santa Cruz draws on long-standing regional divisions, and it has solidified amid the breakdown of the elite-led political party system and the national election of Evo Morales and the Movimiento al Socialismo (Movement Toward Socialism—MAS). Critics and national government supporters view regional autonomy as a defensive stance taken by elites against the redistributive policies, expansion of indigenous sovereignty, and widening popular democracy under the MAS. But lowland regional leaders and elites have begun to present autonomy as inclusive and popular in order to broaden support and challenge the Morales government. Largely removed from debates over autonomy are migrants to the rapidly urbanizing city of Santa Cruz who in many cases experience uneven integration into host communities. Despite the autonomists’ efforts at fostering inclusion and popular buy-in, highland migrants’ support for autonomy is weak, while lowland migrants generally favor autonomy and skilled highlanders—more integrated into Santa Cruz—tend to support it conditionally. Migrants of all three groups perceive class disparities within the city to be as salient as regional and ethnic divisions.

David et al. Respond to "The Socioeconomic Causes of Adverse Birth Outcomes"

We appreciate the supportive reflection presented in the accompanying invited commentary by Drs. Messer and Kaufman (1) on our weathering study (2). We strongly agree with their statement that we have just begun to scratch the surface of this area of research. Data limitations and theoretical perspective have inhibited exploration of social causation in birth outcomes, especially when a long-term view—lifelong or beyond—is concerned. Similar limitations have been reviewed extensively in the Journal (3, 4). The data set constructed for this project could probably be replicated and improved upon in other populations, by using more recent cohorts to expand this promising front in perinatal social epidemiology. Recent work has demonstrated the biologic plausibility of effects of the social environment being transmitted biologically across generations to impact birth outcomes (5). Whether future investigations of possible biologic pathways end up favoring the corticotrophin-releasing hormone trigger mechanism, altered modulation of inflammation impacting the timing of parturition, or some entirely different mechanism, there is growing evidence that the psychosocial context of pregnancy has a predictable impact on birth outcomes. Demonstrating social stressors at the population level is not without difficulties. There are limitations to US population-wide birth outcome data (i.e., vital records) that limited this study and will pose a challenge to others who pursue this field of inquiry. First, there is no true social class designation on vital records in this country. Use of census linkage as in our study is limited to ecologic data on class and is fraught with technical problems (6). Education has been used as a proxy for socioeconomic status at the individual level, but that variable tells us little about younger women. If a 17-year-old mother has completed 10 years of school, she may or may not be a high school dropout. If a woman has completed the age-appropriate years of school at less than the graduate school level, we still know little about her social class. In the innovative work by Emanuel et al. (7) in which Washington State intergenerational birth records were linked to hospital discharge and financial data, additional individual-level socioeconomic status information was available. With maternal insurance status added to the US standard certificate of livebirth in 2003 (http:// www.cdc.gov/nchs/data/dvs/birth11-03final-ACC.pdf), this piece of individual-level social class data should become available in a growing number of states. Unfortunately, this indicator is still limited to identifying the most disadvantaged women (those receiving public insurance). Investigations like the Whitehall studies of British civil servants make it clear that class disparities up and down the social ladder have health consequences (8). In the popular mythology of America, there are no classes, only races. Public data, sadly, reflect this outlook. Limitations on the study of social causation are even more fundamentally associated with the theoretical framework that dominates the life sciences in this historical moment. Epidemiology has not been immune to the siren song of the human genome. One cannot deny the fact that all biology is at some level affected by the genetic substrate on which it is built. However, even when there are sudden shifts in prevalence in populations over less than a generation, such as in the rate of childhood obesity, epidemiologic analyses appear looking for genomic clues (9). This approach seems counterintuitive at best. We have argued that the search for a ‘‘prematurity gene’’ in African Americans is driven by social and political factors rather than a cogent reading of the existing evidence (10). The limitations of available data and theoretical framework are, of course, interlocked. If one considers social factors to be less important—or less amenable to manipulation—than genetic factors, then the collection of detailed and extensive data sets with linked social and medical data is a waste of resources. On the other hand, one can only imagine what sorts of multigenerational social-medical data systems could be created with the sort of funding invested in the Human Genome Project. Perhaps data systems and research initiatives tailored to addressing the social determinants of health will grow in the coming years as new studies make these

Beyond (financial) accessibility: inequalities within the medicalisation of infertility

There is a significant class disparity within the provision of medical treatments for infertility in the United States. Common explanations attribute this inequality to financial inaccessibility due to sparse insurance coverage and exorbitant costs. However, little is known as to why disparities still exist without the presence of such constraints, such as in states with comprehensive insurance coverage of infertility treatments. Drawing on in-depth interviews with women of low socioeconomic status (SES), this paper aims to explore the structural and political barriers to receiving medical care for infertility within the United States context. The paper argues that much of the invisible, unidentified treatment disparities of infertility stem from the social control mechanism of medicalisation. Medicalisation perpetuates the stratified system of reproduction through its structural inaccessibility and the institutionalised classism apparent within medicine's reproductive health practices and policies. The women in this study, however, actively and creatively identified ways to overcome the reproductive limits with which they were faced. In doing so, their solutions served both to accept and reject dominant norms of motherhood and medicine.

Two Decades of Declining Cancer Mortality: Progress with Disparity

The close of the twentieth century brought historic changes in cancer risk factors, early detection, and treatment. As a consequence, we have seen two decades of steadily declining risk of death from cancer in the United States. The reasons for declining cancer mortality rates are largely known: reduced tobacco use, the adoption of cancer early-detection methods, and better cancer therapeutics. Despite this progress, disparities in cancer mortality persist across different groups defined by race and social class. Because all the factors that account for declining cancer trends are influenced strongly by social class, and because of large social class disparities in cancer risk factors, there will likely be a widening gap in cancer mortality among those in lower socioeconomic groups in the future. This article reviews the trends in risk factors for cancer mortality and discusses the persistent problem of disparities by race and social class.

Maternal Practices That Influence Hispanic Infants' Health and Cognitive Growth

Infants born to immigrant mothers, including Hispanic mothers, display birth weight and mortality advantages, compared with other disadvantaged groups. We examined prenatal biological factors and maternal practices that account for this advantage. Then we estimated the extent to which healthy birth outcomes, along with maternal and family factors, contribute to the health and cognitive functioning of Hispanic infants. A representative US sample of 8114 newborns, including 1450 newborns of Hispanic mothers, was drawn randomly in 2001. We compared the mean attributes of infants in subgroups that vary in maternal practices, family attributes, and acculturation levels. We accounted for variations in newborns' gestational age and size for gestational age and their health status and cognitive functioning at 9 months of age. Mexican-heritage and less-acculturated mothers were no more likely than white mothers to bear premature or small-for-gestational age infants, despite large social class disparities, which was explained in part by Hispanic women's low level of prenatal tobacco use. Parenting practices and lower class status of Hispanic mothers then began to slow infants' cognitive development, compared with white infants, because of weaker maternal education and cognitive facilitation during interaction tasks and larger family size. These findings extend earlier research, detailing healthy births among most immigrant Hispanic women. Robust birth outcomes contribute to the early health and cognitive growth of Hispanic infants, but risk factors linked to maternal and home practices overtake these early protective factors by late infancy. Robust births and early health indicators displayed by Hispanic infants should not distract pediatricians from attending to uneven cognitive growth.

Transecting Security and Space in Maputo

Over the past four decades, the Mozambican capital city of Maputo has undergone rapid changes. Although still governed by the (formerly socialist) party that inherited the city from a collapsing Portuguese colonial state in 1975, postsocialist Maputo recasts disparities in class and power. This paper negotiates these fractures, based on two walking transects through the central areas of the city conducted by the coauthors. Initially informed by ‘psychogeography’ literatures on negotiating and representing cities, these were supplemented by and enacted through a focus on security and policing. While the state uses police to secure vital interests, other sites and spaces experience limited policing. To bridge this security gap, commercial and ad hoc security providers are contracted to secure private homes and enterprises. We describe an increased and uneven commoditisation of security. The security landscape of central Maputo thus comprises a complex patchwork of privately secured micro enclaves that relay and rework enclaving on larger scales.

Community psychology: Accomplishments and challenges: Comment on the special section.

The papers in this special section review contributions of Canadian community psychologists and they also look forward, suggesting ways in which the field might evolve in this country. This discussion paper comments on the papers and puts them in the broader context of psychology and public policy. Keywords: community psychology, social action, public policy The role of psychology in public policy has had its ups and downs. On the up side, psychologists have planned interventions and have done research with positive social policy consequences. For instance, their works helped end school segregation in the United States and they were important players in the development of programs such as Head Start (Zigler & Muenchow, 1992). On the down side, psychologists have used their data to support principles of eugenics and theories of accomplishment based on race and gender; they often have contributed to what Ryan (1971) called blaming the victim, treating social problems as if they were the fault of those they affect. And, in a recent controversy, some have participated in the enhanced interrogations at Guantanamo Bay and various Central Intelligence Agency black sites. Somewhere in the midst of these highs and lows, two important events occurred at 1967 annual convention of the American Psychological Convention - events that highlighted the possibilities of the discipline having a positive impact on policy and taking their research and interventions out into the community. The keynote speaker at that convention was the young civil rights leader and Nobel Peace Prize winner who challenged psychologists to expand their scope beyond their traditional work settings - to get out into the community where social problems were having an impact on people's lives (King, 1968). He urged psychologists to study and support structural changes to reduce class, race, and gender disparities - disparities in earnings, health, and education. Commenting on the good deeds done and possible, King (1968) specifically praised Kenneth and Mamie Clark whose research was cited by the U.S. Supreme Court as a social science basis for integrating public schools. Kenneth Clark was the first African American President of American Psychological Association. Sadly, King did not live to see the outcome of his exhortation; he fell to an assassin's bullet within a year. The second major event at that 1 967 convention was the founding of a community psychology division by a group of psychologists whose work was in tune with King's ideas. The emphasis on moving from traditional work sites and into the community was developed at the Swampscott conference in 1965. Aubry, Sylvestre, and Ecker (2010) give an account of the importance of the Swampscott conference, and how it fits into the history of community psychology in Canada; as they point out similar work was underway in Canada well before that conference. Most of those involved in the early days had a clinical background, and their starting point was often the increase in community mental health centers and the opportunities for psychology, social workers, and others to take their practice into those settings. However there was also opposition to simply doing the same things in a different setting. Reiff (1968) in the first presidential address to community psychologists in 1967, warned that they would have to develop a body of theory as well as practice, or the subdiscipline would degenerate into nothing more than an opportunities movement. A decade later, Sarason (1976) referred to community mental health as conceptually bankrupt. The Swampscott Conference focused on prevention as its theoretical underpinning, noting that treatment has never eliminated any disease. Later other theoretical frameworks were placed alongside prevention including empowerment (Prilleltensky, 1994; Rappaport, 1981) and cognitive community psychology (O'Neill, 1981). In addition to the clinicians, others also came on board, most significantly those who worked in education and were dissatisfied with the limited role given to psychologists in school settings (see especially Sarason, 1971). …

The impact of pregnancy on rheumatoid arthritis outcome: The role of maternofetal HLA class II disparity

Objectives To investigate the influence of pregnancy and postpartum on rheumatoid arthritis (RA) course and the impact of maternofetal HLA class II disparity. Methods In 13 women with RA, disease activity was assessed prospectively, before and every three months throughout pregnancy and after delivery until one year in postpartum. The HLA class II disparity was evaluated by typing HLA–DRB1, DQB1 and DQA1 alleles by the PCR-SSOP for 12 couples mothers and babies. Furthermore, for three women, RA disease activity during a previous pregnancy was evaluated retrospectively and HLA typing was performed for the three children. Results The mean age of patients was 30 ± 5 years. All women had successful pregnancy. During pregnancy, a favourable RA outcome was noted in 62.5% of cases. Three patients were in remission after conception. Persistent disease activity was noted in 30% of cases. In postpartum, disease relapse occurred in 92% of cases at a mean delay of 80 ± 63 days. Three women did not resume the initial modifying antirheumatic drugs (DMARDs) 12 months after delivery. For others, the mean delay was 6 ± 3.5 months. There was no significant correlation between the clinicoradiological parameters and the RA outcome. We noted a tendency towards correlation between male newborns and an unfavourable RA outcome ( p = 0.059). A high degree of maternofetal disparity in HLA class II was seen in 73.5% of cases. We observed a more marked improvement in disease activity parameters in case of more than one disparity but without a significant statistical difference. Conclusion A favourable RA outcome during pregnancy in about two-thirds of the cases and a frequent relapse after delivery were observed. RA activity improvement is more obvious at the end of pregnancy. A high degree of maternofetal HLA class II disparity seems to modulate RA disease activity.

Unequal Return: The Uneven Resettlements of New Orleans’ Uptown Neighborhoods

This article examines early resettlement of four neighborhoods in New Orleans’ Uptown district, which was among the first areas to officially reopen for residential return. Drawing on survey data collected from more than 400 households, results show that even in relatively unflooded sections of town, racial and class disparities shaped early returns and accumulated to the disadvantage of African American residents of the city. A key mechanism behind this cumulative disadvantage was that neighborhoods that were predominantly White were disproportionately spared by flooding from the disaster and, consequently, better positioned to host displaced residents from more damaged parts of New Orleans. Because racial boundaries shape housing and social aid networks, White residents from damaged parts of the city became more likely to relocate to these early areas of resettlement, allowing White residents as a whole to play a disproportionate role in the city’s early planning and recovery efforts.

Boost, Control, or Both of Korean Housing Market: 831 Countermeasures

Although the Korean government reported a housing supply ratio of more than 100% in the early 2000s, regional and class disparities in the Korean housing sector have not been correspondingly alleviated. Unfortunately, many Korean households are still enduring the economic burden caused by cyclical price variation, while many housing construction companies are on the verge of bankruptcy. To resolve the ever-expanding socioeconomic problems in the housing and real estate sector, the current Korean government proposed 831 Countermeasures, which has since met with much controversy. In an effort to address these issues, this paper utilizes a qualitative system dynamics model to elucidate and interrogate complex Korean housing mechanisms. By mapping bibliographical and experimental knowledge with causal loop diagrams, the positive and adverse effects of the 831 Countermeasures are also analyzed. Finally, based on the research findings, alternative policy guidelines are proposed that can be used to strengthen positive housing structures and obviate negative ones.

Socioeconomic position and low-back pain – the role of biomechanical strains and psychosocial work factors in the GAZEL cohort

To analyze the role that biomechanical strains and psychosocial work factors play in occupational class disparities in low-back pain in the GAZEL cohort. Recruited in 1989, the GAZEL cohort members were employees of the French national company in charge of energy who volunteered to enroll in an annual follow-up survey. The study population comprised 1487 men who completed questionnaires in 1996 (past occupational exposure to manual material handling, bending/twisting, and driving), 1997 (psychosocial work factors), and 2001 (low-back pain using a French version of the Nordic questionnaire for the assessment of low-back pain). Associations between low-back pain for >30 days in the preceding 12 months and social position at baseline (four categories) were described with a Cox model to determine prevalence ratios for each category. We compared adjusted and unadjusted ratios to quantify the contribution of occupational exposures. The prevalence of low-back pain for >30 days was 13.6%. The prevalence of low-back pain adjusted for age was significantly higher for blue-collar workers and clerks than for managers. The number of socioeconomic disparities observed was significantly reduced when biomechanical strains were taken into account; adjusting for psychosocial factors had little impact. In this population, occupational exposures--especially biomechanical strains--played an important role in occupational class disparities for persistent or recurrent low-back pain.