Publication Type: Conference Paper/Unpublished Manuscript
Review Method: Peer Reviewed
Abstract: African American patients are much more likely than other race patients to receive healthcare from African American physicians. Researchers have assumed that patient preferences influence the race of patients’ healthcare providers, but the strength of preferences and what factors inform them have not been clarified. In this paper, I assess the extent to which 1) knowledge of historical mistreatment, 2) knowledge of current racial inequities in medical treatment, and 3) personal experiences of discrimination predict preference for same-race healthcare providers. Using national phone survey data, I find that only 1 in 5 African Americans states a preference for a same-race healthcare provider. Neither knowledge of historical mistreatment nor knowledge of current racial inequities in medical treatment are related to preferred race of healthcare providers. In contrast, I find that personal experiences of discrimination in healthcare are associated with a preference for same-race healthcare providers. The results contradict prevailing beliefs about African Americans’ preference for black clinicians. They also contradict expectations about the relationship between group-level injustice and preferences. The possible explanations for these findings are reviewed.

Publication Type: Abstract
Abstract: Objective: The objective was to determine if student communication skills differ between patient and physician encounters. Methods: The class of 2008 (n=80), participated in an OSCE as the final in Therapeutics I (Spring P2 year) and Therapeutics II (Fall P3 year). OSCE encounters used standardized participants (SPs) that were either physician- or patient-SPs. Therapeutics I OSCE had 3 physician-SP & 2 patient-SP encounters and Therapeutics II OSCE had 4 physician-SP & 2 patient-SP encounters. Each encounter was graded with a dichotomous therapeutic and communication skill checklist. The communication checklist was the same for all encounters. A communication score was calculated based on the following items: “used appropriate terminology”, “was sensitive to situation”, and “was confident”. Communication scores were compared using a paired T-test. Data are presented as mean  SD with an alpha level of 0.05. Results: The average communication score for physician-SP encounters (96.3% +/- 5.06) was greater than patient-SP encounters (88.3% +/- 7.9, p<0.05). This difference was greater in Therapeutics I (physician-SP = 97.3% +/- 6.1 & patient-SP = 87.9% +/- 18.4 – p<0.05) than in Therapeutics II (physician-SP = 95.3% +/- 6.9 & patient-SP = 88.8% +/- 19.4 – p<0.05). There was no difference in the Therapeutics I and II average cumulative communication scores (93.4 +/- 9.4 & 93.1 +/- 9.2, respectively). Implications: These students appear to have greater skill when communicating with physicians than with patients. Further evaluation of these data needs to be undertaken to determine the cause of such differences and variability in the lay encounters.

Publication Type: Conference Paper/Unpublished Manuscript
Review Method: Peer Reviewed
Abstract: In Justice, Gender, and the Family, Susan Moller Okin argues for an equal division of paid and unpaid labor among spouses, as the solution to gender inequity in modern marriage. While Okin’s argument about gender inequities within marriage turns on the effects of sexism and gender roles, the importance of economic realities should not be overlooked. In addition to gender-based discrimination, our society’s current structure of paid labor effectively undermines the achievement of gender equity. Working in tandem with sexism, the need for at least one full-time employee in a family makes the equal division of paid and unpaid labor highly impractical in most cases. Beginning from the premise that the full-time employment imperative presents a significant obstacle to true equality in the home, this paper identifies one factor that contributes to the need for full-time employment: healthcare. A move away from employer provided healthcare, which currently privileges full-time employment, would reduce as least some of the need families feel to have one full-time wage earner, and would represent a tangible step toward the achievement of Okin’s ideal.

Publication Type: Conference Paper/Unpublished Manuscript
Review Method: Peer Reviewed
Abstract: Recent actions by grassroots organizations to gain universal health coverage are an attempt to disrupt pervasive health inequalities and have far reaching implications for public health policy. A long standing, growing body of social science and epidemiological literature documents a relationship between socioeconomic status and health. Persons in lower socioeconomic positions have worse health and lower life expectancy than those in higher positions. Inequalities in health are resultant of social stratification. In the U.S. these inequalities manifest themselves in differences in healthcare across social class, gender and races. Social health movements are a major force behind change in health care system. These movements have greatly effected the manner in medical research is conducted as well as how illness is conceptualized in society. One of the most recent forms of collective behavior aimed at facilitating change within the medical industry is a multifaceted attempt to gain universal assess to healthcare. Social scientists and activists alike propose combating this inequality by providing universal access to healthcare, thereby financing healthcare regardless of ability to pay. Recent grassroots organizations have mobilized to make the issue of equity in health care a reality, with renewed focus on policymakers. The significance of these grassroots mobilizations are two fold. First, this social action is a series of attempts by citizens to illicit structural changes that could disrupt health inequalities. Moreover, strategies employed by these organizations have implications for public policy that should be acknowledged and researched by social scientists. This paper reviews the relevant literature and highlights current efforts by grassroots organizations mobilized to gain healthcare parity; with specific emphasis on the Physicians for A National Health Plan (PNHP) , as well as the efficacy of this social movement.

Publication Type: Conference Paper/Unpublished Manuscript
Review Method: Peer Reviewed
Abstract: Pescosolido and Kronenfeld (1995) warned against the growing divide between medical sociology and general sociology, as well as the increasing number of researchers who self-identify or are trained as health services researchers rather than sociologists. The racial disparity in medical treatment should serve as a call to sociologists who seek to reverse the divide between sociology and healthcare problems. Yet, despite sociology having the potential to offer groundbreaking theoretical understanding of racial and ethnic differences in medical treatment, sociological analysis has infrequently been employed to this end. In this paper, I offer suggestions about how medical sociologists might bring sociology to the study of racial disparities in medical treatment. I begin by reviewing the existing approaches to understanding the racial disparity in medical treatment. After considering the extant research, I describe some ways that sociology’s theoretical and methodological tools can advance studies of the racial gap in medical treatment.