Browsing by Author "Williams, David R"

Now showing 1 - 7 of 7
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    African American Girls’ Smoking Habits and Day-to-Day Experiences With Racial Discrimination
    (2002) Guthrie, Barbara J; Young, Amy M; Williams, David R; Boyd, Carol J; Kintner, Eileen K
    Background: Although it is recognized that African Americans experience racial discrimination, relatively little research has explored the health implications of this experience. Few studies have examined the relationship between racial discrimination and specific health risks. Objectives: To examine the relationship between smoking habits and perceptions of racial discrimination among African American adolescent girls and to identify and test potential psychological mechanisms through which racial discrimination may operate to increase smoking among this group. Methods: A sample of 105 African American adolescent girls (mean age 15.45 years) derived from a larger cross-sectional research project comprised the sample. Univariate analyses were conducted to provide descriptive data on the participants of the study, including information about their use of licit and illicit substances. Bivariate correlational analyses were conducted to evaluate the relationship between perceptions of discrimination and smoking habits. The ability of stress to mediate the relationship between discrimination and smoking was examined by using standard analytical procedures for testing mediation models as outlined by Baron and Kenny (1986). Results: The sample (93%) reported experiencing discrimination and racial discrimination was highly correlated with cigarette smoking (r = .35, p > .001). Removing the effects of stress significantly reduced the relationship between racial discrimination and smoking (r = .17, p < .05), indicating that racial discrimination is related to smoking because of its stressful nature. Conclusion: Perceptions of racial discrimination are related to the smoking habits of African American adolescent girls.
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    “Being black and feeling blue”: the mental health consequences of racial discrimination
    (2000) Brown, Tony N.; Williams, David R; Jackson, James S; Neighbors, Harold W; Torres, Myriam; Sellers, Sherrill L; Brown, Kendrick T
    Abstract available at publisher's web site.
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    Creating a segregated medical profession: African American physicians and organized medicine, 1846-1910.
    (2009) Baker, Robert B; Washington, Harriet A; Olakanmi, Ololade; Savitt, Todd L; Jacobs, Elizabeth A; Hoover, Eddie; Wynia, Matthew K; Blanchard, Janice; Boulware, L Ebony; Braddock, Clarence; Corbie-Smith, Giselle; Crawley, LaVera; LaVeist, Thomas A; Maxey, Randall; Mills, Charles; Moseley, Kathryn L; Williams, David R
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    Health Disparities Based on Socioeconomic Inequities: Implications for Urban Health Care
    (2004) Fiscella, Kevin; Williams, David R
    Health is unevenly distributed across socioeconomic status. Persons of lower income, education, or occupational status experience worse health and die earlier than do their better-off counterparts. This article discusses these disparities in the context of urban medical practice. The article begins with a discussion of the complex relationship among socioeconomic status, race, and health in the United States. It highlights the effects of institutional, individual, and internalized racism on the health of African Americans, including the insidious consequences of residential segregation and concentrated poverty. Next, the article reviews health disparities based on socioeconomic status across the life cycle, beginning in fetal health and ending with disparities among the elderly. Potential explanations for these socioeconomic-based disparities are addressed, including reverse causality (e.g., being poor causes lower socioeconomic status) and confounding by genetic factors. The article underscores social causation as the primary explanation for health disparities and highlights the cumulative effects of social disadvantage across stages of the life cycle and across environments (e.g., fetal, family, educational, occupational, and neighborhood). The article concludes with a discussion of the implications of health disparities for the practice of urban medicine, including the role that concentration of disadvantage plays among patients and practice sites and the need for quality improvement to mitigate these disparities.
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    Moving upstream: how interventions that address the social determinants of health can improve health and reduce disparities.
    (2008) Williams, David R; Costa, Manuela V; Odunlami, Adebola O; Mohammed, Selina A
    There is considerable scientific and policy interest in reducing socioeconomic and racial/ethnic disparities in healthcare and health status. Currently, much of the policy focus around reducing health disparities has been geared toward improving access, coverage, quality, and the intensity of healthcare. However, health is more a function of lifestyles linked to living and working conditions than of healthcare. Accordingly, effective efforts to improve health and reduce gaps in health need to pay greater attention to addressing the social determinants of health within and outside of the healthcare system. This article highlights research evidence documenting that tackling the social determinants of health can lead to reductions in health disparities. It focuses both on interventions within the healthcare system that address some of the social determinants of health and on interventions in upstream factors such as housing, neighborhood conditions, and increased socioeconomic status that can lead to improvements in health. The studies reviewed highlight the importance of systematic evaluation of social and economic policies that might have health consequences and the need for policy makers, healthcare providers, and leaders across multiple sectors of society to apply currently available knowledge to improve the underlying conditions that impact the health of populations.
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    Social sources of racial disparities in health.
    (2005) Williams, David R; Jackson, Pamela Braboy
    Racial disparities in mortality over time reflect divergent pathways to the current large racial disparities in health. The residential concentration of African Americans is high and distinctive, and the related inequities in neighborhood environments, socioeconomic circumstances, and medical care are important factors in initiating and maintaining racial disparities in health. Efforts are needed to identify and maximize health-enhancing resources that may reduce some of the negative effects of psychosocial factors on health. Health and health disparities are embedded in larger historical, geographic, sociocultural, economic, and political contexts. Changes in a broad range of public policies are likely to be central to effectively addressing racial disparities.
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    The health of U.S. racial and ethnic populations.
    (2005) Williams, David R
    This article provides an overview of racial and ethnic disparities in health in the United States. It describes limitations linked to the quality and method of presentation of the available data. It also considers the complex ways in which immigrant status, race, and SES combine to affect health and outlines important directions for research that would enhance our understanding of the ways in which social factors can lead to changes in health status.