Minority Health and Health Equity Archive
Permanent URI for this collectionhttp://hdl.handle.net/1903/21769
Welcome to the Minority Health and Health Equity Archive (MHHEA), an electronic archive for digital resource materials in the fields of minority health and health disparities research and policy. It is offered as a no-charge resource to the public, academic scholars and health science researchers interested in the elimination of racial and ethnic health disparities.
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Item Striding Toward Social Justice(2009) Lee, Rebecca E.; Cubbin, CatherineAbstract available at publisher's web site.Item Health is power: An ecological theory-based health intervention for women of color(2011) Lee, Rebecca E.; Medina, Ashley V.; Mama, Scherezade K.; Reese-Smith, Jacqueline Y.; O'Connor, Daniel P.; Brosnan, Marcella; Cubbin, Catherine; McMillan, Tracy; Estabrooks, Paul A.Objective Physical inactivity and poor dietary habits plague Americans as health challenges, with women of color most vulnerable to their detrimental effects. Individually focused interventions have not demonstrated lasting success, possibly due to the lack of focus on sustainable social and physical environment factors. This manuscript describes the rationale, design and methodology of Health Is Power (HIP), a transcultural, community based, randomized controlled trial that investigated the effectiveness of a group cohesion intervention to increase physical activity and improve dietary habits in African American and Hispanic or Latina women in Houston and Austin, Texas. Methods The intervention development was guided by group dynamics principles anchored within an ecologic model. Results Women participated in three health assessments and a six month face to face intervention that included evidence-based behavioral methods – integrated into strategies to promote group cohesion – framed to account for environmental factors contributing to health disparities. Women participated in team building activities, environmental mapping exercises, and supervised walks or taste tests. Conclusions Neighborhood contextual and environmental measures are described to test ecologic factors that may contribute to behavioral maintenance. Theoretically guided interventions that account for multiple levels of influence in behavior initiation and maintenance stand to improve health outcomes in vulnerable populations.Item An Approach to Studying Social Disparities in Health and Health Care(2004) Braveman, Paula A.; Egerter, Susan A.; Cubbin, Catherine; Marchi, Kristen S.Objective. We explored methods and potential applications of a systematic approach to studying and monitoring social disparities in health and health care. Methods. Using delayed or no prenatal care as an example indicator, we (1) categorized women into groups with different levels of underlying social advantage; (2) described and graphically displayed rates of the indicator and relativegroup size for each social group; (3) identified and measured disparities, calculating relative risks and rate differences to compare each group with its a priori most-advantaged counterpart; (4) examined changes in rates and disparities over time; and (5) conducted multivariate analyses for the overall sample and “atrisk” groups to identify particular factors warranting attention. Results. We identified at-risk groups and relevant factors and suggest ways to direct efforts for reducing prenatal care disparities. Conclusions. This systematic approach should be useful for studying and monitoring disparities in other indicators of health and health care.Item Socioeconomic Status in Health Research One Size Does Not Fit All(2006) Braveman, Paula; Cubbin, Catherine; Egerter, Susan; Chideya, Sekai; Marchi, Kristen; Metzler, Marilyn; Posner, SamuelProblems with measuring socioeconomic status (SES)—frequently included in clinical and public health studies as a control variable and less frequently as the variable(s) of main interest—could affect research findings and conclusions, with implications for practice and policy.Wecritically examine standard SES measurement approaches, illustrating problems with examples from new analyses and the literature. For example, marked racial/ethnic differences in income at a given educational level and in wealth at a given income level raise questions about the socioeconomic comparability of individuals who are similar on education or income alone. Evidence also shows that conclusions about nonsocioeconomic causes of racial/ethnic differences in health may depend on the measure—eg, income, wealth, education, occupation, neighborhood socioeconomic characteristics, or past socioeconomic experiences—used to “control for SES,” suggesting that findings from studies that have measured limited aspects of SES should be reassessed. We recommend an outcome- and social group–specific approach to SES measurement that involves (1) considering plausible explanatory pathways and mechanisms, (2) measuring as much relevant socioeconomic information as possible, (3) specifying the particular socioeconomic factors measured (rather than SES overall), and (4) systematically considering how potentially important unmeasured socioeconomic factors may affect conclusions. Better SES measures are needed in data sources, but improvements could be made by using existing information more thoughtfully and acknowledging its limitations.