J. Lawrence Aber, Ph.D.Expertise:
Child Health; Disparities; Mental Health | Dynamics of Economic Disadvantage and Child Health Development
with Mary Clare Lennon, Ph.D.
Award Year: 2002 Show AbstractPoverty takes its toll on health and development during childhood as well as in future life. Mary Clare Lennon, Ph.D. and J. Lawrence Aber, Ph.D. offer a new approach to measuring children's economic circumstances. In their project, Dynamics of Economic Disadvantage and Child Health and Development, the investigators focus on the economic trajectory of a child's family, exploring how the income of poor families changes over time, and how turning points in family life, such as unemployment, cohabitation, divorce, illness, and other events, affect family economics and child development. Drs. Lennon and Aber also examine how such health and social programs as cash assistance, food stamps, unemployment insurance, tax credits, Medicaid and the State Children's Health Insurance Program, and others lessen the severity of economic disadvantage. Their work should help identify children at risk due to family circumstances and policies that could reduce risk by helping families withstand economic downturns. |
|
Richard S. Cooper, M.D.Expertise:
Disparities; Health Care Inequalities; Public and Population Health | Use of Racial/Ethnic Identity in Medical Evaluations and Treatments
with Jay S. Kaufman, Ph.D.
Award Year: 2005Show Abstract Views about the importance of race in clinical medicine have come full circle in the past five years as the field of "pharmacogenomics" has ushered in the promise of medical treatments tailored to a patient's particular genetics. Jay S. Kaufman, Ph.D. and Richard S. Cooper, M.D. examine the re-emergence of race as a surrogate for genetic factors that can determine risk of disease, prognosis, and response to treatment. Their project, Use of Racial/Ethnic Identity in Medical Evaluations and Treatments, looks to published studies and surveillance data on health disparities among U.S. racial and ethnic groups for evidence that race should be a factor when considering health interventions. They want to determine whether policies that link race and ethnicity to medical care are scientifically justifiable and to quantify their costs and benefits. Drs. Kaufman and Cooper consider the implications of recruiting patients into clinical trials based on race, federal requirements for reporting trial data by racial group, approving therapies for specific racial/ethnic groups, and using race as a factor in determining therapy and drug dosage. |
|
Dora L. Costa, Ph.D.Expertise:
Disparities; Health Economics | Race and Health across the Twentieth Century
Award Year: 2002Show Abstract In her Investigator Award project, Race and Health across the Twentieth Century, Dr. Dora Costa looks to the past to help us understand the factors that led to health differences between whites and African Americans. Dr. Costa will use various datasets that span the entire twentieth century and, for the early twentieth century, include selected populations, such as children born at Johns Hopkins Hospital and African American Civil War veterans. Armed with these data, she will examine health outcomes during the first 10 days of life, and again at middle and late ages. Her study will explore how differential access to technology and knowledge contributes to disparities in health status. By analyzing conditions such as heart disease, where significant technological advances have been evident, Dr. Costa will investigate the role of access to technology in outcome disparities. She will also consider how historical politics contributed to racial differences in access to clean water, sewage, and medical care. |
|
M. Robin DiMatteo, Ph.D.Expertise:
Disparities; Quality of Care | Ethnicity, Social Class and the Primary Care Medical Visit: The Process of Provider-Patient Communication
Award Year: 2005Show Abstract So much medical information delivered in the mass media - from public health campaigns to drug commercials - concludes by advising the audience to "talk to your doctor." Sounds simple enough, but in fact, research is beginning to suggest that doctor-patient communications can be highly variable, particularly when doctors and patients come from different socio-economic backgrounds. M. Robin DiMatteo, Ph.D. is especially interested in the communication breakdown that occurs when patients are from a disadvantaged background. Her project, Ethnicity, Social Class, and the Primary Care Medical Visit: The Process of Provider-Patient Communication, considers the extent of communication disparities and how they might affect health care outcomes. Dr. DiMatteo also examines whether training programs for physicians and patients can help close the communication gap and enhance physician-patient partnerships. Her project should produce new insights into the use of effective communication as a means of reducing disparities in the delivery of primary care. |
|
José J. Escarce, M.D., Ph.D.Expertise:
Disparities; Health Economics; Health Outcomes; Immigration | The Health of Mexican Immigrants in the United States: Acculturation or Cohort Effects?
with Leo S. Morales, M.D., Ph.D.
Award Year: 2004Show Abstract Hispanics are the largest and fastest-growing ethnic group in the U.S. Nearly 60 percent are of Mexican origin, many of them recent immigrants. Despite the size and continued growth of this population, large gaps remain in our understanding of the factors that affect the health and health behaviors of Mexican immigrants. Co-investigators José J. Escarce, M.D., Ph.D. and Leo S. Morales, M.D., Ph.D., M.P.H., examine the health of Mexican immigrants by assessing the relative importance of acculturation and cohort effects. Their project, The Health of Mexican Immigrants in the U.S.: Acculturation or Cohort Effects?, explores the "Hispanic paradox" — that is, the phenomenon of immigrants of low socioeconomic status who nevertheless are healthy and exhibit healthy behaviors. The co-investigators also examine apparent health declines among Mexican immigrants who have lived in the U.S. for many years and have become acculturated. Drs. Escarce and Morales analyze health trends in Mexico, the types of individuals who migrate, health differences among immigrants who arrived here over various time periods, and changes in immigration policy to assess future demands on the delivery and financing of U.S. health care. |
|
Pamela Braboy Jackson, Ph.D.Expertise:
Disparities | Explaining Elevated Health Risks of the Black Middle Class
Award Year: 2005Show Abstract Although life expectancy and overall health have improved in recent years for many Americans, African-Americans continue to experience higher morbidity and mortality rates than whites from heart disease, cancer, stroke, diabetes, and other medical conditions. Many of these disparities exist even when comparing middle-income African-Americans to lower-income whites. Pamela B. Jackson, Ph.D. examines this perplexing divide in her project, Explaining the Health Risks of the Black Middle Class. Her work considers the physical and mental health conditions that may be associated with race/ethnicity, gender, and socioeconomic status, the role of stressors, and the benefits of psychosocial supports. Dr. Jackson aims to develop an explanation of these patterns, analyzing the many groups within the African-American population and the stress that they experience from racial discrimination, residential segregation, and job discrimination. Her findings should help clarify which African-Americans are most at risk of poor health, the importance of social factors in determining health outcomes, and how interventions might be targeted to those most likely to benefit. |
|
Sherman A. James, Ph.D.Expertise:
Civil Rights; Disparities; Population Health | After the Walls Came Tumbling Down: The Health Legacy of the 1960s Civil Rights Era in a Southern Community
Award Year: 2008Show Abstract During the years immediately following the passage of the Civil Rights Act of 1964, gaps in health and access to medical care between black and white Americans began to narrow. How did civil rights legislation and newly created social programs help lead to those health improvements? Sherman A. James, Ph.D. probes this question in his project, After the Walls Came Tumbling Down: The Health Legacy of the 1960's Civil Rights Era in a Southern Community. Through a case study of Pitt County, North Carolina, a poor rural southern community, Dr. James looks at the activities of those who led the desegregation of the county hospital and efforts by citizen activists, voluntary organizations, community leaders, and the press to open the doors of opportunity. Using the fundamental cause framework developed by Investigator Awardees Jo Phelan, Ph.D., and Bruce Link, Ph.D., Dr. James analyzes how access to money, knowledge, prestige, power, and social connections is linked to population health and to the success of public policies. His findings should help illuminate the role civil society plays in distributing life-enhancing resources more fairly and in facilitating or impeding public policies aimed at improving the health of all Americans. |
|
George A. Kaplan, Ph.D.Expertise:
Disparities; Population Health | Understanding the Complex Causes of Population Health
with Sandro Galea, M.D., M.P.H., Dr.P.H.
Award Year: 2006Show Abstract What really determines whether a population is healthy? Although our knowledge about biological processes, environmental conditions, and socioeconomic factors has expanded enormously, we are not yet able to put the pieces of the health puzzle together. For example, research on the rapid rise of obesity reveals a host of factors operating at many levels: our parents' weight, our income, the size of the food portions we eat, the availability of fresh produce in our neighborhoods, the advertisements we are exposed to, and so on. But what the research doesn't tell us is how much each factor contributes to the problem and which policy levers might work best to reverse specific diseases. Co-investigators at the University of Michigan, Sandro Galea, M.D., Dr.P.H., M.P.H. and George A. Kaplan, Ph.D. believe that new methods are needed to better understand population health and to produce scientific information that can be useful to policymakers. Their innovative project, Understanding the Complex Causes of Population Health, attempts to break new ground by using the theories and tools of complex systems to model how factors and conditions interact at many levels to produce health and disease. |
|
Jay S. Kaufman, Ph.D.Expertise:
Disparities; Health Care Inequalities; Public and Population Health | Use of Racial/Ethnic Identity in Medical Evaluations and Treatments
with Richard S. Cooper, M.D.
Award Year: 2005Show Abstract Views about the importance of race in clinical medicine have come full circle in the past five years as the field of "pharmacogenomics" has ushered in the promise of medical treatments tailored to a patient's particular genetics. Jay S. Kaufman, Ph.D. and Richard S. Cooper, M.D. examine the re-emergence of race as a surrogate for genetic factors that can determine risk of disease, prognosis, and response to treatment. Their project, Use of Racial/Ethnic Identity in Medical Evaluations and Treatments, looks to published studies and surveillance data on health disparities among U.S. racial and ethnic groups for evidence that race should be a factor when considering health interventions. They want to determine whether policies that link race and ethnicity to medical care are scientifically justifiable and to quantify their costs and benefits. Drs. Kaufman and Cooper consider the implications of recruiting patients into clinical trials based on race, federal requirements for reporting trial data by racial group, approving therapies for specific racial/ethnic groups, and using race as a factor in determining therapy and drug dosage. |
|
Mary Clare Lennon, Ph.D.Expertise:
Child Health; Disparities; Gender Issues; Mental Health | Dynamics of Economic Disadvantage and Child Health Development
with J. Lawrence Aber, Ph.D.
Award Year: 2002Show Abstract Poverty takes its toll on health and development during childhood as well as in future life. Mary Clare Lennon, Ph.D. and J. Lawrence Aber, Ph.D. offer a new approach to measuring children's economic circumstances. In their project, Dynamics of Economic Disadvantage and Child Health and Development, the investigators focus on the economic trajectory of a child's family, exploring how the income of poor families changes over time, and how turning points in family life, such as unemployment, cohabitation, divorce, illness, and other events, affect family economics and child development. Drs. Lennon and Aber also examine how such health and social programs as cash assistance, food stamps, unemployment insurance, tax credits, Medicaid and the State Children's Health Insurance Program, and others lessen the severity of economic disadvantage. Their work should help identify children at risk due to family circumstances and policies that could reduce risk by helping families withstand economic downturns. |
|
Carolina Milesi, Ph.D.Expertise:
Disparities; Life Course | Analyzing the Relationship Among Early Childhood Conditions, Reproduction of Socioeconomic Inequalities and Adult Health Disparities
with Alberto Palloni, Ph.D.
Award Year: 2008Show Abstract Despite increased attention to the disturbing problem of disparities, certain groups of Americans remain healthier than others, due largely to differences in race and ethnicity, income, education, residential segregation, and other social factors. Co-PIs Alberto Palloni, Ph.D. and Carolina Milesi, Ph.D. seek to better understand the mechanisms that lead to health gaps by probing the connections between child and adult health. Their project, Early Childhood Conditions, Reproduction of Socioeconomic Inequalities, and the Persistence of Adult Health Disparities, employs innovative methods to study how pathways to fair or poor health in adulthood unfold from early childhood. Drs. Palloni and Milesi analyze a host of factors, including the effects of parents' socioeconomic status, their health and use of tobacco and alcohol, child health outcomes, development of personality traits such as tenacity and perseverance, exposure to stressful environments, and educational attainment. Project findings should help improve the design of strategies aimed at reducing disparities by identifying options for mitigating the consequences of poor health in children. |
|
Leo S. Morales, M.D., Ph.D.Expertise:
Disparities; Health Outcomes; Health Services Research; Immigration | The Health of Mexican Immigrants in the United States: Acculturation or Cohort Effects?
with José J. Escarce, M.D., Ph.D.
Award Year: 2004Show Abstract Hispanics are the largest and fastest-growing ethnic group in the U.S. Nearly 60 percent are of Mexican origin, many of them recent immigrants. Despite the size and continued growth of this population, large gaps remain in our understanding of the factors that affect the health and health behaviors of Mexican immigrants. Co-investigators José J. Escarce, M.D., Ph.D. and Leo S. Morales, M.D., Ph.D., M.P.H., examine the health of Mexican immigrants by assessing the relative importance of acculturation and cohort effects. Their project, The Health of Mexican Immigrants in the U.S.: Acculturation or Cohort Effects?, explores the "Hispanic paradox" — that is, the phenomenon of immigrants of low socioeconomic status who nevertheless are healthy and exhibit healthy behaviors. The co-investigators also examine apparent health declines among Mexican immigrants who have lived in the U.S. for many years and have become acculturated. Drs. Escarce and Morales analyze health trends in Mexico, the types of individuals who migrate, health differences among immigrants who arrived here over various time periods, and changes in immigration policy to assess future demands on the delivery and financing of U.S. health care. |
|
Harold W. Neighbors, Ph.D.Expertise:
Disparities; Mental Health; Public and Population Health | Racial and Ethnic Disparities in Mental Health: A National Study of Unmet Need
Award Year: 2003Show Abstract Despite improved treatments for many mental disorders, profound racial and ethnic disparities continue in access to and use of mental health services in the United States. Social psychologist Harold W. Neighbors, Ph.D. has spent more than 20 years conducting research on mental health disparities. For his Investigator Award project, Racial and Ethnic Disparities in Mental Health: A National Study of Unmet Need, Dr. Neighbors analyzes differences in the prevalence of serious mental disorders, levels of impairment, and help-seeking behavior. He explores why African Americans seek professional help less frequently than white Americans. He also looks at how reliance upon help from social support networks and ministers, common in African American communities, can impede access to professional treatment. By integrating this new information with his past work, Dr. Neighbors plans to produce a comprehensive book that explains disparities in help-seeking and explores policy options for reducing them. |
|
Jonathan S. Skinner, Ph.D.Expertise:
Disparities; Health Economics; Quality of Care; Technology | Productivity and Technology Diffusion in Health Care
Award Year: 2005Show Abstract As U.S. health care spending continues to escalate, there is a vigorous debate about whether that extra cash is purchasing better health. Some feel the increased spending is driven by innovations in medical technology that significantly improve outcomes. Others believe health care costs are rising because money is being wasted on unnecessary treatment. Jonathan S. Skinner, Ph.D., believes that the relationship of cost to quality of care depends on where one lives and on who provides the care. He sees productivity and availability of technology as varying dramatically among different regions and providers. Dr. Skinner's project, Productivity and Technology Diffusion in Health Care, analyzes the treatment of heart attack patients since 1986, the use of cardiac stents, how variations in technology lead to health care disparities, and the link between technological progress and health care costs. Dr. Skinner's work should offer revealing insights into how medical technology is distributed through the health system and the effects on expenditures and health outcomes. |
|
Keith A. Wailoo, Ph.D.Expertise:
Disparities; History of Medicine; Pain Management | Pain as Policy: The Social Negotiation of Pain in Medicine, Culture, and Public Policy in Post WWII America
Award Year: 2001Show Abstract There are wide disparities in the treatment of pain, and options for managing it have long been entangled with ideological debates over addiction and dependence. Dr. Wailoo will analyze and describe the complex evolution of pain policy and management practices as well as the principles underlying pain management in America since World War II. Using historical and sociological methods, he will examine increasing disparities in pain recognition and treatment by race, age, gender, class, disease, and region. The project will document the diverse ways in which cultural values have shaped the manner in which pain is understood and managed. It will trace the evolution of disparities in assessment and treatment and address why pain management has differed by community, clinic, state, and region. The roles of key policymakers (politicians, pharmaceutical companies, medical specialists, courts, and patient advocates) will also be assessed. |
|
Investigator Details:
Section Info