Lower rates of health insurance among minorities compared to whites unequal race relation causes minorities to have higher mortality rates as compared to whites. Well put.
Theories of Race and Ethnicity
But this is so hard to explain to racist-adjacent laypeople. They think you are being an equivocating, politically correct social justice warrior avoiding the inconvenient truth about racial differences. Kyle- Yes I agree with you. It can be challenging to explain this to laypeople especially when there is such variation in interpretation even among scientists.
The trick is to make them realize that the framework I specified applies to any outcome, and any 2 races can be compared which means that unequal race relations can exist between any pair of races, in either direction. In health, most of the time minorities experience worse outcomes compared to whites so we naturally look for an unequal race relation that favors whites over minorities. There are some outcomes where there is less evidence of any difference or evidence of very small differences that may be impractical to pursue to equalize.
And every now and then, minorities will have better outcomes compared to whites for example in the ESRD population, minorities have better survival compared to whites. The above framework could be used to see what unequal race relation is contributing to better survival among minorities. My understanding of the RAND health insurance experiment, and then the more recent Oregon ACA experiment, showed that giving people health insurance resulted in them consuming more health care but not having better health outcomes.
So in terms of U. Wonks- Yes I should have chosen a better mediator because you;re right, there is still controversy regarding the causal effect of insurance. Perhaps a better example would be in cancer.
And yes you are correct that there are some instances where minorities have better outcomes than whites I also cited the ESRD population where minorities survive longer than whites. However, when you look at all health outcomes, minorities consistently have worse outcomes as compared to whites with of course some exception. The causal inference framework that I cited could be used to compare any health outcome between races, no matter what direction the disparity goes. What data is this claim based on? My impression is that Asian-Americans generally have better health outcomes than white Americans.
Hispanics also often have better outcomes than whites. I was just being general re: minorities vs. It is generally accepted that large racial disparities in treatment, morbidity and mortality exist and in general whites seem to experience better outcomes. As Ive also stated above: there are many health outcomes that are very similar between races and those where there is a paradox.
Its called the hispanic paradox because it goes against what you typically expect. And yes, as a public health researcher, I can say that it is generally well accepted that racial minority subgroups experience worse health outcomes as compared to their white counterparts. Ive already stated that the causal inference approach I cited could be used to compare any health outcome between races, no matter what direction the disparity goes. Youre right minority group is very different but in general Whites experience superior health outcomes:. There ar eplenty of outcomes that are similar between races and plenty where one minority group or more experiences better outcomes than whites.
Hispanic paradox. Wouldnt be called a paradox if it was going against the norm. Most public health professionals and clinicians generally accept the statement that whites experience better outcomes compared to whites and disparities in treatment and access to care are well documented. For example, this article on the largest health disparities between racial and ethnic groups in the US found see Table 1 that among the health disparities identified, whites had the lowest prevalence for nine outcomes while Asians often lumped together with Pacific Islanders had the lowest prevalence for up to sixteen outcomes differences not always significant given low sample sizes for Asians.
The idea that white vs. That being said race is even more complex than just 5 categories. But causal inference framework can compare any two groups. I would survey physicians and ask them if they believe there are racial disparities because they actually see patients everyday. I agree that using multiple and more fine-grained categories is a much better approach and one that shows the fallacy of the white vs.
In fact, it was due to racially prejudiced assumptions like the above that of course White Privilege means whites live longer that almost nobody noticed the White Death, the growing mortality among poorer-educated whites for about 15 years until Angus Deaton and Ann Case finally managed to call attention to it a few years ago. I doubt lower rates of health insurance cause death.
Burning oil and coal has probably increased life spans far more than health insurance. There is some evidence that the ACA may not have been as impactful as we would have hoped. But thats just one type of insurance model. Innovative and different from previous insurance models. However, in health policy literature, general forms of insurance such as fee for service Medicare have been shown to have strong causal effects on morbidity and mortality.
If you disagree go speak to John Michael McWilliams:.
- Astrology made easy (1).
- Theories of Race and Ethnicity | Introduction to Sociology.
- Taking Care of Precious ONes;
- SparkNotes: On Liberty: Chapter 2, Of the Liberty of Thought and Discussion (Part 1);
- Essence of the Upanishads: A Key to Indian Spirituality (Wisdom of India);
- The Official Guide to Steinway Pianos.
That means that they are also mediators of race and mortality disparities. The causal inference framework I cited allows for multiple mediators and SAS macros applying the potential outcomes framework can be easily applied to solve a multiple mediation problem. I meant that access to modern healthcare has dubious net benefit at best, health insurance doubly so.
A great example is Cuba with their chronic shortages and old equipment, yet similar life expectancy to the US. Another thing to keep in mind is the effect of abortions on infant mortality and life expectancy stats. Infant mortality is about 5. What happens if you start counting abortions as early deaths? We are now transitioning from volume to value based care and we are now barely starting to have enough follow up to evaluate recent experimental value based payment models including accountable care organizations, bundled payments and Medicare Advantage of course.
Theres definitely evidence of cost reductions the biggest problem in healthcare and modest evidence for mortality:. This sounds like an arbitrary number to me. Are you referring to the US of today? The US government is obsessed with race. Just look at the space devoted to breaking things down by race in the demographic data they produce. It was disturbing to me…. The critiques and I are both name-calling, except that they are calling something Darwinism and I am calling it Social Darwinism.
A technical comment from a geneticist. This is a purely statistical effect that must occur in populations not in genetic contact, unless there are balancing selective forces acting to cancel the drift. Most, perhaps.
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Although there are clear exceptions. Adaptations for oxygen at high altitudes, dark skin near the equator.
As a geneticist can you help me to understand something: Why do folks equate genetics with race? Is automatically thinking about genetics when the topic of race is brought up troublesome? However there are for sure genetic differences between human groups. Incidentally most genetic differences caused by drift which is what I intensively study have no effect at all on phenotype and therefore are not under selection. Based on my low IQ understanding of genetics, I run under the assumption that there are genetic differences between human groups. My interpretation of the paper I linked to is that two individuals of the same race are more genetically diverse as compared to two individuals of different races.
It just means that those differences are smaller as compared to the genetic differences observed among 2 individuals from same racial group. To me, trying to understand how genetic differences between races causes differences in human outcomes will not be as fruitful since you will only explain the minority of the variation.
The correct interpretation is: among all the things that vary from one person to another, things that vary consistently with race are a small fraction.
The Behavioral Makeover Behind the Industrial Revolution
I see Mike has already replied with the study showing how self-reported race could be predicted almost perfectly by genetic analysis — already some 15 years ago. If you look carefully enough at the cars you can find information about them that identifies the factory…. The first is that somehow this rules out important genetic differences between populations.
We can see with our own eyes racial characteristics that allow identification to genetic ancestry at extremely high levels of accuracy. The second is more technical, and it is that genetic differences may be correlated.
This would be expected when natural selection causes differences between populations and it would be shocking if populations separated for centuries who reside in notably different environments were not subject to differential selection. Nonetheless, we believe that the four propositions above comprise a fair summary of her main arguments. Both the study of intelligence and the study of human genetic variation are extremely stats-heavy… in fact as I recall many of the central concepts of statistics were originally developed for the problem of analyzing intelligence.
But when slurs are used here, instead of stats to condemn e. Watson, I start to get very suspicious. Opinions will differ, and I respect that. Different people have different experiences, attitudes, and perspectives.