Culture, Race/Ethnicity and Disparities: Fleshing Out the Socio-Cultural Framework for Health Services Disparities

  • Margarita Alegría
  • Bernice A. Pescosolido
  • Sandra Williams
  • Glorisa Canino
Part of the Handbooks of Sociology and Social Research book series (HSSR)


There is little question that the issue of “health disparities” has been given a central place across medicine and contemporary society of late (e.g., Institute of Medicine 2002). From research, to policy and even to the popular press, the unmasking of the disparities in health and health care for individuals who belong to certain race and ethnic groups has been a prominent theme (van Ryn and Fu 2003). While the attention to these matters is welcome by sociologists and other social scientists, the existence of inequality in health, illness, and healing is hardly a revelation. From the earliest times in our history, the focus on the differential in infant mortality; the incidence and prevalence of disease; and access to, treatment in, and the outcomes of care for those at the lower ends of the stratification hierarchy in any society have been the mainstay of both the sociological and public health enterprises. From Marx, to Durkheim, to Weber in sociology, and from Virchow to Snow to the Roemers outside of sociology, the understanding that stratification plays itself out, in part, in morbidity and mortality statistics represented a principal theme of theory, empirical investigation and the design of interventions (Pescosolido and Kronenfeld 1995).


Mental Health Racial Minority Substance Abuse Problem Underrepresented Minority Health Care Outcome 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



The writing of this chapter was supported by NIH Research Grant # 1P50 MHO 73469 and U01 MH 06220-06A2, both funded by the National Institute of Mental Health, as well as Grant #P60 MD0 02261, funded by the National Center for Minority Health and Health Disparities. In addition, support as provided from the College of Arts and Sciences, Indiana University, to the Indiana Consortium for Mental Health Services Research.


  1. Abreu J (1999) Consciout and nonconsciout African American stereotypes: impact on first impression and diagnostic ratings by therapists. J Consult Clin Psychol 67:387–393CrossRefGoogle Scholar
  2. Alarcon DR, Bell CC, Laurence Kirmayer J, Lin K-M, Ustun B, Katherine Wisner L (2002) Beyond the funhouse mirrors. In: First BM, Regier DA (eds) A research agenda for DSM-V. American Psychiatric Association, Washington, DC, pp 219–281Google Scholar
  3. Alegría M, Canino G, Rios R, Vera M, Calderon J, Rusch D, Ortega AN (2002) Inequalities of use in specialty mental health services among Latinos, African Americans, and non-Latino Whites. Psychiatr Serv 53:1547–1555CrossRefGoogle Scholar
  4. Alegría M, Chatterji P, Wells KB, Cao Z, Chen Chih-nan, Takeuchi D, Jackson J, Meng Xiao-Li (2008) Disparity in access to and quality of depression treatment among racial and ethnic minorities in the US. Psychiatr Serv 59:1264–1272CrossRefGoogle Scholar
  5. Alegría M, Perez DJ, Williams S (2003) The role of public policies in reducing disparities in mental health status for people of color. Health Aff 22:51–64CrossRefGoogle Scholar
  6. Alegría M, Pescosolido BA, Canino G (2009) A socio-cultural framework for health services disparities: illustrating the case of mental health and substance abuse. In: Sadock BJ, Sadock VA, Ruiz A (eds) Comprehensive textbook of psychiatry. Wolters Kluwer Health, Lippincott Williams & Wilkins, Baltimore, MD, pp 4370–4379Google Scholar
  7. Allison PD, Scott Long J, Krauze TK (1982) Cumulative advantage and inequality in science. Am Sociol Rev 47:615–625CrossRefGoogle Scholar
  8. Antshel KM (2002) Integrating culture as a means of improving treatment adherence in the Latino population. Psychol Health Med 7:435–449CrossRefGoogle Scholar
  9. Association of American Medical Colleges (2000) Minority graduates of U.S. medical schools: trends, 1950–1998. Association of American Medical Colleges, Washington DCGoogle Scholar
  10. Balsa A, Cao Z, McGuire TE (2007) Does managed health care reduce unfair differences in health care use between minorities and Whites? J Health Econ 26:101–121CrossRefGoogle Scholar
  11. Balsa A, McGuire TE (2003) Prejudice, clinical uncertainty and stereotypes as sources of health disparities. J Health Econ 22(1):89–116CrossRefGoogle Scholar
  12. Bernal G, Trimble JE, Burlew AK, Leong F (2003) Handbook of racial and ethnic minority psychology. In: Leong FTL (ed) Racial and ethnic minority psychology series. Sage Publications, Thousand OaksGoogle Scholar
  13. Beutler LE, Machado PPO, Neufeldt SA (1994) Therapist variables. In: Bergin AE, Garfield SL (eds) Handbook of psychotherapy and behavior change. Wiley, New York, pp 229–269Google Scholar
  14. Blanchard J, Lurie N (2004) R-E-S-P-E-C-T: patient reports of disrespect in the health care setting and its impact on care. J Fam Pract 53:721–730Google Scholar
  15. Bloche MG (2001) Race and discretion in American medicine. Yale J Health Policy Law Ethics 1:95–131Google Scholar
  16. Blow F, Zeber J, McCarthy J, Valenstein M, Gillon L, Raymond Bingham C (2004) Ethnicity and diagnosis patterns in veterans with psychoses. Soc Psychiatry Psychiatr Epidemiol 39:841–851Google Scholar
  17. Bodenheimer T (2005) High and rising health care costs, part 1: seeking an explanation. Ann Intern Med 142:847–854Google Scholar
  18. Buka SL (2002) Disparities in health status and substance use: ethnicity and socioeconomic factors. Public Health Rep 117:S118–S125Google Scholar
  19. Cao Z, McGuire TE (2003) Service-level selection by HMOs medicare in medicare. J Health Econ 22:915–931CrossRefGoogle Scholar
  20. Caronna CA (2010) Clash of logics, crisis of trust: entering the era of public for-profit health care? Forthcoming In: Pescosolido BA, McLeod JD, Martin JK, Rogers A (eds) The handbook of the sociology of health, illness, and healing: blueprint for the 21st century. Springer, New York.Google Scholar
  21. Cauce AM, Domenech-Rodriguez M, Paradise M, Cochran B, Shea J, Srebnik D, Baydar N (2002) Cultural and contextual influences in mental health help seeking: a focus on ethnic minority youth. J Counsel Clin Psychol 70:44–55CrossRefGoogle Scholar
  22. Chartier MJ, Walker JR, Stein MB (2001) Social phobia and potential childhood risk factors in a community sample. Psychol Med 31:307–315CrossRefGoogle Scholar
  23. Clausen JA, Yarrow MR (1955) Pathways to the mental hospital. J Soc Issues 11:25–32CrossRefGoogle Scholar
  24. Collins KS, Hughes DL, Doty MM, Ives B, Edwards J, Tenney K (2002) Diverse communities, common concerns: assessing health care quality for minority Americans. In: Findings from The Commonwealth Fund 2001, Health Care Quality Survey. The Commonwealth Fund, New York, NYGoogle Scholar
  25. Cooper-Patrick L, Gallo L, Gonzales JJ, Vu H, Powe NR, Nelson C, Ford D (1999) Race, gender, and partnership in the patient-physician relationship. J Am Med Assoc 282:583–589CrossRefGoogle Scholar
  26. Croghan TW, Tomlin M, Pescosolido BA, Martin JK, Lubell KM, Swindle R (2003) Americans’ knowledge and attitudes towards and their willingness to use psychiatric medications. J Nerv Ment Dis 191:166–174CrossRefGoogle Scholar
  27. Cunningham PJ, Hadley J (2008) Effects of changes in incomes and practice circumstances on physicians’ decisions to treat charity and medicaid patients. Millibank Q 86:91–123, Center for Studying Health System ChangeCrossRefGoogle Scholar
  28. Currie J, Fahr J (2004) Hospitals, managed care, and the charity caseload in California. J Health Econ 23:421–442CrossRefGoogle Scholar
  29. Daley M (2005) Race, managed care, and the quality of substance abuse treatment. Adm Policy Ment Health 32:457–476CrossRefGoogle Scholar
  30. Derose KP, Baker DW (2000) Limited english proficiency and latinos’ use of physician services. Med Care Res Rev 57:76–91CrossRefGoogle Scholar
  31. Dewalt D, Berkman N, Sheridan S, Lohr KN, Pignone M (2004) Literacy and health outcomes: a systematic review of the literature. J Gen Intern Med 19:1228–1239CrossRefGoogle Scholar
  32. Diamant AL, Hays RD, Morales LS, Ford W, Calmes D, Asch S, Duan N, Fielder E, Kim S, Fielding J, Sumner G, Shapiro MF, Hayes-Bautista D, Gelberg L (2004) Delays and unmet need for health care among adult primary care patients in a restructured urban public health system. Am J Public Health 94:783–789CrossRefGoogle Scholar
  33. DiMaggio PJ (1997) Culture and cognition. Annu Rev Sociol 23:263–287CrossRefGoogle Scholar
  34. DiMaggio P, Powell W (1991) Introduction. In: Powell W, DiMaggio P (eds) The new institutionalism in organizational analysis. University of Chicago Press, ChicagoGoogle Scholar
  35. DiPrete TA, Eirich GM (2006) Cumulative advantage as a mechanism for inequality: a review of theoretical and empirical developments. Annu Rev Sociol 32:271–297CrossRefGoogle Scholar
  36. Elder GH Jr (1992) The Life Course. In: Borgatta E, Borgatta M (eds) The encyclopedia of sociology, vol 3. MacMillan, New York, pp 1120–1130Google Scholar
  37. Elder GH Jr (1998) Children of the great depression. Westview Press, New YorkGoogle Scholar
  38. Elder GH Jr, Caspi A (1990) Studying lives in a changing society: sociological and personological explorations. In: Rabin AI, Zucker RA, Emmons RA, Frank S (eds) Studying persons and lives. Springer, New York, pp 201–247Google Scholar
  39. Fabrega H Jr (1990) Hispanic mental health research: a case for cultural psychiatry. Hisp J Behav Sci 12:339–365CrossRefGoogle Scholar
  40. Fiscella K, Franks P (2001) Impact of patient socioeconomic status on physician profiles: a comparison of census-derived and individual measures. Med Care 39:8–14CrossRefGoogle Scholar
  41. Fischer CS (1982) To dwell among friends. University of California Press, Berkeley, CAGoogle Scholar
  42. Flores G (2000) Culture and the patient–physician relationship: achieving cultural competency in health care. J Pediatr 136:14–23CrossRefGoogle Scholar
  43. Flores G, Laws MB, Mayo SJ, Zuckerman B, Abreu M, Medina L, Hardt EJ (2003) Errors in medical interpretation and their potential clinical consequences in pediatric encounters. Pediatrics 111:6–14CrossRefGoogle Scholar
  44. Garland AF, Hough RL, Yeh McCabe M, Wood P, Aarons G (2001) Prevalence of psychiatric disorders for youth in public sectors of care. J Am Acad Child Adolesc Psychiatry 40:409–418CrossRefGoogle Scholar
  45. Gazmararian JA, Curran JW, Parker RM, Bernhardt JM, DeBuono BA (2005) Public health literacy in America: an ethical imperative. Am J Prev Med 28:317–322CrossRefGoogle Scholar
  46. Green BL, Lewis RK, Wang MQ, Person S, Rivers B (2004) Powerlessness, destiny, and control: the influence on health behaviors of African Americans. J Commun Health 29:15–27CrossRefGoogle Scholar
  47. Guarnaccia PJ, Rodriguez O (1996) Concepts of culture and their role in the development of culturally-competent mental health services. Hisp J Behav Sci 18:419–443CrossRefGoogle Scholar
  48. Hafferty FW, Castellani B (2010) Two cultures – two ships: the rise of a professionalism movement within modern medicine nad medical sociology’s disappearance from the professionalism debate. Forthcoming In: Pescosolido BA, McLeod JD, Martin JK, Rogers A (eds) The handbook of the sociology of health, illness, and healing: blueprint for the 21st century. Springer, New York.Google Scholar
  49. Hampers L, Cha S, Gutglass D, Binns H, Krug S (1999) Language barriers and resource utilization in a pediatric emergency department. Pediatrics 103:1253–1256CrossRefGoogle Scholar
  50. Hargraves JL, Hadley J (2003) The contribution of insurance coverage and community resources to reducing racial/ethnic disparities in access to care. Health Serv Res 38:809–829CrossRefGoogle Scholar
  51. Hohmann AA, Katherine Shear M (2002) Community-based intervention research: coping with the “noise” of real life in study design. Am J Psychiatr 159:201–207CrossRefGoogle Scholar
  52. Institute of Medicine (2002) In: Smedley BD, Stith AY, Nelson A (eds) Unequal treatment: confronting racial and ethnic disparities in health care. The National Academies Press, Washington, DCGoogle Scholar
  53. Jackson PB (2004) Role sequencing: does order matter for mental health? J Health Soc Behav 45:132–154CrossRefGoogle Scholar
  54. Kaiser Family Foundation (2008) Employee health benefits: 2008 annual survey. Health research & educational trust, 2008 summary of findings.Google Scholar
  55. Keogan K (2002) A sense of place: the politics of immigration and the symbolic construction of identity in southern California and the new york metropolitan area. Sociol Forum 17:223–253CrossRefGoogle Scholar
  56. Kirmayer LJ, Young A (1999) Culture and context in the evolutionary concept of mental disorder. J Abnorm Psychol 108:446–452CrossRefGoogle Scholar
  57. Kumanyika SK (1993) Diet and nutrition as influences on the morbidity/mortality gap. Ann Epidemiol 3:154–158CrossRefGoogle Scholar
  58. Kunda Z, Sherman-Williams B (1993) Stereotypes and the construal of individuating information. Pers Soc Psychol Bull 19:90–99CrossRefGoogle Scholar
  59. Kurasaki K, Sue S, Chun C, Gee K (2000) Ethnic minority intervention and treatment research. In: Aponte J, Boston JW (eds) Psychological intervention and cultural diversity. Allyn and Bacon, MA, pp 2324–2349Google Scholar
  60. LaVeist TA, Diala C, Jarrett NC (2000) Social status and perceived discrimination: who experiences discrimination in the health care system, how, and why. In: Hogue C, Hargraves M, Scott-Collins K (eds) Minority health in America. Johns Hopkins University Press, Baltimore, MD, pp 194–208Google Scholar
  61. Lillie-Blanton M, Hoffman C (2005) The role of health insurance coverage in reducing racial/ethnic disparities in health care. Health Aff 24:398–408CrossRefGoogle Scholar
  62. Link BG, Phelan JC (1995) Social conditions as fundamental causes of disease. J Health Soc Behav 35:80–94, Extra issueCrossRefGoogle Scholar
  63. Link BG, Phelan JC (2000) Evaluating the fundamental cause explanation for social disparities in health. In: Bird CE, Conrad P, Fremont AM (eds) Handbook of medical sociology. Prentice-Hall, Inc, Upper Saddle River, NJ, pp 33–46Google Scholar
  64. Link BG, Phelan JC (2005) Fundamental sources of health inequalities. In: Mechanic D, Rogut L, Colby D (eds) Policy challenges in modern health care. Rutgers University Press, New Brunswick, NJ, pp 71–84Google Scholar
  65. Littlewood R, Lipsedge M (1981) Acute psychotic reactions in caribbean-born patients. Psychol Med 11:303–318CrossRefGoogle Scholar
  66. Long JS (1987) Problems and prospects for research on sex differences in the scientific career. In: Dix LS (ed) Women: their underrepresentation and career differentials in science and engineering. National Academy Press, Washington DC, pp 163–169Google Scholar
  67. Long JS, Fox MF (1995) Scientific careers: ascription and achievement. Annu Rev Sociol 21:45–71CrossRefGoogle Scholar
  68. Lopez SR (1989) Patient variable biases in clinical judgment: conceptual overview and methodological ­considerations. Psychol Bull 106:184–203CrossRefGoogle Scholar
  69. Lutfey KE, Freese J (2005) Toward some fundamentals of fundamental causality: socioeconomic status and health in the routine clinic visit for diabetes. Am J Sociol 110:1326–1372CrossRefGoogle Scholar
  70. Massey DS, Denton N (1998) American apartheid: segregation and the making of the underclass. Harvard University Press, Cambridge, MAGoogle Scholar
  71. Massoglia M (2008) Incarceration as exposure: the prison, infectious disease, and other stress-related illnesses. J Health Soc Behav 49:56–71CrossRefGoogle Scholar
  72. McGovern D, Cope R (1991) Second generation Afro-Caribbeans and young Whites with a first admission diagnosis of schizophrenia. Soc Psychiatry Psychiatr Epidemiol 26:95–99CrossRefGoogle Scholar
  73. McLean C, Campbell C, Cornish F (2003) African-Caribbean interactions with mental health services in the U.K.: experiences and expectations of exclusion as (re)productive of health inequalities. Soc Sci Med 56:657–669CrossRefGoogle Scholar
  74. McLeod JD, Fettes DL (2007) Trajectories of failure: the educational careers of children with mental health problems. Am J Sociol 113:655–656CrossRefGoogle Scholar
  75. McLeod JD, Pescosolido BA, Takeuchi DT, White TF (2004) Public attitudes toward the use of psychiatric medications for children. J Health Soc Behav 45:53–67CrossRefGoogle Scholar
  76. Mechanic D (2004) The rise and fall of managed care. J Health Soc Behav 45:76–86, Extra issueGoogle Scholar
  77. Merton RK (1957) Social theory and social structure. Free Press, Glencoe, ILGoogle Scholar
  78. Miranda J, Bernal G, Lau A, Kohn L, Hwang WC, Lafromboise T (2005) State of the science on psychosocial ­interventions for ethnic minorities. Annu Rev Clin Psychol 1:113–142CrossRefGoogle Scholar
  79. Mull J (1993) Cross-cultural communication in the physician’s office. West J Med 159:609–613Google Scholar
  80. National Advisory Mental Health Council Workgroup on Clinical Treatment and Services Research (1997) Bridging science and service. National Institutes of Health/National Institute of Mental Health, Bethesda, MDGoogle Scholar
  81. National Center for Health Statistics (2004) Health, United States, 2004. National Center for Health Statistics Hyattsville, MDGoogle Scholar
  82. Nelson K, Geiger AM, Mangione CM (2002) Effect of health beliefs on delays in care for abnormal cervical cytology in a multi-ethnic population. J Gen Inter Med 17:709–716CrossRefGoogle Scholar
  83. Olafsdottir S, Pescosolido BA (2009) Drawing the line: the cultural cartography of utilization recommendations for mental health problems. J Health Soc Behav 50(2):228–244CrossRefGoogle Scholar
  84. Olfson M, Lewis-Fernandez R, Weissman MM, Feder A, Gameroff M, Pilowsky D (2002) Psychotic symptoms in an urban general medicine practice. Am J Psychiatry 159:1412–1419CrossRefGoogle Scholar
  85. Parsons T (1951) The social system: the major exposition of the author’s conceptual scheme for the analysis of the dynamics of the social system. Free Press, New York, NYGoogle Scholar
  86. Pavalko EK, Harding CM, Pescosolido BA (2007) Mental illness careers in an era of change. Soc Probl 54:504–522CrossRefGoogle Scholar
  87. Pawlak R (2005) Economic considerations of health literacy. Nurs Econ 23:173–180Google Scholar
  88. Perez MC, Fortuna L (2005) Psychosocial stressors, psychiatric diagnoses and utilization of mental health services among undocumented immigrant Latinos. J Immigr Refug Serv 3:107–123CrossRefGoogle Scholar
  89. Perry M, Kannel S, Riley T, Pernice C (2001) What parents say: why eligible children lose SCHIP. National Academy for State Health Policy, Portland, MEGoogle Scholar
  90. Pescosolido BA (1991) Illness careers and network ties: a conceptual model of utilization and compliance. In: Albrecht GL, Levy JA (eds) Advances in medical sociology. JAI Press, CT, pp 161–184Google Scholar
  91. Pescosolido BA (1992) Beyond rational choice: the social dynamics of how people seek help. Am J Sociol 97:1096–1138CrossRefGoogle Scholar
  92. Pescosolido BA (2006) Of pride and prejudice: the role of sociology and social networks in integrating the health sciences. J Health Soc Behav 47:189–208CrossRefGoogle Scholar
  93. Pescosolido BA, Boyer CA (1999) How do people come to use mental health services? Current knowledge and changing perspectives. In: Horwitz AV, Scheid TL (eds) A handbook for the study of mental health: social ­contexts, theories, and systems. Cambridge University Press, New York, pp 392–411Google Scholar
  94. Pescosolido BA, Brooks-Gardner C, Lubell KM (1998) How people get into mental health services: stories of choice, coercion and ‘muddling through’ from ‘first-timers’. Soc Sci Med 46:275–286CrossRefGoogle Scholar
  95. Pescosolido BA, Kronenfeld J (1995) “Health, illness, and healing in an uncertain era: Challenges from and for medical sociology.” Journal of Health and Social Behavior 35:5–33CrossRefGoogle Scholar
  96. Pescosolido BA, Jensen P et al (2008) Public knowledge and assessment of child mental health problems: findings from the national stigma study–children. J Am Acad Child Adolesc Psychiatry 47:339–349CrossRefGoogle Scholar
  97. Pescosolido BA, Wright ER, Sullivan WP (1995) Communities of care: a theoretical perspective on care management models in mental health. In: Greenwich GA (ed) Advances in medical sociology, vol 6. JAI Press, CT, pp 37–80Google Scholar
  98. Putsch R, Pololi L (2005) Distributive justice in American healthcare: institutions, power, and the equitable care of patients. Am J Manag Care 10:SP45–SP53Google Scholar
  99. Rogers A, Pilgrim D (2003) Mental health and inequality. Palgrave MacMillan, New YorkGoogle Scholar
  100. Rogers WA (2004) Evidence-based medicine and justice: a framewrok for looking at the impact of EBM upon vulnerable or disadvantaged groups. J Med Ethics 30:141–145CrossRefGoogle Scholar
  101. Rogler HL (1996) Research on mental health services for Hispanics: targets of convergence. Cult Divers Ment Health 2:145–156CrossRefGoogle Scholar
  102. Rosenbaum PR (2002) Observational studies. Springer-Verlag, New York, NYGoogle Scholar
  103. Roter D, Hall J (1992) Doctors talking with patients/patients talking with doctors: improving communication in ­medical visits. Praeger/Greenwood, LondonGoogle Scholar
  104. Rylko-Bauer B, Farmer P (2002) Managed care or managed inequality? A call for critiques of market-based ­medicine. Med Anthropol Q 16:476–502CrossRefGoogle Scholar
  105. Safeer RS, Keenan J (2005) Health literacy: the gap between physicians and patients. Am Fam Physician 72:463–468Google Scholar
  106. Saha S, Komaromy M, Koepsell TD, Bindman AB (1999) Patient-physician racial concordance and the perceived quality and use of health care. Arch Inter Med 159:997–1004CrossRefGoogle Scholar
  107. Sampson RJ, Raudenbush SW (1997) Neighborhoods and violent crime: a multilevel study of collective efficacy. Science 277:918–924CrossRefGoogle Scholar
  108. Schneider E, Zaslavsky AM, Epstein A (2002) Racial disparities in the quality of care for enrollees in medicare ­managed care. J Am Med Assoc 287:1288–1294CrossRefGoogle Scholar
  109. Schnittker J, Pescosolido BA, Croghan TW (2005) Are African Americans really less willing to use health care? Soc Probl 52:255–271CrossRefGoogle Scholar
  110. Shone L, Dick A, Klein J, Zwanziger J, Szilagyi P (2005) Reduction in racial and ethnic disparities after enrollment in the state children’s health insurance program. Pediatrics 115:e679–e705CrossRefGoogle Scholar
  111. Stiffman AR, Hadley-Ives E, Dore P, Polgar MF, Horvath VE, Striley C, Elze D (2000) Youths’ access to mental health services: the role of providers’ training, resource connectivity, and assessment of need. Ment Health Serv Res 2:141–154CrossRefGoogle Scholar
  112. Stiffman AR, Pescosolido BA, Cabassa LJ (2004) Building a model to understand youth service access: the gateway provider model. Ment Health Serv Res 6:189–198CrossRefGoogle Scholar
  113. Stiffman AR, Striley C, Horvath V, Hadley-Ives E, Polgar M, Elze D, Pescarino R (2001) Organizational context and provider perception as determinants of mental health service use. J Behav Serv Res 28:188–204CrossRefGoogle Scholar
  114. Strauss C, Quinn N (1997) A cognitive theory of cultural meaning. Cambridge University Press, CambridgeGoogle Scholar
  115. Suchman EA (1965) Social patterns of illness and medical care. J Health Hum Behav 6:2–16CrossRefGoogle Scholar
  116. Swidler A (2001) Talk of love: how culture matters. University of Chicago Press, Chicago, ILGoogle Scholar
  117. Tai-Seale M, Freund D, LoSasso A (2001) Racial disparities in service use among medicaid beneficiaries after ­mandatory enrollment in managed care: a difference in differences approach. Inquiry 38:49–59Google Scholar
  118. Tai-Seale M, McGuire T, Colenda C, Rosen D, Cook M (2007) Two-minute mental health care for elderly patients: inside primary care visits. J Am Geriatr Soc 55:1903–1911CrossRefGoogle Scholar
  119. Takeuchi DT, Bui Khanh-Van T, Kim L (1993) The referral of minority adolescents to community mental health centers. J Health Soc Behav 34:153–164CrossRefGoogle Scholar
  120. Tilly C (1999) Durable Inequality. In: Moen P, Dempster-McClain D, Walker H (eds) A nation divided: diversity, inequality, and community in American society. Cornell University Press, Ithaca, NY, pp 15–33Google Scholar
  121. Tilly C (2000) Chain migration and opportunity hoarding. In: Dacyl JW, Westin C (eds) Governance of cultural diversity. Centre for research in international migration and ethnic relations, StockholmGoogle Scholar
  122. Tilly C (2002) Event catalogs as theories. Sociol Theory 20(2):248–254CrossRefGoogle Scholar
  123. U.S. Bureau of the Census (2002) Statistical abstract of the united states. U.S. Government Printing Office, Washington, DCGoogle Scholar
  124. U.S. Department of Health & Human Services (2000) National standards on culturally and linguistically appropriate services (CLAS). Office of Minority Health, Rockville, MDGoogle Scholar
  125. U.S. Department of Health and Human Services (2003) National healthcare disparities report. Agency for Healthcare Research and Quality, Rockville, MDGoogle Scholar
  126. Van Ryn M, Burke J (2000) The effect of patient race and socio-economic status on physicians’ perceptions of patients. Soc Sci Med 50:813–828CrossRefGoogle Scholar
  127. van Ryn M, Fu S (2003) Paved with good intentions: do public health and human service providers contribute to racial/ethnic disparities in health? Am J Public Health 93:248–255CrossRefGoogle Scholar
  128. Vega WA, Lewis-Fernandez R (2008) Ethnicity and variability of psychotic symptoms. Curr Psychiatry Rep 10:223–228CrossRefGoogle Scholar
  129. Walton MA, Blow FC, Booth BM (2001) Diversity in relapse prevention needs: gender and race comparisons among substance abuse treatment patients. Am J Drug Alcohol Abuse 27:225–240CrossRefGoogle Scholar
  130. Warnecke RB, Oh A, Breen N, Gehlert S, Paskett E, Tucker KL et al (2008) Approaching health disparities from a population perspective: the National Institutes of Health Centers for Population Health and Health Disparities. Am J Public Health 98:1608–1615CrossRefGoogle Scholar
  131. Wellman B, Potter S (1999) The elements of personal communities. In: Boulder BW (ed) Networks in the global village: life in contemporary communities. Westview Press, CO, pp 49–82Google Scholar
  132. Wells K, Klap R, Koike A, Sherbourne C (2001) Ethnic disparities in unmet need for alcoholism, drug abuse, and mental health care. Am J Psychiatry 158:2027–2032CrossRefGoogle Scholar
  133. Williams DR, Jackson PB (2005) Social sources of racial disparities in health. Health Affairs 24(2):325–334CrossRefGoogle Scholar
  134. Williams D (2005) Patterns and Causes of Disparities in Health. In: Policy Challenges in Modern Health Care. New Brunswick, NJ: Rutgers University Press. pp 115–134CrossRefGoogle Scholar
  135. Williams JW Jr, Rost K, Dietrich AJ, Ciotti MC, Zyzanski SJ, Cornell J (1999) Primary care physicians’ approach to depressive disorders: effects of physician specialty and practice structure. Arch Fam Med 8:58–67CrossRefGoogle Scholar
  136. Wilson WJ (1990) The truly disadvantaged: the inner-city, the underclass, and public policy. University of Chicago Press, ChicagoGoogle Scholar
  137. Wilson WJ (1997) When work disappears: the world of the new urban poor. Vintage, New YorkGoogle Scholar
  138. Wilson CM, Williams DR (2004) Mental Health of African Americans. In: Praeger Handbook of Black American Health: Policies nad Issues Behind Disparities in Health, Vol. 1. I.L. Livingston, Ed. Westport, CT: Praeger Publishers. pp 369–382Google Scholar
  139. Young A, Klap R, Sherbourne CD, Wells KB (2001) The quality of care for depressive and anxiety disorders in the United States. Arch Gen Psychiatry 58:55–61CrossRefGoogle Scholar
  140. Zola IK (1973) Pathways to the doctor – from person to patient. Soc Sci Med 7:677–689CrossRefGoogle Scholar
  141. Zuckerman H, Cole JR (1975) Women in American science. Minerva 13:82–102CrossRefGoogle Scholar
  142. Zuckerman S, Haley JM, Roubideaux Y, Lillie-Blanton M (2004) Access, use, and insurance coverage among American Indians/Alaska Natives and Whites: what role does the Indian health service play? Am J Public Health 94:53–59CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Margarita Alegría
    • 1
  • Bernice A. Pescosolido
  • Sandra Williams
  • Glorisa Canino
  1. 1.Cambridge Health Alliance and Harvard Medical SchoolSomervilleUSA

Personalised recommendations