3/9/15
90% of African Americans live in areas that are 60% or more African American
88% of whites agree with the principle of fair housing
Only 43% said they would feel comfortable living in an area that was one-third black
Consequences of segregation
Economic inequality
Spatial mismatch
Urban underclass
Crime, lack of economic opportunities, poor health, social isolation
Marriage markets
Housing Problems
Stigmatized addresses
Housing vacancy
Empty buildings increase fear
Places for drug dealers and fugitives to hide
Housing Shortage
Lack of safe, livable, low-income housing
Public Housing
Scattered site housing
Low density in diverse, middle-class neighborhoods
Private market vouchers
Section 8 subsidies:
Residents pay 30% of HH income for housing
Integration into existing communities
Run by city
Challenges in relocation
Shortages in available section 8 housing
Landlords opt out
Cant charge above Fair market rent
Government Inspections
Requirements:
Applications, credit checks, utilities, housekeeping inspections, neighborhood familiarity
Documents
Social security cards, school attendance, birth certificates
Consequences of segregation
Health
Personal and property crime
Environmental toxins
Increased exposure to stress

3/11/15
Social Problems: Health
Distribution of disease burden
Who, what, why?
Health care quality, access, equity
Types of disease and societal response
Social Determinants
Economic Stability
Education
Health and health care
Neighborhood and built environment
Social and Community Context
Health Disparities
Differences between groups of people
How frequently a disease affects a group
How many people get sick
How often disease causes death
Lower income more likely to die of heart disease
High income have more advantages to treat and deal with disease
Disparities by:
Race/ethnicity
Gender
Living areas (rural/urban)
SES
Gender Differences
Compared to women:
Men have higher rates of fatal illness
Heart Disease
Smoking
Preventative Care
Stress
Cancer
Smoking
Occupational Exposure
Men have higher rates of injuries (both intentional and non intentional)
Drive more
More work accidents
Greater use of guns (suicide)
Heavier use of alcohol
More physically active
Masculinity
Men have lower rates of health care utilization
Health care gatekeeper for the family

3/23/15
Health Disparities: SES and Race/Ethnicity
SES Gradient
As income increases, risk of death decreases
SES and Health
Occupational status/prestige
Health Risks
Physical Activity
Stress
Responsibility and Control
SES and Health: Education
Skills linked to social, psychological, and economic resources
Health information
Well paid jobs
Personally satisfying jobs
Better control over lives
Importance of education gets stronger over lifespan
Health Care Problems
Quality
Access to insurance
Pre-existing
Private costs
Rescission
Equity
Cost

3/25/15

Health Care problems
Quality
Equity
Cost
Access to insurance
Declining coverage
Uninsured Americans
22 percent of population under 65 are uninsured
Percentage uninsured rose rapidly prior to 2014
2000:40 million
2007: 47 million
2010: 50 million; (15 percent of US)
13.1% of Kansans
Underinsured
25 million
High deductibles, limited coverage
Effects of insufficient insurance?
Life chances
Directly effects health care use
Free clinics
Emergency rooms
Can be very expensive
Experimental trials
Indirectly affects health outcomes
Receives less preventive care
Receive worse treatment
Less often admitted to hospitals, fewer services, more likely to die early
Patient Provider Affordable Care Act (ACA)
2014 ACA provisions