In the fall of 2005 the streets of France were rocked by civil disturbances on a scale unseen for decades. Only months earlier Azouz Begag, France's first minister for equal opportunities and first-ever cabinet minister of North African immigrant origin, wrote an essay laying bare the festering social and ethnic injustices that, as can now be seen in hindsight, led to the riots.

In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.

As the population of older Americans grows, it is becoming more racially and ethnically diverse. Differences in health by racial and ethnic status could be increasingly consequential for health policy and programs. Such differences are not simply a matter of education or ability to pay for health care. For instance, Asian Americans and Hispanics appear to be in better health, on a number of indicators, than White Americans, despite, on average, lower socioeconomic status. The reasons are complex, including possible roles for such factors as selective migration, risk behaviors, exposure to various stressors, patient attitudes, and geographic variation in health care. This volume, produced by a multidisciplinary panel, considers such possible explanations for racial and ethnic health differentials within an integrated framework. It provides a concise summary of available research and lays out a research agenda to address the many uncertainties in current knowledge. It recommends, for instance, looking at health differentials across the life course and deciphering the links between factors presumably producing differentials and biopsychosocial mechanisms that lead to impaired health.

Racial and ethnic disparities in health care are known to reflect access to care and other issues that arise from differing socioeconomic conditions. There is, however, increasing evidence that even after such differences are accounted for, race and ethnicity remain significant predictors of the quality of health care received. In Unequal Treatment, a panel of experts documents this evidence and explores how persons of color experience the health care environment. The book examines how disparities in treatment may arise in health care systems and looks at aspects of the clinical encounter that may contribute to such disparities. Patients' and providers' attitudes, expectations, and behavior are analyzed. How to intervene? Unequal Treatment offers recommendations for improvements in medical care financing, allocation of care, availability of language translation, community-based care, and other arenas. The committee highlights the potential of cross-cultural education to improve provider-patient communication and offers a detailed look at how to integrate cross-cultural learning within the health professions. The book concludes with recommendations for data collection and research initiatives. Unequal Treatment will be vitally important to health care policymakers, administrators, providers, educators, and students as well as advocates for people of color.

Using an international approach, this book demonstrates the way that the intersection of gendered and ethnic identities operate at work and home. It provides an authoritative account of ethnicity and gender at work, and the theoretical underpinning explanations.

Challenging the dominant view of Hawai’i as a “melting pot paradise”—a place of ethnic tolerance and equality—Jonathan Okamura examines how ethnic inequality is structured and maintained in island society. He finds that ethnicity, not race or class, signifies difference for Hawaii’s people and therefore structures their social relations. In Hawai’i, residents attribute greater social significance to the presumed cultural differences between ethnicities than to more obvious physical differences, such as skin color. According to Okamura, ethnicity regulates disparities in access to resources, rewards, and privileges among ethnic groups, as he demonstrates in his analysis of socioeconomic and educational inequalities in the state. He shows that socially and economically dominant ethnic groups—Chinese Americans, Japanese Americans, and Whites—have stigmatized and subjugated the islands’ other ethnic groups—especially Native Hawaiians, Filipino Americans, and Samoans. He demonstrates how ethnic stereotypes have been deployed against ethnic minorities and how these groups have contested their subordinate political and economic status by articulating new identities for themselves.