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Cited by 415Health disparities and outcomesRacial and Ethnic Identity ResearchPublic Health and Social Inequalities

Reducing Racial Inequities in Health: Using What We Already Know to Take Action

Open access
Williams, David R., Cooper, Lisa A.·2019·International Journal of Environmental Research and Public Health
DOI 10.3390/ijerph16040606PMC PMC6406315
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Abstract

This paper provides an overview of the scientific evidence pointing to critically needed steps to reduce racial inequities in health. First, it argues that communities of opportunity should be developed to minimize some of the adverse impacts of systemic racism. These are communities that provide early childhood development resources, implement policies to reduce childhood poverty, provide work and income support opportunities for adults, and ensure healthy housing and neighborhood conditions. Second, the healthcare system needs new emphases on ensuring access to high quality care for all, strengthening preventive health care approaches, addressing patients’ social needs as part of healthcare delivery, and diversifying the healthcare work force to more closely reflect the demographic composition of the patient population. Finally, new research is needed to identify the optimal strategies to build political will and support to address social inequities in health. This will include initiatives to raise awareness levels of the pervasiveness of inequities in health, build empathy and support for addressing inequities, enhance the capacity of individuals and communities to actively participate in intervention efforts and implement large scale efforts to reduce racial prejudice, ideologies, and stereotypes in the larger culture that undergird policy preferences that initiate and sustain inequities.

AI snapshot

Written from the paper’s full text.

TL;DR

This review argues that eliminating racial health inequities requires coordinated action on communities of opportunity, health care delivery, and political will/awareness. It synthesizes evidence for specific policies and interventions, from early childhood programs and income supports to provider bias reduction and social-needs integration.

Key findings

  • The paper organizes needed action into three strategies: creating communities of opportunity, building more health into medical care delivery, and raising awareness/building political will to address inequities.
  • Early childhood and income-support evidence includes Perry Preschool, where at age 40 the intervention group had higher income, high school completion, college graduation, health insurance coverage, and home ownership and lower crime, out-of-wedlock births, and welfare assistance; Abecedarian treatment males had systolic blood pressure of 126 mm Hg versus 143 mm Hg in controls, and none versus one in four controls met metabolic syndrome criteria; early childhood programs were reported to return $3 to $17 per dollar invested.
  • In 2017, child poverty rates were 33% for American Indian children, 33% for African American children, 26% for Hispanic children, 11% for Asian and Pacific Islander children, and 11% for white children. A $1 minimum wage increase above the federal minimum was associated with a 1%–2% decrease in low birth weight and a 4% decrease in post-neonatal mortality; if all states in 2014 had increased their minimum wage by $1, the researchers estimated 2,790 fewer low birth weight births and 518 fewer post-neonatal deaths.
  • The Delaware colorectal cancer program increased colonoscopy screening by 54% for blacks and 29% for whites and eliminated the racial screening gap; CRC incidence declined 34% for African Americans and 26% for whites, and mortality declined 42% for blacks and 13% for whites, with annual program costs of $7 million versus $8.5 million in savings. Kidney transplantation disparities increased: 2-year cumulative incidence of live donor kidney transplantation in 1995 was 7.0% for white, 3.4% for black, 6.8% for Hispanic, and 5.1% for Asian patients; in 2014 it was 11.4% for white, 2.9% for black, 5.9% for Hispanic, and 5.6% for Asian patients.

Methods

  • Design: narrative review/overview of scientific evidence, not a new empirical study.
  • Data/sample: published research, national data, and program evaluations cited in the paper; no new primary data were collected.
  • Analysis: the paper synthesizes evidence around three intervention strategies—communities of opportunity, health care delivery reform, and awareness/political will—and cites specific studies and examples to support each.

Limitations

  • Stated: the authors note that much remains to be learned about optimal timing and sequencing of interventions, scaling up promising local studies, and effective mass-media communication strategies; research on raising awareness of racial inequities is described as limited with significant gaps.
  • Evident: as a narrative review, it does not report a systematic search strategy, inclusion criteria, or quantitative synthesis.
  • Evident: many cited interventions are small/local studies, natural experiments, or program evaluations, and the paper does not formally assess risk of bias across the evidence base.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.3390/ijerph16040606

Cites

116 of 116 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 275 cited sources checked · 0 supported · 0 flagged

  • Findingcitation

    Between 1993 and 2012, among children aged 5 to 11 years, the suicide rate was stable for Hispanics and other racial groups.

    “was stable for Hispanics and other racial groups”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [7] Bridge, 2015, Suicide Trends Among Elementary School-Aged Children in the United States From 1993 to 2012, JAMA Pediatr. source

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  • Findingcitation

    Two-thirds of blacks and Hispanics currently aged 2 to 19 are projected to be obese by age 35, compared to the national average of 57%.

    “two-thirds of blacks and Hispanics currently aged 2 to 19, are projected to be obese by the age 35, compared to the national average of 57% [6]”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [6] Ward, 2017, Simulation of Growth Trajectories of Childhood Obesity into Adulthood, N. Engl. J. Med. source

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  • Findingcitation

    Black migration from Africa has outpaced migration from the Caribbean since 2000.

    “black migration from Africa has outpaced migration from the Caribbean since 2000”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [5] Hamilton, 2018, From the West Indies to Africa: A universal generational decline in health among blacks in the United States, Soc. Sci. Res. source

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  • Findingcitation

    In one national study, recent Mexican immigrants had a health profile similar to whites.

    “while recent immigrants had a health profile similar to whites [4]”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [4] Kaestner, 2009, Stress, Allostatic Load and Health of Mexican Immigrants, Soc. Sci. Q. source

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  • Findingcitation

    Black immigrants are an increasing share of the black population.

    “Black immigrants are an increasing share of the black population”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [5] Hamilton, 2018, From the West Indies to Africa: A universal generational decline in health among blacks in the United States, Soc. Sci. Res. source

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  • May combine two claims. 99
  • Classified as probably not a substantial claim. 15

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    Findingcitation

    In the Abecedarian project, by age 21, individuals in the intervention group had fewer symptoms of depression, lower marijuana use, a more active lifestyle, and significant educational and vocational advantages compared to controls.

    “By age 21, individuals in the intervention group had fewer symptoms of depression, lower marijuana use, a more active lifestyle, and significant educational and vocational advantages compared to the controls [15,16].”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [15] Campbell, 2008, Young adult outcomes of the Abecedarian and CARE early childhood educational interventions, Early Child. Res. Q. source

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    • cites [16] McLaughlin, 2007, Depressive Symptoms in Young Adults: The Influences of the Early Home Environment and Early Educational Child Care, Child Dev. source

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    Findingcitation

    In the Perry Preschool Program, at age 10, children who received the intervention did not have higher IQ scores than controls but had higher achievement test scores.

    “At age 10, children who received the intervention did not have higher IQ scores than the children in the control condition, but they had higher achievement test scores”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [14] Heckman, 2006, Skill Formation and the Economics of Investing in Disadvantaged Children, Science source

      Not checked in the free run.

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    Findingcitation

    In the Perry Preschool Program, at age 40, the intervention group had better overall health and engaged in fewer risky behaviors, although there were no differences in medical conditions.

    “At age 40, the intervention group also had better overall health and engaged in fewer risky behaviors (driving without seat belt, smoking, illicit use of sedatives, marijuana, LSD, cocaine, heroin) although there were no differences in medical conditions [13].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [13] Muennig, 2009, Effects of a prekindergarten educational intervention on adult health: 37-year follow-up results of a randomized controlled trial, Am. J. Public Health source

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    Findingcitation

    In the Perry Preschool Program, at age 40, the intervention group had higher income, high school completion, college graduation, health insurance coverage and home ownership and lower rates of crime, out-of-wedlock births, and welfare assistance compared to controls.

    “At age 40, the intervention group had higher income, high school completion, college graduation, health insurance coverage and home ownership and lower rates of crime, out-of-wedlock births, and welfare assistance compared to the controls [13].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [13] Muennig, 2009, Effects of a prekindergarten educational intervention on adult health: 37-year follow-up results of a randomized controlled trial, Am. J. Public Health source

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    Findingcitation

    State EITCs increased birth weights and reduced maternal smoking.

    “state EITCs increased birth weights and reduced maternal smoking [25].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [25] Strully, 2010, Effects of Prenatal Poverty on Infant Health: State Earned Income Tax Credits and Birth Weight, Am. Sociol. Rev. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    A one percent increase in obesity rates was associated with an increase of two deaths per 100,000 population.

    “a one percent increase in smoking and obesity rates was associated with an increase of one and two deaths per 100,000 population, respectively.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [23] Kim, 2009, Effects of U.S. States’ Social Welfare Systems on Population Health, Policy Stud. J. source

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    Findingcitation

    A dollar increase in the minimum wage above the federal minimum was associated with a 1% to 2% decrease in low birth weight and a 4% decrease in post-neonatal mortality.

    “a dollar increase in the minimum wage above the federal minimum was associated with a 1% to 2% decrease in low birth weight and a 4% decrease in post-neonatal mortality.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [26] Komro, 2016, The Effect of an Increased Minimum Wage on Infant Mortality and Birth Weight, Am. J. Public Health source

      Not checked in the free run.

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    Findingcitation

    Both the initial implementation of Social Security and later increases in benefit levels were associated with mortality declines for the elderly.

    “both the initial implementation of the program and later increases in the level of benefits were associated with mortality declines for the elderly [27].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [27] Arno, 2011, Social security and mortality: The role of income support policies and population health in the United States, J. Public Health Policy source

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    Findingcitation

    Income from EITC reduced the rate of low birth weight and increased mean birth weight, with associations larger for blacks than whites.

    “income from EITC reduced the rate of low birth weight and increased mean birth weight, with the associations being larger for blacks than for whites [24].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [24] Hoynes, H.W., Miller, D.L., and Simon, D. (2012). Income, the Earned Income Tax Credit, and Infant Health. Natl. Bur. Econ. Res. Work. Pap. Ser., No. 18206. source

      Not checked in the free run.

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    Findingcitation

    In the Great Smoky Mountain Study, declining rates of deviant and aggressive behavior were found among adolescents whose families received additional income, with the level of psychiatric symptoms for those who had received cash supplements for four years being similar to those of adolescents who had never been poor.

    “The study found declining rates of deviant and aggressive behavior among adolescents whose families received additional income, with the level of psychiatric symptoms for those who had received the cash supplements for four years being similar to those of adolescents who had never been poor [28].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [28] Costello, 2003, Relationships between poverty and psychopathology: A natural experiment, J. Am. Med. Assoc. source

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    Findingcitation

    In the Abecedarian project, by mid-30s, children who received the intervention had lower levels of multiple risk factors of cardiovascular and metabolic disease, with effects stronger for males than females.

    “By their mid-30s, the children who received the intervention had lower levels of multiple risk factors of cardiovascular and metabolic disease with the effects being stronger for males than for females [17].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [17] Campbell, 2014, Early childhood investments substantially boost adult health, Science source

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    Findingcitation

    Adults who were raised in poor families complete fewer years of school, earn lower incomes, and are more likely to be poor in adulthood relative to adults who do not come from a poor family.

    “adults who were raised in poor families complete fewer years of school, earn lower incomes, and are more likely to be poor in adulthood relative to adults who do not come from a poor family [21].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [21] Corcoran, 1995, Rags to rags: Poverty and mobility in the United States, Annu. Rev. Sociol. source

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    Findingcitation

    In the Great Smoky Mountain Study, the effect of additional income on psychiatric disorders was present only for those in the youngest cohort (age 12 when supplements began) who had the longest exposure, with no effect in the two older cohorts (age 14 and 16 at initial supplement).

    “subgroup analyses revealed that this effect was present only for those in the youngest cohort (age 12 when the supplements began) who had had the longest exposure to the additional income with no effect of income evident in the two older cohorts who were age 14 and age 16 at the time of the initial supplement.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [29] Costello, 2010, Association of Family Income Supplements in Adolescence With Development of Psychiatric and Substance Use Disorders in Adulthood Among an American Indian Population, J. Am. Med. Assoc. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    A one percent increase in smoking rates was associated with an increase of one death per 100,000 population.

    “a one percent increase in smoking and obesity rates was associated with an increase of one and two deaths per 100,000 population, respectively.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [23] Kim, 2009, Effects of U.S. States’ Social Welfare Systems on Population Health, Policy Stud. J. source

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  • May combine two claims.

    Findingcitation

    In 2017, 33% of American Indian children, 33% of African American children, 26% of Hispanic children, 11% of Asian and Pacific Islander children, and 11% of white children lived in households below the poverty line.

    “In 2017, 33% of American Indian children, 33% of African American children, 26% of Hispanic children, 11% of Asian and Pacific Islander children, and 11% of white children lived in households below the poverty line [20].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [20] Annie, E. (2019, January 04). Casey Foundation. Children in Poverty by Race and Ethnicity. Available online: https://datacenter.kidscount.org/data/tables/44-children-in-poverty-by-race-and-ethnicity#detailed/1/any/false/871,870,573,869,36,868,867,133,38,35/10,11,9,12,1,185,13/324,323.

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  • May combine two claims.

    Findingcitation

    U.S. states with higher spending on education, greater public expenditures, less regressive taxes, and more generous welfare policies had better health as measured by lower death rates, with effects stronger for overall mortality than infant mortality.

    “U.S. states with higher spending on education, greater public expenditures, less regressive taxes, and more generous welfare policies (as reflected in Temporary Assistance to Needy Families (TANF) and Medicaid program rules) had better health as measured by lower death rates, with the effects being stronger for overall mortality than for infant mortality [23].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [23] Kim, 2009, Effects of U.S. States’ Social Welfare Systems on Population Health, Policy Stud. J. source

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  • May combine two claims.

    Findingcitation

    Ending racial residential segregation would completely eliminate racial differences, among young adults, in income, education, and unemployment and reduce gaps in single motherhood by two-thirds.

    “ending racial residential segregation would completely eliminate racial differences, among young adults, in income, education, and unemployment and reduce gaps in single motherhood by two-thirds [36].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [36] Cutler, 1997, Are ghettos good or bad?, Q. J. Econ. source

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    Findingcitation

    During 1965-1974, black women had larger gains in life expectancy than black men and white men and women, with the life expectancy increase for black women during this period being three times as large as those in the decade before.

    “during 1965–1974 black women had larger gains in life expectancy than black men and white men and women, with the life expectancy increase for black women during this period being three times as large as those in the decade before [32].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [32] Schoeni, R.F., House, J.S., Kaplan, G.A., and Pollack, H. (2008). Lifting Gates–Lengthening Lives: Did Civil Rights Policies Improve the Health of African-American Woman in the 1960s and 1970s?. Making Americans Healthier: Social and Economic Policy as Health Policy, Russell Sage Foundation Publications.

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  • May combine two claims.

    Findingcitation

    Black women born between 1967 and 1969 had better health status as adults and were less likely to have low-birth weight infants and infants with low APGAR scores than those born between 1961 and 1963.

    “black women born between 1967 and 1969 had better health status as adults and were less likely to have low-birth weight infants and infants with low APGAR scores than those born between 1961 and 1963 [34].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [34] Almond, D., and Chay, K.Y. (2006). The Long-Run and Intergenerational Impact of Poor Infant Health: Evidence from Cohorts Born During the Civil Rights Era, University of California-Berkeley.

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    Findingcitation

    Between 1968 and 1978, both black males and females aged 35-74 had larger absolute and relative declines in mortality than their white counterparts, with mortality declines larger for black women than black men.

    “between 1968 and 1978, both black males and females, aged 35-74, had larger absolute and relative declines in mortality than their white counterparts, with the mortality declines being larger for black women than black men [33].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [33] Cooper, 1981, Improved mortality among U.S. blacks, 1968-1978: The role of antiracist struggle, Int. J. Health Serv. source

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    Findingcitation

    These HUD interventions can increase income, improve safety and security and improve physical and mental health.

    “these interventions can increase income, improve safety and security and improve physical and mental health.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [52] Turner, M.A., and Rawlings Lynette, A. (2005). Overcoming Concentrated Poverty and Isolation: Lessons from Three HUD Demonstration Initiatives, Urban Institute.

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    Findingcitation

    In the Yonkers Housing Intervention, two years later, compared to residents who stayed, those who moved reported better health (overall health and lower levels of substance abuse), higher neighborhood quality, and improved economic outcomes.

    “Two years later, compared to those residents who had stayed, those who moved reported better health (overall health and lower levels of substance abuse), higher neighborhood quality (lower neighborhood disorder and violence and higher levels of satisfaction with public transportation, recreation facilities and medical care) and improved economic outcomes (higher rates of employment and lower rates”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [46] Fauth, 2004, Short-term effects of moving from public housing in poor- to middle-class neighborhoods on low-income, minority adults’ outcomes, Soc. Sci. Med. source

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    Findingcitation

    Military service has provided disadvantaged black men increased education, higher earnings and greater occupational mobility than their civilian peers.

    “military service has provided disadvantaged black men increased education, higher earnings and greater occupational mobility than their civilian peers [37].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [37] Teachman, 2007, Race, military service, and marital timing: Evidence from the NLSY-79, Demography source

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    Findingcitation

    Children raised in single-parent homes are more likely to become sexually active at a younger age, use illegal drugs, and engage in illegal activities.

    “They are also more likely to become sexually active at a younger age, use illegal drugs, and engage in illegal activities [41].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [41] Antecol, 2007, Does single parenthood increase the probability of teenage promiscuity, substance use, and crime?, J. Popul. Econ. source

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    Findingcitation

    Active duty military service promotes marriage over cohabitation, increases the likelihood of first marriage, and leads to greater stability of marriage, and all of these effects were greater for blacks than for whites.

    “active duty military service promotes marriage over cohabitation, increases the likelihood of first marriage, and leads to greater stability of marriage and all of these effects were greater for blacks than for whites [37,38,39].”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [37] Teachman, 2007, Race, military service, and marital timing: Evidence from the NLSY-79, Demography source

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    • cites [38] Teachman, 2008, Divorce, race, and military service: More than equal pay and equal opportunity, J. Marriage Fam. source

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    • cites [39] Teachman, 2009, Military Service, Race, and the Transition to Marriage and Cohabitation, J. Fam. Issues source

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    Findingcitation

    Civil rights policies led to increases in employment and wages that narrowed the black-white economic gap, with gains larger for black women than black men.

    “civil rights policies led to increases in employment and wages that narrowed the black-white economic gap with the gains being larger for black women than for black men [32].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [32] Schoeni, R.F., House, J.S., Kaplan, G.A., and Pollack, H. (2008). Lifting Gates–Lengthening Lives: Did Civil Rights Policies Improve the Health of African-American Woman in the 1960s and 1970s?. Making Americans Healthier: Social and Economic Policy as Health Policy, Russell Sage Foundation Publications.

      Not checked in the free run.

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    Findingcitation

    Children raised in single-parent homes perform more poorly in school and are less likely to graduate from high school.

    “children raised in single-parent homes perform more poorly in school, and are less likely to graduate from high school [40].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [40] Sandefur, 1992, The effects of parental marital status during adolescence on high school graduation, Soc. Forces source

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    Findingcitation

    Rigorous evaluation of the Harlem Children's Zone has shown that it eliminated racial gaps in academic achievement and was successful in improving housing conditions and childhood asthma outcomes.

    “Rigorous evaluation of the HCZ has shown that it eliminated racial gaps in academic achievement and was successful in improving housing conditions and childhood asthma outcomes [50,51].”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [50] Spielman, 2006, Interdisciplinary planning for healthier communities: Findings from the Harlem Children’s Zone Asthma Initiative, J. Am. Plann. Assoc. source

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    • cites [51] Dobbie, W., and Fryer, R.G. (2009). Are High Quality Schools Enough to Close the Achievement Gap? Evidence from a Social Experiment in Harlem, National Bureau of Economic Research. source

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    Findingcitation

    In the Seattle-King County Healthy Homes Project RCT, the program was effective in reducing asthma symptoms and urgent health care use among children, and in improving quality-of-life among adults who cared for them.

    “A randomized controlled trial (RCT) with these low income households in which children with asthma were present found that the program was effective in reducing asthma symptoms and urgent health care use among the children, and in improving quality-of-life among the adults who cared for them [48].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [48] Krieger, 2005, The Seattle-King County Healthy Homes Project: A randomized, controlled trial of a community health worker intervention to decrease exposure to indoor asthma triggers, Am. J. Public Health source

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  • Probably not a substantial claim: may not pass S2 (checkable), S4 (based).

    Interpretationreasoning

    Improving health of disadvantaged groups and reducing gaps in health requires changing systems to improve conditions that determine health in homes, schools, neighborhoods, workplaces, houses of worship and other social contexts.

    “Improving health of disadvantaged groups and reducing gaps in health requires changing systems to improve conditions that determine health in homes, schools, neighborhoods, workplaces, houses of worship and other social contexts.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationreasoning

    Reducing inequities in health requires dismantling the systems that initiate and sustain inequities in a broad range of societal institutions that are the drivers of inequities in health.

    “Reducing inequities in health requires dismantling the systems that initiate and sustain inequities in a broad range of societal institutions that are the drivers of inequities in health.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

    Premisecitation

    Racism is an organized societal system in which the dominant racial group categorizes and ranks people into races and uses power to devalue, disempower, and differentially allocate resources and opportunities to groups defined as inferior.

    “Racism is an organized societal system, in which the dominant racial group, based on a hierarchy of human value, categorizes and ranks people into social groups called “races”, and uses its power to devalue, disempower, and differentially allocate societal resources and opportunities to groups defined as inferior [8,9].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [8] Bonilla-Silva, E. (1997). Rethinking racism: Toward a structural interpretation. Am. Sociol. Rev., 465–480. source

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    • cites [9] Williams, D.R., Lawrence, J.A., and Davis, B.A. (2019). Racism and Health: Evidence and Needed Research. Annu. Rev. Public Health. source

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  • May combine two claims.

    Premisereasoning

    Despite progress in reducing inequities over time, racial gaps in health persist.

    “despite progress in reducing inequities over time, racial gaps in health persist.”
    Quote in the paperSubstantial claim

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    Premisecitation

    Structural or institutional racism exists within, and is reinforced and supported by, multiple societal systems, including the housing market, education system, labor market, criminal justice system, credit markets, economy and health care system.

    “structural or institutional racism (we use these terms interchangeably) exists within, and is reinforced and supported by multiple societal systems, including the housing market, the education system, the labor market, the criminal justice system, credit markets, the economy and the health care system.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [12] Reskin, 2012, The Race Discrimination System, Annu. Rev. Sociol. source

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    Interpretationcitation

    The economies of some peer nations produce child poverty rates similar to the U.S., but those societies have developed policies to markedly reduce child poverty.

    “the economies of some of our peer nations produce child poverty rates similar to the U.S., but those societies have developed policies to markedly reduce child poverty.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [22] UNICEF (2012). Measuring Child Poverty: New League Tables of Child Poverty in the World’s Rich Countries, UNICEF.

      Not checked in the free run.

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    Premisecitation

    Some limited research indicates that income supplementation to racial minorities can lead to improved health and the reduction of at least some racial differences in health.

    “Some limited research also indicates that income supplementation to racial minorities can lead to improved health and the reduction of at least some racial differences in health.”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [28] Costello, 2003, Relationships between poverty and psychopathology: A natural experiment, J. Am. Med. Assoc. source

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    • cites [29] Costello, 2010, Association of Family Income Supplements in Adolescence With Development of Psychiatric and Substance Use Disorders in Adulthood Among an American Indian Population, J. Am. Med. Assoc. source

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    • cites [30] Akee, 2010, Parents’ Incomes and Children’s Outcomes: A Quasi-experiment Using Transfer Payments from Casino Profits, Am. Econ. J. Appl. Econ. source

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    Interpretationcitation

    The mid 1960s to the mid 1970s was a period in which the health of African Americans improved more rapidly than the health of whites so that there was a narrowing of the black-white gap in health.

    “the mid 1960s to the mid 1970s was a period in which the health of African Americans improved more rapidly than the health of whites so that there was a narrowing of the black-white gap in health.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S4 (based).

    Premisenone given

    Virtually every health-enhancing resource is linked to where one lives in the U.S.

    “Given that virtually every health-enhancing resource is linked to where one lives in the U.S.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Neighborhood transformation is possible and is associated with improved health.

    “There are multiple examples that illustrate that neighborhood transformation is possible and is associated with improved health.”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [46] Fauth, 2004, Short-term effects of moving from public housing in poor- to middle-class neighborhoods on low-income, minority adults’ outcomes, Soc. Sci. Med. source

      Not checked in the free run.

    • cites [47] Krieger, 2002, Housing and health: Time again for public health action, Am. J. Public Health source

      Not checked in the free run.

    • cites [48] Krieger, 2005, The Seattle-King County Healthy Homes Project: A randomized, controlled trial of a community health worker intervention to decrease exposure to indoor asthma triggers, Am. J. Public Health source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Civil rights policies are an example of a large-scale economic initiative that led to improved health for blacks and reduced black-white disparities in health.

    “Civil rights policies are an example of a large-scale economic initiative that led to improved health for blacks and reduced black-white disparities in health.”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [31] Hahn, 2018, Civil rights as determinants of public health and racial and ethnic health equity: Health care, education, employment, and housing in the United States, SSM Popul. Health source

      Not checked in the free run.

    • cites [32] Schoeni, R.F., House, J.S., Kaplan, G.A., and Pollack, H. (2008). Lifting Gates–Lengthening Lives: Did Civil Rights Policies Improve the Health of African-American Woman in the 1960s and 1970s?. Making Americans Healthier: Social and Economic Policy as Health Policy, Russell Sage Foundation Publications.

      Not checked in the free run.

    • cites [33] Cooper, 1981, Improved mortality among U.S. blacks, 1968-1978: The role of antiracist struggle, Int. J. Health Serv. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    An analysis of the costs of the Medicare for All Act revealed that it would increase demand for healthcare services by about 12%, realize cost savings of about 19%, and reduce overall healthcare costs by about 9.6%.

    “A recent analysis of the costs of this program revealed that although it would increase the demand for healthcare services by about 12%, the implementation of the program could realize cost savings of about 19%, which would reduce overall healthcare costs by about 9.6% [61].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [61] Pollin, R., Heintz, J., Arno, P., Wicks-Lim, J., and Ash, M. (2018). Economic Analysis of Medicare for All, Political Economy Research Institute, University of Massachusetts.

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Primary care contributes to smaller health inequities through increased access for disadvantaged populations, emphasis on preventive care and early disease management, encouragement of high quality and more appropriate care, and reduction of unnecessary specialty care.

    “Several aspects of primary care appear to contribute to this: primary care increases access of disadvantaged populations, provides an emphasis on preventive care and the early management of disease, encourages high quality care, more appropriate care and reduces unnecessary specialty care [63].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [63] Starfield, 2005, Contribution of primary care to health systems and health, Milbank Q. source

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    Early intervention and/or minimal thresholds of exposure to the new environment are important before positive effects of moving are evident.

    “This highlights the importance of early intervention and/or the need of minimal thresholds of exposure to the new environment before positive effects are evident.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    The Delaware CRC program produced cost savings: the annual bill was $7 million and annual savings from reduced CRC incidence were $8.5 million.

    “The annual bill for the screening and treatment program was $7 million but the annual savings from reduced incidence of CRC was $8.5 million.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [59] Grubbs, 2013, Eliminating racial disparities in colorectal cancer in the real world: It took a village, J. Clin. Oncol. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    By 2009, colonoscopy screening rates in Delaware had increased by 54% for blacks and 29% for whites, and the racial gap in screening was eliminated.

    “By 2009, colonoscopy screening rates had increased by 54% for blacks and 29% for whites and the racial gap in screening was eliminated.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [59] Grubbs, 2013, Eliminating racial disparities in colorectal cancer in the real world: It took a village, J. Clin. Oncol. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Implicit biases guide our expectations and social interactions with others and can become harmful when assumptions and generalizations about a group affect our interactions with an individual.

    “Importantly, they guide our expectations and social interactions with others and can become harmful when assumptions and generalizations about a group affect our interactions with an individual.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [69] American Psychological Association Presidential Task Force on Preventing Discrimination and Promoting Diversity (2012). Dual Pathways to a Better America: Preventing Discrimination and promoting Diversity, American Psychological Association.

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In the Yonkers Housing Intervention, movers had weaker social ties in their new neighborhoods and smaller networks of neighborhood-based friends compared to poor residents who did not move.

    “in the Yonkers Housing Intervention, compared to poor residents who did not move, movers had weaker social ties in their new neighborhoods and smaller networks of neighborhood-based friends [56].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [56] Fauth, 2008, Seven years later: Effects of a neighborhood mobility program on poor Black and Latino adults’ well-being, J. Health Soc. Behav. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In Delaware, the mortality gap was almost eliminated by 2009, with a mortality decline of 42% for blacks and 13% for whites.

    “The mortality gap was almost eliminated by 2009 with a mortality decline of 42% for blacks and 13% for whites.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [59] Grubbs, 2013, Eliminating racial disparities in colorectal cancer in the real world: It took a village, J. Clin. Oncol. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In 2006 the rate of in-hospital death was 248 percent higher for Black women, 50 percent higher for Hispanic women, and 69 percent higher for Asian/Pacific Islander women than for White women; in 2015, the rate for Blacks was 193 percent higher and the rate for Hispanics was 31 percent higher than the rate for Whites.

    “In 2006 the rate of in-hospital death was 248 percent higher for Black women, 50 percent higher for Hispanic women, and 69 percent higher for Asian/Pacific Islander women than for White women.”
    • Also stated in: § 3.3. Eliminating Inequities in the Receipt of High Quality Care · plain
      “In 2015, the rate for Blacks was 193 percent higher and the rate for Hispanics was 31 percent higher than the rate for Whites.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [68] Fingar, K.R., Hambrick, M.M., Heslin, K.C., and Moore, J.E. (2019, January 04). Healthcare Cost and Utilization Project Statistical Briefs: Trends and Disparities in Delivery Hospitalizations Involving Severe Maternal Morbidity, 2006–2015: Statistical Brief #243, Available online: https://www.ncbi.nlm.nih.gov/books/NBK532465/#sb243.s1.

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Ten years after the implementation of the Purpose Built Communities model in East Lake Atlanta, the elementary school was transformed from one of the worst performing among Atlanta public schools to one of the best performing in the state, even though 74% of the students qualify for free and reduced price lunch.

    “the elementary school was transformed from one of the worst performing among Atlanta public schools to one of the best performing in the state, even though 74% of the students qualify for free and reduced price lunch.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [57] Andrews, N.O., and Erickson, D.J. (2012). It Takes a Neighborhood: Purpose Built Communities and Neighborhood Transformation. Investing in What Works for America’s Communities, Federal Reserve Bank of San Franciso and Low Income Investment Fund.

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    A renewed emphasis on prevention could have an enormous impact on improving overall health and reducing inequities in health.

    “Thus, a renewed emphasis on prevention could have an enormous impact on improving overall health and reducing inequities in health.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Implicit biases are normal, natural, subtle and often subconscious.

    “Research reveals that these implicit biases are normal, natural, subtle and often subconscious [69].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [69] American Psychological Association Presidential Task Force on Preventing Discrimination and Promoting Diversity (2012). Dual Pathways to a Better America: Preventing Discrimination and promoting Diversity, American Psychological Association.

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Racial disparities in in-hospital maternal mortality decreased between 2006 and 2015, but significant disparities remain.

    “Racial disparities in in-hospital maternal mortality decreased between 2006 and 2015, but significant disparities remain [68].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [68] Fingar, K.R., Hambrick, M.M., Heslin, K.C., and Moore, J.E. (2019, January 04). Healthcare Cost and Utilization Project Statistical Briefs: Trends and Disparities in Delivery Hospitalizations Involving Severe Maternal Morbidity, 2006–2015: Statistical Brief #243, Available online: https://www.ncbi.nlm.nih.gov/books/NBK532465/#sb243.s1.

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In the U.S., 75% of health care dollars are spent on preventable conditions, while only 3% of health care expenditure is on prevention.

    “It is estimated that although 75% of health care dollars in the U.S. is spent on preventable conditions, only 3% of America’s health care expenditure is on prevention [58].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [58] Forsberg, V., and Fichtenberg, C. (2012). The Prevention and Public Health Fund: A Critical Investment in Our Nation’s Physical and Fiscal Health, Center for Public Health Policy, American Public Health Association.

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Implicit biases are universal; all humans have them, with even the most well-meaning individual capable of harboring deep-seated biases.

    “Moreover, they are universal, all humans have them, with even the most well-meaning individual capable of harboring deep-seated biases.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [69] American Psychological Association Presidential Task Force on Preventing Discrimination and Promoting Diversity (2012). Dual Pathways to a Better America: Preventing Discrimination and promoting Diversity, American Psychological Association.

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Access to primary care is associated with smaller social disparities in health and is a likely determinant of the unexpectedly good health profiles of countries like Cuba and Costa Rica.

    “Access to primary care is associated with smaller social disparities in health and is a likely determinant of the unexpectedly good health profiles of countries like Cuba and Costa Rica [63].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [63] Starfield, 2005, Contribution of primary care to health systems and health, Milbank Q. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    A greater emphasis on person-focused primary care (instead of disease-focused care) would better address the health care needs of patients and reduce inequities in health.

    “Research reveals that a greater emphasis on person-focused primary care (instead of disease-focused care) would better address the health care needs of patients and reduce inequities in health [62].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [62] Starfield, 2012, Clinical Care and Health Disparities, Annu. Rev. Public Health source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Ten years after the implementation of the Purpose Built Communities model in East Lake Atlanta, crime had declined by 73% and violent crime by 90%.

    “Ten years after the implementation of this model in East Lake Atlanta, crime had declined by 73% and violent crime by 90% [57].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [57] Andrews, N.O., and Erickson, D.J. (2012). It Takes a Neighborhood: Purpose Built Communities and Neighborhood Transformation. Investing in What Works for America’s Communities, Federal Reserve Bank of San Franciso and Low Income Investment Fund.

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In 1995, the cumulative incidence of LDKT at 2 years after appearing on the waiting list was 7.0% among white patients, 3.4% among black patients, 6.8% among Hispanic patients, and 5.1% among Asian patients; in 2014, it was 11.4% among white patients, 2.9% among black patients, 5.9% among Hispanic patients, and 5.6% among Asian patients.

    “In 1995, the cumulative incidence of LDKT at 2 years after appearing on the waiting list was 7.0% among white patients, 3.4% among black patients, 6.8% among Hispanic patients, and 5.1% among Asian patients.”
    • Also stated in: § 3.3. Eliminating Inequities in the Receipt of High Quality Care · plain
      “In 2014, the cumulative incidence of LDKT was 11.4% among white patients, 2.9% among black patients, 5.9% among Hispanic patients, and 5.6% among Asian patients.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [67] Purnell, 2018, Association of Race and Ethnicity With Live Donor Kidney Transplantation in the United States From 1995 to 2014, JAMA source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    The implementation of the Affordable Care Act completely eliminated the disparity for Asian Americans, Native Hawaiians and other Pacific Islanders, but not for other racial groups.

    “completely eliminated that disparity for Asian Americans, Native Hawaiians and other Pacific Islanders, but not for other racial groups [60]”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [60] Park, 2018, Health insurance for asian americans, native hawaiians, and pacific islanders under the affordable care act, JAMA Intern. Med. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    More implicit bias was associated with less patient-centered dialogue, lower patient positive affect, lower perception of respect from the clinician, less patient liking of the clinician and lower trust and confidence in clinician.

    “For example, more implicit bias was associated with less patient-centered dialogue, lower patient positive affect, lower perception of respect from the clinician, less patient liking of the clinician and lower trust and confidence in clinician”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [74] Cooper, 2012, The Associations of Clinicians’ Implicit Attitudes About Race With Medical Visit Communication and Patient Ratings of Interpersonal Care, Am. J. Public Health source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    These strategies reduced bias in participants and the effect remained evident three months later.

    “The study found that these strategies reduced bias in participants and that this effect remained evident three months later.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [77] Devine, 2012, Long-term reduction in implicit race bias: A prejudice habit-breaking intervention, J. Exp. Soc. Psychol. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    About 70 percent of physicians have an implicit preference for whites over blacks, similar to the pattern observed for other professionals and the general population.

    “Analyses of data from a large, volunteer and non-representative sample of persons who took the Implicit Association Test (IAT), a widely used test to assess the presence of implicit bias, concluded that about 70 percent of physicians have an implicit preference for whites over blacks, similar to the pattern observed for other professionals and the general population [71].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [71] Sabin, 2009, Physicians’ Implicit and Explicit Attitudes About Race by MD Race, Ethnicity, and Gender, J. Health Care Poor Underserved source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Higher implicit bias scores among physicians are associated with biased treatment recommendations in the care of black patients, although the pattern is not uniform.

    “Research reveals that higher implicit bias scores among physicians is associated with biased treatment recommendations in the care of black patients [66], although the pattern is not uniform [72].”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [66] Burgess, 2011, The impact of racism on clinician cognition, behavior, and clinical decision making, Du Bois Rev. source

      Not checked in the free run.

    • cites [72] Haider, 2011, Association of unconscious race and social class bias with vignette-based clinical assessments by medical students, JAMA

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Premisecitation

    A panel of the NAM has highlighted the enormous potential of the routine screening of all patients for the social determinants of health, as a part of comprehensively addressing the needs of patients.

    “A panel of the NAM has highlighted the enormous potential of the routine screening of all patients for the social determinants of health, as a part of comprehensively addressing the needs of patients [90].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [90] Adler, 2015, Patients in context--EHR capture of social and behavioral determinants of health, N. Engl. J. Med. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    The CAPABLE program cost less than $3000 per participant and provided a 10-fold return on investment via reduced healthcare utilization.

    “The program cost less than $3000 per participant and provided a 10-fold return on investment via reduced healthcare utilization.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [87] Szanton, 2014, CAPABLE trial: A randomized controlled trial of nurse, occupational therapist and handyman to reduce disability among older adults: Rationale and design, Contemp. Clin. Trials source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Racial concordance between a patient and a clinician has been associated with better patient-provider communication and overall health outcomes, as well as higher levels of patient satisfaction with care and adherence to provider recommendations.

    “Research also indicates that racial concordance between a patient and a clinician has been associated with better patient-provider communication and overall health outcomes, as well as higher levels of patient satisfaction with care and adherence to provider recommendations [92,93].”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [92] Cooper, L.A., and Powe, N.R. (2004). Disparities in Patient Experiences, Health Care Processes, and Outcomes: The Role of Patient-Provider Racial, Ethnic, and Language Concordance, Commonwealth Fund (Publication #753).

      Not checked in the free run.

    • cites [93] Lightfoote, 2014, Improving diversity, inclusion, and representation in radiology and radiation oncology part 1: Why these matter, J. Am. Coll. Radiol. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Non-black adults could be motivated to increase their awareness of racial bias, their concerns about the effects of such bias and their willingness to implement strategies to reduce such bias.

    “One study of university students documented that non-black adults could be motivated to increase their awareness of racial bias, their concerns about the effects of such bias and their willingness to implement strategies to reduce such bias [77].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [77] Devine, 2012, Long-term reduction in implicit race bias: A prejudice habit-breaking intervention, J. Exp. Soc. Psychol. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    For the 1968-69 school year, of the 9,863 first year medical school enrollees in the U.S., 266 (2.7%) were black, three (0.0%) were Native American, 20 (0.2%) were Mexican American and 3 (0.0%) were mainland Puerto Rican.

    “For the 1968-69 school year, of the 9,863 first year medical school enrollees in the U.S., 266 (2.7%) were black, three (0.0%) were Native American, 20 (0.2%) were Mexican American and 3 (0.0%) were mainland Puerto Rican [95].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [95] Association of American Medical Colleges (2019, January 04). Diversity in Medical Education: Facts & Figures 2012 (Table 4). Available online: https://members.aamc.org/eweb/upload/Diversity%20in%20Medical%20Education%20Facts%20and%20Figures%202012.pdf.

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S1 (asserted).

    Premisecitation

    Implicit biases can be viewed as deeply engrained habits that can be replaced by learning multiple new prejudice-reducing strategies including stereotype replacement, counter-stereotype imaging, individuation, perspective taking and increasing interracial contact.

    “These researchers viewed implicit biases as deeply engrained habits that can be replaced by learning multiple new prejudice-reducing strategies including stereotype replacement, counter-stereotype imaging, individuation, perspective taking and increasing interracial contact.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [77] Devine, 2012, Long-term reduction in implicit race bias: A prejudice habit-breaking intervention, J. Exp. Soc. Psychol. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Compared to placebo, propranolol eliminated implicit bias and reduced heart rate, but had no effect on explicit bias.

    “The study found that compared to placebo, propranolol eliminated implicit bias and reduced heart rate, but had no effect on explicit bias (measured by feeling thermometer: warmth towards blacks, whites, homosexuals, Muslims, Christians, drug addicts).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [75] Terbeck, 2012, Propranolol reduces implicit negative racial bias, Psychopharmacology source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Provider implicit bias was associated with poorer quality of patient provider communication and lower patient evaluation of the quality of the medical encounter including provider nonverbal behavior.

    “Another study of providers who work in safety net clinics in a major metropolitan area found that provider implicit bias was associated with poorer quality of patient provider communication and lower patient evaluation of the quality of the medical encounter including provider nonverbal behavior [74].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [74] Cooper, 2012, The Associations of Clinicians’ Implicit Attitudes About Race With Medical Visit Communication and Patient Ratings of Interpersonal Care, Am. J. Public Health source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    For mothers, the Nurse-Family Partnership led to lower smoking during pregnancy, fewer subsequent pregnancies, increased labor force participation, reduced use of public assistance programs, and lower rates of child abuse and neglect.

    “For mothers, the NFP led to lower smoking during pregnancy, fewer subsequent pregnancies, increased labor force participation, reduced use of public assistance programs, and lower rates of child abuse and neglect.”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [82] Olds, 2006, The nurse–family partnership: An evidence-based preventive intervention, Infant Ment. Health Journal source

      Not checked in the free run.

    • cites [84] Olds, 2008, Preventing Child Maltreatment and Crime with Prenatal and Infancy Support of Parents: The Nurse-Family Partnership, J. Scand. Stud. Criminol. Crime Prev. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In 2015, Asians were 19.8% (3701), African Americans were 5.7% (n = 10,610) and Latinos were 4.6% (n = 854) of medical school graduates.

    “In 2015, Asians were 19.8% (3701), African Americans were 5.7% (n = 10,610) and Latinos were 4.6% (n = 854) of medical school graduates [96].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [96] Association of American Medical Colleges (2019, January 04). Current Trends in Medical Education (Figures 17–18). Available online: http://www.aamcdiversityfactsandfigures2016.org/report-section/section-3/.

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    There were significant improvements in activities of daily living (ADLs) and independent activities of daily living (IADLs) and reductions in depressive symptoms in the CAPABLE program.

    “There were significant improvements in activities of daily living (ADLs) and independent activities of daily living (IADLs) and reductions in depressive symptoms.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [87] Szanton, 2014, CAPABLE trial: A randomized controlled trial of nurse, occupational therapist and handyman to reduce disability among older adults: Rationale and design, Contemp. Clin. Trials source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Underrepresented minorities (URM) are more likely to work with underserved populations, with URM from the highest SES backgrounds working in under-served areas at higher rates than do white physicians from the lowest SES backgrounds.

    “This research indicates that underrepresented minorities (URM) are more likely to work with underserved populations, with URM from the highest SES backgrounds working in under-served areas at higher rates than do white physicians from the lowest SES backgrounds [93].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [93] Lightfoote, 2014, Improving diversity, inclusion, and representation in radiology and radiation oncology part 1: Why these matter, J. Am. Coll. Radiol. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Among the children, the Nurse-Family Partnership led to a reduction in childhood injuries, substance use and juvenile crime.

    “Among the children, the program led to a reduction in childhood injuries, substance use and juvenile crime [82,84].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [82] Olds, 2006, The nurse–family partnership: An evidence-based preventive intervention, Infant Ment. Health Journal source

      Not checked in the free run.

    • cites [84] Olds, 2008, Preventing Child Maltreatment and Crime with Prenatal and Infancy Support of Parents: The Nurse-Family Partnership, J. Scand. Stud. Criminol. Crime Prev. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Among URM graduates in 2015, females were the majority: women made up 65% of black graduates, 53% of Hispanic graduates, 75% of Native American graduates and 60% of Native Hawaiian and other Pacific Islander graduates.

    “Among URM graduates in 2015, females were the majority.”
    • Also stated in: § 3.5. Diversifying the Healthcare Workforce · plain
      “Women made up 65% of black graduates, 53% of Hispanic graduates, 75% of Native American graduates and 60% of Native Hawaiian and other Pacific Islander graduates [96].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [96] Association of American Medical Colleges (2019, January 04). Current Trends in Medical Education (Figures 17–18). Available online: http://www.aamcdiversityfactsandfigures2016.org/report-section/section-3/.

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Reviews of research in the U.S. indicate that CHW interventions have been effective in improving the control of high blood pressure and reducing cardiovascular risk, enhancing diabetes control, managing HIV infection, and increasing the uptake of cancer screening tests.

    “Reviews of research in the U.S. indicate that CHW interventions have been effective in improving the control of high blood pressure and reducing cardiovascular risk, enhancing diabetes control, managing HIV infection, and increasing the uptake of cancer screening tests [88].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [88] Perry, 2014, Community health workers in low-, middle-, and high-income countries: An overview of their history, recent evolution, and current effectiveness, Annu. Rev. Public Health source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Implicit biases may affect not only medical decision making but also the quality of communication and nonverbal behavior.

    “Implicit biases may affect not only medical decision making but also the quality of communication and nonverbal behavior [66].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [66] Burgess, 2011, The impact of racism on clinician cognition, behavior, and clinical decision making, Du Bois Rev. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Only 20 (0.1%) American Indian or Alaska Natives and 5 Native Hawaiian and other Pacific Islanders graduated from medical school in 2015.

    “Only 20 (0.1%) American Indian or Alaska Natives and 5 Native Hawaiian and other Pacific Islanders graduated from medical school in 2015.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [96] Association of American Medical Colleges (2019, January 04). Current Trends in Medical Education (Figures 17–18). Available online: http://www.aamcdiversityfactsandfigures2016.org/report-section/section-3/.

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In national data, 70% of whites would support giving businesses and industry special tax breaks for locating in poor and high unemployment areas, but only 43% of whites would support such initiatives in largely black areas.

    “in national data, 70% of whites would support giving businesses and industry special tax breaks for locating “in poor and high unemployment areas” but only 43% of whites would support such initiatives in “largely black areas” [104].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [104] Marsden, P.B. (2012). The Real Record on Racial Attitudes. Social Trends in American Life: Findings from the General Social Survey Since 1972, Princeton University Press. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    The racial ingroup bias is more pronounced among persons with higher implicit racial bias, individuals from cultures that are more collectivistic than individualistic in emphasis, and when individuals are exposed to harsh living conditions.

    “This research has also documented that the racial ingroup bias is more pronounced among persons with higher implicit racial bias, individuals from cultures that are more collectivistic than individualistic in emphasis, and when individuals are exposed to harsh living conditions [110].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [110] Han, 2018, Neurocognitive Basis of Racial Ingroup Bias in Empathy, Trends Cogn. Sci. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Public opinion research over the last four decades in the U.S. has shown that levels of support for government interventions to help blacks have been low and are declining over time.

    “Public opinion research over the last four decades in the U.S. has shown that levels of support for government interventions to help blacks have been low and they are declining over time [104].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [104] Marsden, P.B. (2012). The Real Record on Racial Attitudes. Social Trends in American Life: Findings from the General Social Survey Since 1972, Princeton University Press. source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Premisecitation

    Dominant frames include that American society has made important progress on race in recent decades because changes in laws and policies have eliminated the discrimination and racism that had characterized American society in the past.

    “These dominant frames include that American society has made important progress on race in recent decades because changes in laws and policies have eliminated the discrimination and racism that had characterized American society in the past.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [105] Davey, L. (2009). Talking About Disparities: The Effect of Frame Choices on Support for Race-Based Policies, FrameWorks Institute.

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    A study measuring EEG brain activity of non-blacks found that seeing someone from one's own racial group who is sad elicited the same brain activity as feeling sad oneself, while viewing someone of another race triggered no corresponding brain activity.

    “It found that seeing someone from one’s own racial group who is sad elicited the same brain activity as feeling sad oneself. In contrast, viewing someone of another race (outgroup), triggered no corresponding brain activity.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [111] Gutsell, 2012, Intergroup differences in the sharing of emotive states: Neural evidence of an empathy gap, Soc. Cogn. Affect. Neurosci. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    The existing research on effective strategies for raising awareness of racial inequities in health by using mass media is limited and significant gaps exist in current understanding.

    “The existing research on the effective strategies for raising awareness of racial inequities in health by using the mass media is limited and significant gaps exist in our current understanding [100].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [100] Niederdeppe, 2013, Communication about health disparities in the mass media, J. Commun. source

      Not checked in the free run.

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    Dominant frames include that residual racism is only at the individual level and is as common in minorities as in whites.

    “There is a residual racism but it is only at the individual level and it is as common in minorities as in whites.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [105] Davey, L. (2009). Talking About Disparities: The Effect of Frame Choices on Support for Race-Based Policies, FrameWorks Institute.

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Framings identified as likely to be successful in building support to address disparities included those that de-emphasized racial inequities but concentrated on widely shared American values and that linked communities in a sense of shared fate.

    “Framings identified as likely to be successful in building support to address disparities included those that de-emphasized racial inequities but concentrated on widely shared American values (like ingenuity and enhancing opportunity for all) and that linked communities in a sense of shared fate.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [105] Davey, L. (2009). Talking About Disparities: The Effect of Frame Choices on Support for Race-Based Policies, FrameWorks Institute.

      Not checked in the free run.

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    Dominant frames include that discrimination plays no role in racial inequities, and any differences in societal outcomes between whites and non-whites are due to blacks' failure to live by core American values such as personal responsibility, self-reliance, and effort.

    “Accordingly, discrimination plays no role in racial inequities, and any differences in societal outcomes between whites and non-whites are due to blacks’ failure to live by core American values such as those linked to personal responsibility, self-reliance, and effort.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [105] Davey, L. (2009). Talking About Disparities: The Effect of Frame Choices on Support for Race-Based Policies, FrameWorks Institute.

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Ineffective approaches included framing diversity as a strength, arguing that disparities for minorities were canaries in a coal mine, or framing racial inequities as reflecting white privilege or as structurally driven.

    “These ineffective approaches included framing diversity as a strength, arguing that disparities for minorities were canaries in a coal mine (early warning indicators), or framing racial inequities as reflecting white privilege or as structurally driven [105].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [105] Davey, L. (2009). Talking About Disparities: The Effect of Frame Choices on Support for Race-Based Policies, FrameWorks Institute.

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In the mid-1960s, 2.9% of all practicing physicians in the U.S. were black, and in 2012, 3.8% of all practicing physicians were black (5.2% were Hispanic).

    “In the mid- 1960s, 2.9% of all practicing physicians in the U.S. were black, and in 2012, 3.8% of all practicing physicians were black (5.2% were Hispanic) [98].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [98] Deville, 2015, Diversity in Graduate Medical Education in the United States by Race, Ethnicity, and Sex, 2012, JAMA Intern. Med. source

      Not checked in the free run.

  • May combine two claims.

    Interpretationcitation

    People are less likely to 'catch and match' the emotion of outgroup members and therefore less likely to be motivated to act to meet their needs.

    “Thus, people are less likely to ‘catch and match’ the emotion of outgroup members and therefore less likely to be motivated to act to meet their needs.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    Specific frames identified as potentially successful included emphasizing opportunity for all, highlighting effective solutions and innovation, making salient the interdependence of all communities, stressing preventing community problems before they occurred, and emphasizing fairness between places.

    “Specific frames identified included emphasizing opportunity for all, highlighting effective solutions and innovation, making salient the interdependence of all communities, stressing preventing community problems before they occurred, and emphasizing fairness (not between individuals but) between places have the potential to be successful.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [105] Davey, L. (2009). Talking About Disparities: The Effect of Frame Choices on Support for Race-Based Policies, FrameWorks Institute.

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Premisecitation

    Based on testing of a variety of framings, researchers concluded that many widely used framing strategies do not work because the dominant racial framing blocks this alternative viewpoint.

    “Based on testing of a variety of framings that could be used to talk about disparities, the researchers concluded that many widely used framing strategies do not work because the dominant racial framing blocks this alternative viewpoint.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [105] Davey, L. (2009). Talking About Disparities: The Effect of Frame Choices on Support for Race-Based Policies, FrameWorks Institute.

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Follow-up analyses revealed that there was an inverse association between racial pride and substance abuse, violence, recidivism, and a positive association with education and employment after being released from jail.

    “Follow-up analyses revealed that there was an inverse association between racial pride and substance abuse, violence, recidivism, and a positive association with education and employment after being released from jail [124].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [124] Upadhyayula, 2017, The Association of Ethnic Pride With Health and Social Outcomes Among Young Black and Latino Men After Release From Jail, Youth Soc. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    These changes were present for Democratic and Republican voters and conversations were effective with both transgender and non-transgender canvassers.

    “Importantly, these changes were present for Democratic and Republican voters and conversations were effective with both transgender and non-transgender canvassers.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [133] Broockman, 2016, Durably reducing transphobia: A field experiment on door-to-door canvassing, Science source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Denial of racism more strongly predicted voting behavior in 2016 than in 2012 and it predicted some voters who voted for Obama in 2012 becoming Trump supporters in 2016.

    “Also, denial of racism more strongly predicted voting behavior in 2016 than in 2012 and it predicted some voters who voted for Obama in 2012 becoming Trump supporters in 2016.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [129] Schaffner, 2018, Understanding white polarization in the 2016 vote for president: The sobering role of racism and sexism, Political Sci. Q. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Emotions have a large impact on decision-making in general, and on race-related attitudes and policy, in particular.

    “Relatedly, research indicates that emotions have a large impact on decision-making in general, and on race-related attitudes and policy, in particular.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    The racial gap in empathic brain activity is reduced when individuals are instructed to focus on an individual's suffering (individuation) instead of his/her racial background, when individuals are on the same team with members of a racial outgroup, and among persons who have experienced greater inter-racial interaction in their socialization.

    “These include when individuals are instructed to focus on an individual’s suffering (individuation) instead of his/her racial background, when individuals are on the same team with members of a racial outgroup, and among persons who have experienced greater inter-racial interaction in their socialization.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [110] Han, 2018, Neurocognitive Basis of Racial Ingroup Bias in Empathy, Trends Cogn. Sci. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Mental disorders are more disabling than many common chronic conditions such as diabetes, arthritis, cardiovascular disease and cancer.

    “Research finds, for example, that mental disorders are more disabling that many common chronic conditions such as diabetes, arthritis, cardiovascular disease and cancer [120].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [120] Alonso, 2011, Days out of role due to common physical and mental conditions: Results from the WHO World Mental Health surveys, Mol. Psychiatry source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    An experimental study found that simply exposing white Trump supporters to a picture of a black (vs. a white man) in the context of seeking their support for a housing assistance policy led them to be less supportive of housing assistance programs, angrier that some people receive assistance from government, and more likely to blame people who receive assistance for their circumstances.

    “An experimental study also found that simply exposing white Trump supporters to a picture of a black (vs. a white man) in the context of seeking their support for a housing assistance policy, led them to be less supportive of housing assistance programs, angrier that some people receive assistance from government, and more likely to blame people who receive assistance for their circumstances [132]”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [132] Luttig, 2017, Supporters and opponents of Donald Trump respond differently to racial cues: An experimental analysis, Res. Politics source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In the Great Smoky Mountains Study, the provision of additional income was associated with increased adolescent obesity among low-income families, but there was no effect among high-income families.

    “in the Great Smoky Mountains Study, the provision of additional income was associated with increased adolescent obesity among low-income families, but there was no effect among high-income families [30].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [30] Akee, 2010, Parents’ Incomes and Children’s Outcomes: A Quasi-experiment Using Transfer Payments from Casino Profits, Am. Econ. J. Appl. Econ. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In a study of 16 to 18 year old African American and Latino males being released from jail, those who received an eight session, 30-hour educational program that included building racial pride had spent fewer days in jail, were more likely to have attended school and found work, and had reduced odds of substance abuse one year after release.

    “The study found that one year after release, those who had received the comprehensive intervention had spent fewer days in jail, were more likely to have attended school and found work, and had reduced odds of substance abuse [123].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [123] Freudenberg, 2010, Reducing drug use, human immunodeficiency virus risk, and recidivism among young men leaving jail: Evaluation of the REAL MEN re-entry program, J. Adolesc. Health source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In that study, the intervention led to substantial reductions in prejudice against transgender people and increases in support for a law that would protect transgender individuals from discrimination.

    “The study found that this intervention led to substantial reductions in prejudice against transgender people and increases in support for a law that would protect transgender individuals from discrimination.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [133] Broockman, 2016, Durably reducing transphobia: A field experiment on door-to-door canvassing, Science source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In that study, the emotional essay increased feelings of anger about the problems faced by Japanese-Brazilians and sadness about their distress.

    “The study found that the emotional essay increased feelings of anger about the problems faced by Japanese-Brazilians and sadness about their distress.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [135] Numata, 2013, Effects of a letter-writing task on empathy toward Japanese-Brazilians as out-group members: An educational method for intercultural understanding in universities and colleges, Psychologia source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    An evaluation revealed that these parents had low levels of financial literacy, a history of negative experiences with financial institutions and more severe household financial constraints than was recognized by the designers of the intervention.

    “An evaluation revealed that these parents had low levels of financial literacy, a history of negative experiences with financial institutions and more severe household financial constraints than was recognized by the designers of the intervention [119].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [119] Shanks, 2014, Assets and African Americans: Attempting to Capitalize on Hopes for Children Through College Savings Accounts, Rev. Black Political Econ. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Among whites, Trump had a four point margin of voter support over Hilary Clinton among college graduates, but a nearly 40% margin among those without a college education.

    “Among whites, Trump had a four point margin of voter support over Hilary Clinton among college graduates, but a nearly 40% margin among those without a college education.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [129] Schaffner, 2018, Understanding white polarization in the 2016 vote for president: The sobering role of racism and sexism, Political Sci. Q. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable), S4 (based). May combine two claims.

    Interpretationnone given

    The evidence reviewed indicates that while reducing racial inequities in health is neither simple nor straightforward, there is a sizable body of scientific research, much larger than most researchers and practitioners recognize, that has identified key priorities for comprehensive efforts to reduce and ultimately eliminate disparities in health.

    “The evidence reviewed here indicates that while reducing racial inequities in health is neither simple nor straightforward, there is a sizable body of scientific research, much larger than most researchers and practitioners recognize, that has identified key priorities for comprehensive efforts to reduce and ultimately eliminate disparities in health.”
    Quote in the paperNot a substantial claim
109 of 109

  • The paper relies on this without support.

    Obesity is a risk factor for several chronic conditions.

    “Obesity is a risk factor for several chronic conditions”

  • The paper relies on this without support.

    Low birth weight is a leading cause of mortality among newborns and is associated with an increased risk of health problems in infancy, childhood and adulthood.

    “Low birth weight is a leading cause of mortality among newborns and is associated with an increased risk of health problems in infancy, childhood and adulthood.”

  • The paper relies on this without support.

    The military is a more race-blind environment than the larger society.

    “The military is a more race-blind environment than the larger society”

  • The paper relies on this without support.

    Virtually every health-enhancing resource is linked to where one lives in the U.S.

    “virtually every health-enhancing resource is linked to where one lives in the U.S.”

  • The paper relies on this without support.

    Much of medical care in the U.S. is focused on treating disease after it has occurred.

    “Much of medical care in the U.S. is focused on treating disease after it has occurred.”

  • The paper relies on this without support.

    Implicit bias is likely the most common form of bias among healthcare providers.

    “Although implicit bias is likely the most common form of bias among healthcare providers, explicit bias also persists in society and efforts are needed to minimize its occurrence as well.”

  • The paper relies on this without support.

    Explicit bias persists in society.

    “explicit bias also persists in society”

  • The paper relies on this without support.

    Hospitals are often the largest employer in many communities.

    “Hospitals are often the largest employer in many communities.”

  • The paper relies on this without support.

    A broad range of affirmative action policies have been implemented in the last 50 years to increase the participation and success of women and minorities in education and occupational contexts.

    “A broad range of affirmative action policies have been implemented in the last 50 years to increase the participation and success of women and minorities in education and occupational contexts.”

  • The paper relies on this without support.

    The Purpose Built Communities model is being replicated in multiple communities across the U.S.

    “The purpose built model is being replicated in multiple communities across the U.S.”

  • The paper relies on this without support.

    Raising awareness of racial inequities, building political support, and increasing empathy are necessary to reduce racial inequities in health.

    “There are three interrelated communication challenges: we need to raise awareness of inequities, build political support, and increase empathy for addressing social inequities in health.”

  • The paper relies on this without support.

    Findings from studies in other countries and on other stigmatized groups are applicable to reducing racial inequities in health in the U.S.

    “Similarly, an RCT in Japan showed that it was possible to get Japanese university students to increase their empathy toward a stigmatized outgroup (Japanese-Brazilians residing in Japan who had lost their jobs because of an economic recession) [135].”

  • The paper relies on this without support.

    Interventions that reduce prejudice or increase empathy in small or local studies can be scaled to reduce racial inequities in health.

    “Major investments in research are needed to identify how to best close the empathy gap in real world contexts and to expeditiously bring to scale interventions that are proven to be effective.”
13 of 13

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Black medical graduate count conflicts with reported share

    Minor

    The figures describe the same pool of 2015 medical school graduates. African Americans cannot be 5.7% of graduates and number 10,610 when Asians number only 3,701 but account for 19.8%.

1 of 1

Cites

Flagged first, then by citations

Research works printed but not linked: 2

  1. Smedley, B.D., Stith, A.Y., and Nelson, A.R. (2003). Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care, National Academy Press.
  2. Fingar, K.R., Hambrick, M.M., Heslin, K.C., and Moore, J.E. (2019, January 04). Healthcare Cost and Utilization Project Statistical Briefs: Trends and Disparities in Delivery Hospitalizations Involving Severe Maternal Morbidity, 2006–2015: Statistical Brief #243, Available online: https://www.ncbi.nlm.nih.gov/books/NBK532465/#sb243.s1.

Cited by

Sorted by citations

Related

Authors
Williams, D. R., & Cooper, L. A.
Affiliations
  • Harvard University (US)
  • Johns Hopkins University (US)
Corresponding author
Williams, David R.
ORCID
Venue
International Journal of Environmental Research and Public Health
Publisher
MDPI AG
Published
2019-02-19
Volume
16
Issue
4
Pages
606
ISSN
1660-4601 (ISSN-L)
DOI
10.3390/ijerph16040606
PMC
PMC6406315
OpenAlex
W2917886734
Semantic Scholar
9f743d6c498e222135111f243100d42694bf27d4
Cited by
415
References
114
Citations by year
2026: 25 · 2025: 47 · 2024: 80 · 2023: 68 · 2022: 73 · 2021: 73 · 2020: 41 · 2019: 7
FWCI
10.32
Type
journal article
Language
en
Open access
Licence
Locations
  • International Journal of Environmental Research and Public Health (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, other-oa)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • RePEc: Research Papers in Economics (submittedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
Funders
W.K. Kellogg Foundation (P0131281)
Topics
  • Social Sciences › Health › Health disparities and outcomes
  • Social Sciences › Sociology and Political Science › Racial and Ethnic Identity Research
  • Social Sciences › Health › Public Health and Social Inequalities
Keywords
racial disparities in health, systemic racism, early childhood development, child poverty, healthy housing, neighborhood conditions, preventive medicine, health workforce diversity, social determinants of health, political will, racial prejudice, stereotypes, health equity policy
MeSH terms
Delivery of Health Care, Ethnicity, Humans, Health Knowledge, Attitudes, Practice, Quality of Health Care, Research Design, Community Networks, Healthcare Disparities, Racism

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-09.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-09.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

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