Children, Families, and Health (HDFS 4343), Alan Reifman, Texas Tech University Family Factors on Health Disparities

• Kaiser Family Foundation:

o “Health and health care disparities refer to differences in health and health care between population groups. Disparities occur across many dimensions, including race/ethnicity, socioeconomic status, age, location, gender, disability status, and sexual orientation.”

o See KFF website for further details…

• Notes sociologist Kenzie Latham, “…the family is a powerful social institution and as such contributes to health disparities in multiple ways.”

I’d like to begin with a discussion of…

DIAPERS

(more specifically, diaper expenses as a source of health disparities)

http://cepr.net/blogs/cepr-blog/the-hygiene-assistance-for-families-of-infants-and-toddlers-act-will-help-the-poor-pay-for-diapers

Kevin Cashman, “Policies Like the Hygiene Assistance for Families of Infants and Toddlers Act Will Help the Poor Pay for Diapers,” November 23, 2015

Currently, families are unable to use money from nutrition programs (such as food stamps or WIC) to pay for diapers, and those receiving benefits from the Temporary Assistance for Needy Families program (TANF) often find that they also need to choose between diapers and other necessities. Community “diaper banks” work to distribute diapers to those who need them, but they can only satisfy a portion of the need. The National Diaper Bank Network estimates that a third of families have a need for more diapers. They can be very costly, and infants can use up to 240 of them per month, with an average annual cost of around a thousand dollars. The poor are also less likely to be able to shop around for the least expensive diapers or to be able to buy them in bulk, which can also reduce the per-diaper cost. Those who are unable to afford an adequate supply of diapers will wash and reuse soiled diapers. This inappropriate reuse of diapers and an inadequate supply in general can lead to health problems for caregivers and children: urinary tract and other infections for the child, and mental health problems for the caregivers who struggle to keep children healthy.

ANOTHER EXAMPLE: Flint, Michigan Lead-Water Crisis

Television segment (MSNBC)

TIME Magazine article

“Food Deserts” & Nutrition

Chicago Report (2012)

Baltimore Program to Mitigate Food Deserts (2020)

“Dying of Whiteness” and Racial Resentment A Provocative Theory!

Schematic based on Dr. Reifman’s interpretation of text.

Resentment of Minorities & Immigrants

in SOME Whites

Votes for Conservative Candidates

Government Cuts to (or Refusal to Expand)

Health Insurance

Some graphs from book will be shown in class, but are not on the web.

Life Expectancy in Different Countries by Social Class/Income

United States

United Kingdom

Internationally (presented by the great Hans Rosling!)

Possible Ways to Alleviate Health Disparities • Expanded access to health insurance (aim of Affordable Care Act)

• Family planning (see population video on next slide)

• Having pediatricians screen/ask parents about economic difficulties

• Engle, P. L., et al. (2011). Strategies for reducing inequalities and improving developmental outcomes for young children in low-income and middle-income countries. The Lancet, 378(9799), 1339-1353. (LINK)

More In-Depth Hans Rosling Video Don’t Panic: The Truth About Population

Greater education linked to lower birthrates (see Table 2 and Figure 3)

http://www.clipartpanda.com/clipart_images/downloads-6923649

Additional Resources • As of around 2012-2014, U.S. Black-White life-expectancy gap was smallest

it had ever been (here, here, here, and here)

• 2010 special issue of the Journal of Health and Social Behavior on health disparities (see especially article by Shim on “Cultural Health Capital”)