Mary E. Campbell

The Implications of Racial Misclassification by Observers

We hypothesize that individuals who self-identify with one racial group but are routinely perceived by observers as “looking like” another racial group may experience negative outcomes associated with this stressful situation. Since American Indians experience very high rates of misclassification, we use them as our case in point. Drawing from the National Longitudinal Survey of Adolescent Health, our analyses compare young American Indian adults who are perceived as another race by an observer to those who are correctly classified, using several indicators of psychological distress: depression, suicidal thoughts, use of psychological counseling services, suicide attempts, and fatalism. We also investigate differences in racial attitudes and behaviors, such as belonging to an ethnic solidarity organization or believing it is important to have a committed relationship with someone of the same race. The evidence suggests that, onthe whole, misclassified American Indians have higher rates of psychological distress. We conclude by discussing our findings and their wider implications, especially in the context of an increasingly heterogeneous and multiracial society.

Racial Segregation and Disparities in Health Care Delivery: Conceptual Model and Empirical Assessment

OBJECTIVE This study examines two dimensions of racial segregation across hospitals, using a disease for which substantial disparities have been documented. DATA SOURCES Black (n=32,289) and white (n=244,042) patients 67 years and older admitted for acute myocardial infarction during 2004-2005 in 105 hospital markets were identified from Medicare data. Two measures of segregation were calculated: Dissimilarity (i.e., dissimilar distribution by race across hospitals), and Isolation (i.e., racial isolation within hospitals). For each measure, markets were categorized as having low, medium, or high segregation. STUDY DESIGN The relationship of hospital segregation to residential segregation and other market characteristics was evaluated. Cox proportional hazards regression was used to evaluate disparities in the use of revascularization within 90 days by segregation level. RESULTS Agreement of segregation category based on Dissimilarity and Isolation was poor (kappa=0.12), and the relationship of disparities in revascularization to segregation differed by measure. The hazard of revascularization for black relative to white patients was lowest (i.e., greatest disparity) in markets with low Dissimilarity, but it was unrelated to Isolation. CONCLUSIONS Significant racial segregation across hospitals exists in many U.S. markets, although the magnitude and relationship to disparities depends on definition. Dissimilar distribution of race across hospitals may reflect divergent cultural preferences, social norms, and patient assessments of provider cultural competence, which ultimately impact utilization.

Racial Differences In Hospital Use After Acute Myocardial Infarction: Does Residential Segregation Play A Role?

This study compares the likelihood of admission to high-mortality hospitals for black and white Medicare patients in 118 health care markets, and whether admission patterns vary if residential racial segregation is greater in the area. Risk of admission to high-mortality hospitals was 35 percent higher for blacks than for whites in markets with high residential segregation. Moreover, blacks were more likely than whites to be admitted to hospitals with high mortality, even in analyses limited to patients who lived closest to lower-mortality hospitals. Eliminating health care disparities may require policies that address social factors leading to segregation.

Politics and policies: attitudes toward multiracial Americans

Abstract The growing prominence of the multiracial population in the United States is prompting new questions about attitudes toward multiracial people and popular opinion of policies designed to protect them from discrimination. Currently, American anti-discrimination policies are directed at groups who identify with a single race, but the rising profile of multiracial groups introduces new complexity into questions about racial policy. In this study, we find generally positive affect toward multiracial people, although monoracial minorities are more positive toward multiracial people than whites are. About half of the monoracial minorities and the majority of whites oppose including multiracial people in anti-discrimination policies. Attitudes are associated with traditional predictors such as education and political beliefs, and also with the racial heterogeneity of the local context and intimate contact with other racial groups. Although multiracial people report experiencing discrimination at levels similar to those of monoracial minorities, our results suggest there may be significant resistance to anti-discrimination policies that include multiracial groups.

Further Data on Misclassification: A Reply to Cheng and Powell

We appreciate Cheng and Powell’s (henceforth C&P) comment on our 2007 article on the effects of racial misclassification, and we are very enthusiastic about the growing field of research, using several different data sources, on the differences between self-identification and the perceptions of others (e.g., Herman 2010; Penner and Saperstein 2008; Roth 2010; Saperstein 2006, 2009; Saperstein and Penner 2010; Stepanikova 2010). C&P focus on a key conundrum facing researchers who wish to use racial and ethnic data from surveys: because racial identification is a reflection of a socially constructed and ongoing life course process, any survey measure is necessarily an imperfect snapshot rather than a flawless measure of a stable individual trait. We completely agree with the idea that this is an issue that all research on race and ethnicity needs to take seriously, and we value the care with which C&P investigated the issue in this particular case. As they point out, inconsistency in survey responses about race is an important window into the complexity of racial and ethnic identification. In our reply, we review the concerns they raise, propose avenues for addressing them, and offer an analysis of data drawn from an alternative survey. This analysis provides further support for our hypothesis that when a respondent believes other people’s expectations conflict with the respondent’s expectations for herself, the conflict generates stress (Moore 1985; Troyer and Younts 1997). CHENG AND POWELL’S CRITIQUE

MIXING RACES: FROM SCIENTIFIC RACISM TO MODERN EVOLUTIONARY IDEAS

developing the critical frame for the analysis of contemporary multi-culture, racism and policy agendas. In some ways the final empirical chapters have a ‘jolt’ feel as Husband and Alam move to present and discuss fieldwork data. As they explain at the beginning of the book, the research is the outcome of an initial Joseph Rowntree project and then five West Yorkshire local authorities funding a further project, which explored how elected councillors, senior managers, policy makers and deliverers implement and work with Cohesion and Prevent initiatives. These final chapters spend time showing how, not surprisingly, those involved in the rolling out and management of Cohesion and Prevent ‘in the field’ have to do so in ways that highlight the Cohesion and Prevent policy duality and its inherent contradictions. I particularly liked how the authors capture this local world so effectively. They detail, through the fieldwork, all the ambivalences, policy overload, emotional demands, complicities, concerns about the racism and the intrusive nature of Prevent and the knowing sense of the participants of the problematics and inherent anti-Muslim of this policy agenda. It is not always easy to do justice to the multi-textured world of local policy practices that operate within these sometimes related, sometimes distinct complexities, but these are all powerfully present in this account. It is the way in which Social Cohesion and Counter-Terrorism works in the convergent spaces between policy, data, concepts and theory that gives it particular value. It is the consistent contextualization historical and structural and political that pushes this analysis of policy formations onto another level of thinking about race, ethnicity, identity, nation and citizenship. Place and locality are an absence (briefly acknowledged by the authors, p. 7) in the book. But while I would have been interested to have had more sense of West Yorkshire and the ways in which the identities, histories and geographies of the five local authority areas shaped and were apparent in the fieldwork findings and research stories, to ask for more from this thoughtful, thorough, rich and needed analysis and indictment of New Labour’s governance and containment of cultural difference feels more than a little unfair.