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Populations and Health Problems

Social and Economic Influences on Health
There are marked social disparities in health across socioeconomic levels, ethnic groups, and by gender. CHC faculty are examining these disparities, are identifying the mechanisms by which they occur, and are advising on policies to reduce them. These disparities occur at all levels of society, exist across the life span, and affect all of us. Access to health care is an important part, but plays only a minor role.

Among the projects are an international research network on the mechanisms by which SES affects health, funded by a $4.6 million grant from the John D. and Catherine T. MacArthur Foundation, and a grant from the California Wellness Foundation to support a longitudinal sample of working-age and older Californians to examine the relationship of unemployment or underemployment and health. Current projects include analysis of:

Pathways by which socioeconomic factors influence the onset and progression of disease;
Access to and use of health services by SES, ethnicity and gender and ways to reduce obstacles to care;
Changes in the economic environment as these influence health;
Social disparities in health both within the United States and internationally; and
How avoidable hospitalization can be prevented in low-income areas of San Francisco.

In June 2000, Eliseo Perez Stable, MD received $3.75 million from the National Cancer Institute for a five year program  to study cancer among Latinos.  According to NCI, Latinos die disproportionately of colon and breast cancer compared to groups having higher rates of those types of cancer and Latinas have one of the highest cervical cancer death rates. 

In October 2000, Paula Braveman, MD, MPH received funding for two years from the Centers for Disease Control to describe socioeconomic and racial/ethnic disparities in maternal and infant health in California and 4-6 other states. The main goals of the project are to (1) describe disparities in low birth weight, unintended pregnancy, delayed prenatal care, and non-initiation/discontinuation of breast-feeding during the last decade; and (2) to recommend individual/household- and area-level measures of  socio- economic status for ongoing, routine monitoring of social disparities in the selected indicators over time.

In January 2001, Braveman was funded by the Kaiser Family Foundation  to conduct research focused on both describing and interpreting the policy implications of socioeconomic and racial/ethnic disparities in four indicators of maternal and child health (low birth weight, unintended pregnancy, delayed prenatal care, and breastfeeding non-initiation/discontinuation) in California.

In October 2002, William Holzemer, RN, PhD, received $1.5 million funding for 5 years to establish the  "Nursing Research Center on HIV/AIDS Health Disparities."  This project links a the University of California, San Francisco  and a minority serving institution (MSI, University of Puerto Rico). The virtual Center will address issues related to the disproportionate impact of the HIV/AIDS epidemic on racial and ethnic minorities. The goal of the Center is to enhance the knowledge base for nursing care in order to improve the health and quality of life of people living with and affected by HIV disease. The long-term goal is to ensure the independence of the partnering Minority Serving Institution (MSI), namely the UPR School of Nursing. This application proposes to establish the Nursing Research Center on HIV/AIDS Health Disparities to achieve the following aims (1) to expand the number of nurse researchers involved in research on HIV/AIDS health disparities; (2) to increase the number of research projects aimed at reducing health disparities in HIV disease; and, (3) to enhance the career development of minority nurse investigators.

MacArthur SES and Health Network
Center for Aging in Diverse Communities

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