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Racial inequity in the provision of healthcare is widely recognized. In this paper I assess the role of social distance from healthcare providers in accounting for whites' higher rating of healthcare providers. Using data from the Detroit Area Study, I test whether having higher socioeconomic status, like most healthcare providers, and racial concordance with healthcare provider account for the gap in satisfaction between whites and African Americans. I find that socioeconomic status and racial concordance variables account for a portion of whites' higher rating of the respect shown by their healthcare provider Racial differences in evaluation of time spent with healthcare provider are accounted for by socioeconomic status, but not racial concordance. As researchers explore the causes of and remedies for the racial disparity in use and evaluation of healthcare, the subtle and indirect effects of race on the patient-healthcare provider relationship must be considered. [ABSTRACT FROM AUTHOR]

This paper reports the first results from a survey of unemployment in Southeastern Michigan. The study includes samples of currently unemployed, previously unemployed and stably employed respondents. Special efforts were made to obtain information about the context surrounding each job loss reported, thus allowing the explicit analysis of selection bias in the estimation of unemployment effects. The analysis documents the substantial influences that unemployment has on self-reported physical health, somatization, anxiety, and depression that cannot be explained by selection bias. [ABSTRACT FROM AUTHOR]

Most American households carry debt, yet we have little understanding of how debt influences health behavior, especially health care seeking. We examined associations between foregone medical care and debt using a population-based sample of 914 southeastern Michigan residents surveyed in the wake of the late-2000s recession. Overall debt and ratios of debt to income and debt to assets were positively associated with foregoing medical or dental care in the past 12 months, even after adjusting for the poorer socioeconomic and health characteristics of those foregoing care and for respondents’ household incomes and net worth. These overall associations were driven largely by credit card and medical debt, while housing debt and automobile and student loans were not associated with foregoing care. These results suggest that debt is an understudied aspect of health stratification. [ABSTRACT FROM PUBLISHER]

A survey of Detroit adults shows that employment, marriage, and parenthood are associated with good physical health for both women and men. Employed married parents tend to have the best health profile, while people with none of these roles tend to have the worst profile. Of the three roles, employment has the strongest effect, and parenthood the weakest. Multiple roles (the combination of job plus family responsibilities) have no special effects on health, either negative or positive. Thus, people with both job and family roles enjoy the health benefits of each role (main effects)and incur no special health disadvantage or benefit (interaction effect) for being so busy. This is true for both women and men. Three explanations are considered: First, health risks may actually be lower for socially active people than for nonactive ones. Second, involved people may have health attitudes which reduce their sensitivity to symptoms and their willingness to take curative health actions. Third, social selection may operate so that healthy people are able to acquire and keep roles more easily than unhealthy people. In sum, there is no evidence in the Detroit data that combining employment, marriage, and parenthood is harmful to women's health. Implications of the results for women's future health are suggested. [ABSTRACT FROM AUTHOR]