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Background: Physicians do not prescribe opioid analgesics for pain treatment equally across groups, and such disparities may pose significant public health concerns. Although research suggests that institutional constraints and cultural stereotypes influence doctors' treatment of pain, prior quantitative evidence is mixed. The objective of this secondary analysis is therefore to clarify which institutional constraints and patient demographics bias provider prescribing of opioid analgesics.Methods: We used electronic medical record data from an emergency department of a large U.S hospital during years 2008-2014. We ran multi-level logistic regression models to estimate factors associated with providing an opioid prescription during a given visit while controlling for ICD-9 diagnosis codes and between-patient heterogeneity.Results: A total of 180,829 patient visits for 63,513 unique patients were recorded during the period of analysis. Overall, providers were significantly less likely to prescribe opioids to the same individual patient when the visit occurred during higher rates of emergency department crowding, later times of day, earlier in the week, later years in our sample, and when the patient had received fewer previous opioid prescriptions. Across all patients, providers were significantly more likely to prescribe opioids to patients who were middle-aged, white, and married. We found no bias towards women and no interaction effects between race and crowding or between race and sex.Conclusions: Providers tend to prescribe fewer opioids during constrained diagnostic situations and undertreat pain for patients from high-risk and marginalized demographic groups. Potential harms resulting from previous treatment decisions may accumulate by informing future treatment decisions. [ABSTRACT FROM AUTHOR]

Background: Economic inequality in the United States is extreme, but little is known about the national origin of affluent households. Households in the top one percent by total wealth own vastly disproportionate quantities of household assets and have correspondingly high levels of economic, social, and political influence. The overrepresentation of white natives (i.e., those born in the U.S.) among high-wealth households is well-documented, but changing migration dynamics suggest that a growing portion of top households may be immigrants. Methods: Because no single survey dataset contains top wealth holders and data about country of origin, this paper uses two publicly-available data sets: the Survey of Consumer Finances (SCF) and the Survey of Income and Program Participation (SIPP). Multiple imputation is used to impute country of birth from the SIPP into the SCF. Descriptive statistics are used to demonstrate reliability of the method, to estimate the prevalence of immigrants among top wealth holders, and to document patterns of asset ownership among affluent immigrants. Results: Significant numbers of top wealth holders who are usually classified as white natives may be immigrants. Many top wealth holders appear to be European and Canadian immigrants, and increasing numbers of top wealth holders are likely from Asia and Latin America as well. Results suggest that of those in the top one percent of wealth holders, approximately 3% are European and Canadian immigrants, .5% are from Mexico or Cuban, and 1.7% are from Asia (especially Hong Kong, Taiwan, Mainland China, and India). Ownership of key assets varies considerably across affluent immigrant groups. Conclusion: Although the percentage of top wealth holders who are immigrants is relatively small, these percentages represent large numbers of households with considerable resources and corresponding social and political influence. Evidence that the propensity to allocate wealth to real and financial assets varies across immigrant groups suggests that wealth ownership is more global than previous research suggests and that immigrant groups are likely to become more prevalent in top wealth positions in the U.S. As the representation of immigrants in top wealth positions grows, their economic, social, and political influence is likely to increase as well. [ABSTRACT FROM AUTHOR]

Chinese immigrants are a diverse and growing group whose members provide a unique opportunity to examine within-immigrant group differences in adaptation. In this paper, we move beyond thinking of national-origin groups as homogenous and study variation among Chinese immigrants in wealth ownership, a critical indicator of adaptation that attracts relatively little attention in the immigration literature. We develop an analytical approach that considers national origin, tenure in the U.S., and age to examine heterogeneity in economic adaptation among the immigrant generation. Our results show that variations among Chinese immigrants explain within-group differences in net worth, asset ownership, and debt. These differences also account for important variation between Chinese immigrants, natives, and other immigrant groups and provide important, new insight into the processes that lead to immigrant adaptation and long-term class stability. [ABSTRACT FROM AUTHOR]

The article provides a review and evaluation of sociological research that explores the two aspects of transition from socialism to some form of market system, the nature of the transition process and the consequences of transition for stratification and mobility. The authors look into the two theoretical approaches, institutional and corporatist, that have been the focus of debate regarding transition and evaluate the empirical evidence for each. They also argue that empirical evidence provides support for elements of each but that detailed scope conditions and more nuanced arguments are critical.

Temporary employment in the United States has increased considerably in recent decades, but the financial well-being of temporary employees is not well understood. This article examines the effect of both recent and past temporary employment on asset accumulation and portfolio behavior. The authors find that temporary work reduces workers' assets and that this negative effect remains even after a worker has left the temporary position. The authors also show that suppressed or delayed homeownership substantially contributes to the reduction of assets among temporary workers. These results provide insight into the role that work status plays in creating and maintaining wealth inequality. [ABSTRACT FROM AUTHOR]

Wealth inequality is among tile most extreme forms of stratification in the United States, and upward wealth mobility is not common. Yet mobility is possible, and this paper takes advantage of trends among a unique group to explore the processes that generate mobility. I show that non-Hispanic whites raised in Roman Catholic families have been upwardly mobile in the wealth distribution in recent decades, and I find that unique fertility, marriage and education patterns contributed to this change. I also show that Catholic values related to work and money contributed to relatively high saving and portfolio behavior that facilitated mobility. The results provide important insight into the process by which childhood experiences shape adult well-being, particularly adult wealth ownership. The findings also contribute to understanding of social inequality by identifying important behaviors and processes that facilitate mobility. [ABSTRACT FROM AUTHOR]

During an economic transition from socialism, market exchange replaces redistribution. We study firm decisions to enter product markets to understand the factors that influence this process. Managers in Chinese State Owned Enterprises operated within institutional constraints to make strategic decisions, and state intervention shaped which factors were salient. Firms financed through central government and bond issues relied less on markets. Firms funded through local government moved into markets faster; firms funded by banks were initially faster to markets but slower to markets after bank reform shifted lending policies. Thus, the accessibility, flexibility, and stability of financing shaped decisions about market entrance. [ABSTRACT FROM AUTHOR]

Racial differences in wealth ownership are among the most extreme and persistent forms of stratification in the United States, but the factors that contribute to this inequality are unclear. One potentially important contributing factor is family background. it is a critical determinant of attainment, and both childhood family resources and family structure vary racially. This article reports that family size during childhood contributes significantly to racial differences in adult wealth. I find that siblings strain material and nonmaterial resources during childhood and decrease adult home ownership, stock ownership, and total assets. Having extended family in the home also decreases wealth for those from intact families, but an extended family minimizes the negative effect of divorce and separation and increases wealth in disrupted families. I also find that childhood family size and family structure are related to racial differences in adult wealth accumulation trajectories, allowing whites to begin accumulating high-yield assets earlier in life. The results provide insight into the role of family background in creating and maintaining inequality, particularly racial stratification in wealth ownership. [ABSTRACT FROM AUTHOR]

Researchers have documented extreme inequalities in wealth ownership, but the processes that create these inequalities are not well understood. One important contributing factor that attracts little attention is religion. This study explores the relationship between religious participation, religious affiliation, and patterns of wealth accumulation. I argue that religion affects wealth ownership indirectly by shaping demographic behaviors. I also argue that religion directly influences wealth accumulation by identifying valuable goals, by providing a set of competencies that direct strategies of action, and by contributing to social contacts that provide information and opportunities that can enhance wealth ownership. The findings suggest that Jews enjoy tremendous gains in wealth ownership, while conservative Protestants accumulate relatively little wealth. In contrast, mainline Protestants and Catholics are indistinguishable from each other and from the general population. The results demonstrate the importance of family processes in shaping wealth accumulation, and they underscore the importance of culture in shaping economic behavior and ultimately in creating social inequality. [ABSTRACT FROM AUTHOR]

Inequality in wealth has been well-documented, but its causes remain uncertain. Family processes in childhood are likely to shape adults' wealth accumulation, but these factors have attracted little attention. I argue that family size matters: children from larger families accumulate less wealth than do those from smaller families. Siblings dilute parents' finite financial resources and nonmaterial resources, such as time. This diminishment of resources reduces educational attainment, inter vivos transfers, and inheritance. Reduced educational attainment and transfers alter financial behavior; saving; and, ultimately, adults' wealth. I demonstrate that sibship size is associated with lower overall wealth in adulthood and that parents' resources and education, respondent's education, financial transfers, and financial behavior all mitigate the effect of siblings. Sibship size also reduces the likelihood of receiving a trust account or an inheritance and decreases home- and stock ownership. The findings provide important insights into early family processes that shape wealth accumulation and inequality. [ABSTRACT FROM AUTHOR]

The study of financial markets, money, and banking is largely considered the purview of economics. Yet sociologists have contributed greatly to understanding financial relations since the early history of the discipline. This review begins with an overview of classical sociological approaches to financial markets, money, and banking and then describes how research in these areas exploded in recent decades. I describe the current state of research on money, relations among firms and banks, and interlocking directorates. I consider the ways financial relations shape firm behaviors and processes, and I describe the growing body of work that treats financial markets as outcomes. I discuss research on the transformation of financial systems during transition from state socialism, and I conclude with a discussion of a growing literature that combines studies of financial markets and social stratification. [ABSTRACT FROM AUTHOR]

The networks of interfirm relations that developed in business groups during economic transition are central to China's reform and are becoming an important part of the country's emergent economic structure. Using a recent and original data set that includes direct observations of economic choices made by firms, the process by which these interfirm lending and trade ties emerged and evolved in the early stages of reform is explored. Initially, information from sources external to the network dominated the formation and direction of exchange relations. Firms turned to their prior connections, took advantage of market position, and drew on bureaucratic power to develop alliances. Over time, internal influences gained importance, and managers increasingly drew on internal nontrade relations and other indicators inside the business group to identify lending and trade partners. The results demonstrate the central but changing role that social relations and environmental cues played in the creation of economic structure during China's transition. This study also contributes to an understanding of the processes of organizational adaptation to a major economic transition and interfirm alliance formation more generally. The findings reveal that firms select exchange partners of known reputation and solicit relations that reduce uncertainty, even when there is a cost involved. [ABSTRACT FROM AUTHOR]

This study compares wealth ownership and mobility patterns among baby, boomers and their parents to explore whether the baby boomers have fared as well during their working years and whether they will be as secure in retirement as their parents. Cohort comparisons using survey data indicate that baby boomers had accumulated more wealth as young adults than their parents had at a similar age. Estimates from a simulation model reveal that baby boomers had more wealth than their actual same-sex parents at every stage of the life course. The simulation model also reveals that baby boomers were considerably more likely' than their actual same-sex parents to experience upward wealth mobility, at each point in the life course. These results suggest that speculations that baby' boomers may be the first generation to do worse than their parents are misleading. [ABSTRACT FROM AUTHOR]

Wealth ownership in the United States has long been concentrated in the hands of a small minority of the population, yet researchers have paid relatively little attention to the causes and consequences of this inequality. In this essay, we review the literature that does exist on wealth accumulation and distribution. We begin with an examination of the reasons that wealth inequality has received little empirical attention. We then discuss methods of creating empirical estimates of wealth accumulation and distribution, and we present some estimates of recent trends in wealth inequality. We explore a diverse collection of research that explains these trends, covering treatments of aggregate influences and individual and household factors. We conclude the chapter with a review of research on intergenerational processes and wealth mobility. [ABSTRACT FROM AUTHOR]