MC 281 is the second in the required sophomore sequence for Social Relations and Policy. In this course, we will explore the interactions and experiences between and among various groups in American history. We will consider how Americans both defended and contested prevailing definitions of fitness for citizenship and inclusion in the political process and American life, and how groups sought to gain access to social and political equality. This course focuses on the history of relationships within and between different groups in the United States, and explores the complexities of those relations. Rarely centered solely on race or ethnicity, such interactions were also affected by gender, sexuality, religion, nation, and class. We will also explore the shifting definitions of race and ethnicity. Students will analyze not only the experiences of the different groups, but also the connections between them to assess the larger dynamics and their implications for public policy.

Whiteness of a Different Color: European Immigrants and the Alchemy of Race

Decades of research have demonstrated that diabetes affects racial and ethnic minority and low-income adult populations in the U.S. disproportionately, with relatively intractable patterns seen in these populations’ higher risk of diabetes and rates of diabetes complications and mortality (1). With a health care shift toward greater emphasis on population health outcomes and value-based care, social determinants of health (SDOH) have risen to the forefront as essential intervention targets to achieve health equity (2–4). Most recently, the COVID-19 pandemic has highlighted unequal vulnerabilities borne by racial and ethnic minority groups and by disadvantaged communities. In the wake of concurrent pandemic and racial injustice events in the U.S., the American College of Physicians, American Academy of Pediatrics, Society of General Internal Medicine, National Academy of Medicine, and other professional organizations have published statements on SDOH (5–8), and calls to action focus on amelioration of these determinants at individual, organizational, and policy levels (9–11).

In diabetes, understanding and mitigating the impact of SDOH are priorities due to disease prevalence, economic costs, and disproportionate population burden (12–14). In 2013, the American Diabetes Association (ADA) published a scientific statement on socioecological determinants of prediabetes and type 2 diabetes (15). Toward the goal ofunderstanding and advancing opportunities for health improvement among the population with diabetes through addressing SDOH, ADA convened the current SDOH and diabetes writing committee, prepandemic, to review the literature on 1 ) associations of SDOH with diabetes risk and outcomes and 2 ) impact of interventions targeting amelioration of SDOH on diabetes outcomes. This article begins with an overview of key definitions and SDOH frameworks. The literature review focuses primarily on U.S.-based studies of adults with diabetes and on five SDOH: socioeconomic status (education, income, occupation); neighborhood and physical environment (housing, built environment, toxic environmental …

/pdf/social-determinants-of-health-and-diabetes-a-scientific-5gt7qvg60y.pdf

Social Determinants of Health and Diabetes: A Scientific Review.

The Smithsonian institution

Introduction
Social, cultural, and economic environments are associated with high rates of disease incidence and mortality in poor Appalachian regions of the United States. Although many historical studies suggest that aspects of Appalachian culture (e.g., fatalism, patriarchy) include values and beliefs that may put Appalachians at risk for poor health, other cultural aspects may be protective (e.g., strong social ties). Few recent studies have explored regional cultural issues qualitatively. The purpose of this study was to examine social and cultural factors that may be associated with health and illness in an Appalachian region.

Peer Reviewed: Social and Cultural Factors Influencing Health in Southern West Virginia: A Qualitative Study

RAE • v. 41 • n. 3 • Jul./Set. 2001 stima-se que, atualmente, as companhias norteamericanas despendam cerca de 2 bilhões de dólares por ano em pesquisa e desenvolvimento de marketing dirigido para determinados segmentos étnicos e raciais, com o objetivo de conquistar ou manter a lealdade dos chamados grupos “minoritários” a determinadas marcas e produtos. Esses grupos, por sua vez, apresentam um poder de compra estimado em cerca de 1 trilhão de dólares anuais. Embora classificados como minoritários, esses segmentos são formados por 35 milhões de negros, 30 milhões de hispânicos e 10 milhões de asiáticos que, segundo projeções, juntos, representarão um terço da população norte-americana em 2010. Marketing direcionado para raça e etnicidade, fenômeno recente no mundo dos negócios norte-americanos, é o tema analisado no livro de Marilyn Halter, Shopping for identity. Halter tem várias publicações na área de cultura e economia, assim como de migrações internacionais. O livro resultou de uma pesquisa desenvolvida no Institute for the Study of Economic Culture da Boston University, um centro de estudos voltado para a análise das conexões entre comportamento cultural e econômico. Nesse livro, a autora aborda, mais especificamente, as relações entre identidade étnica e consumo. Em tempos pós-modernos, diz ela, a maioria das pessoas constrói sua própria identidade mediante a aquisição de mercadorias: “com o crescimento do individualismo, e a evolução do consumo de massa, objetos se tornam uma exSHOPPING FOR IDENTITY: the marketing of ethnicity

/pdf/shopping-for-identity-the-marketing-of-ethnicity-17owcr6t8g.pdf

Shopping for identity: the marketing of ethnicity

The burden of substance use and especially the unmatched rates of overdoses in rural Central Appalachia highlight the need for innovative approaches to curb the initiation to drug misuse and to address current substance use disorders. Effective substance use interventions involve a thorough understanding of the region. In Central Appalachia, many of the barriers to treatment are shared with other rural and impoverished areas, including a lack of access to health care and lack of health care providers with specialized training. Parts of Appalachia also present their own considerations, including the challenges of fostering trust and encouraging treatment-seeking in communities with dense, long-term, place-based social and family networks. Current policies and interventions for substance use have been largely inadequate in the region, as evidenced by continued increases in substance use and substance-related deaths, especially related to nonmedical prescription drug use and increasing heroin use. The authors discuss ways in which rural life, poverty, identity, and values in Appalachia have influenced substance use and treatment and propose strategies and interventions to improve outcomes.

/pdf/substance-use-in-rural-central-appalachia-current-status-and-4t1jihnsl4.pdf

Substance Use in Rural Central Appalachia: Current Status and Treatment Considerations

Health disparities that cannot be fully explained by socio-behavioral factors persist in the Central Appalachian region of the United States. A review of available studies of environmental impacts on Appalachian health and analysis of recent public data indicates that while disparities exist, most studies of local environmental quality focus on the preservation of nonhuman biodiversity rather than on effects on human health. The limited public health studies available focus primarily on the impacts of coal mining and do not measure personal exposure, constraining the ability to identify causal relationships between environmental conditions and public health. Future efforts must engage community members in examining all potential sources of environmental health disparities to identify effective potential interventions.

/pdf/environmental-health-disparities-in-the-central-appalachian-319978tqgr.pdf

Environmental health disparities in the Central Appalachian region of the United States

No other region in America is so fraught with projected meaning as Appalachia. Many people who have never set foot in Appalachia have very definite ideas about what the region is like. Whether these assumptions originate with movies like Deliverance (1972) and Coal Miner's Daughter (1980), from Robert F. Kennedy's widely publicized Appalachian Tour, or from tales of hiking the Appalachian Trail, chances are these suppositions serve a purpose to the person who holds them. A person's concept of Appalachia may function to reassure them that there remains an "authentic" America untouched by consumerism, to feel a sense of superiority about their lives and regions, or to confirm the notion that cultural differences must be both appreciated and managed. In Selling Appalachia: Popular Fictions, Imagined Geographies, and Imperial Projects, 1878-2003, Emily Satterwhite explores the complex relationships readers have with texts that portray Appalachia and how these varying receptions have created diverse visions of Appalachia in the national imagination. She argues that words themselves not inherently responsible for creating or destroying Appalachian stereotypes, but rather that readers and their interpretations assign those functions to them. Her study traces the changing visions of Appalachia across the decades from the Gilded Age (1865-1895) to the present and includes texts such as John Fox Jr.'s Trail of the Lonesome Pine (1908), Harriet Arnow's Hunter's Horn (1949), and Silas House's Clay's Quilt (2001), charting both the portrayals of Appalachia in fiction and readers' responses to them. Satterwhite's unique approach doesn't just explain how people view Appalachia, it explains why they think that way. This innovative book will be a noteworthy contribution to Appalachian studies, cultural and literary studies, and reception theory.

Dear Appalachia: Readers, Identity, and Popular Fiction since 1878

This article reads the Smithsonian's annual folklife festival as a cultural product buffeted by changing material conditions and funding constraints as the United States transitioned from a Fordist industrial economy to a post-Fordist information economy. Based upon visitor interviews, promotional materials, and news reports, this article argues that the transition from a national to an international framework reconfigured the role of Appalachia in visitors' imaginations. In 2002, Appalachia represented ideals of "nation" and "home" in contrast to tantalizing and threatening foreign cultures and allowed visitors to entertain the wishful belief that the United States was a simple place peopled by simple denizens innocent of imperial ambitions.

/pdf/imagining-home-nation-world-appalachia-on-the-mall-onvor47pkw.pdf

Imagining Home, Nation, World: Appalachia on the Mall

This article describes a collaboration among a group of university faculty, undergraduate students, local governments, local residents, and U.S. Army staff to address long-standing concerns about the environmental health effects of an Army ammunition plant. The authors describe community-responsive scientific pilot studies that examined potential environmental contamination and a related undergraduate research course that documented residents' concerns, contextualized those concerns, and developed recommendations. We make a case for the value of resource-intensive university-community partnerships that promote the production of knowledge through collaborations across disciplinary paradigms (natural/physical sciences, social sciences, health sciences, and humanities) in response to questions raised by local residents. Our experience also suggests that enacting this type of research through a university class may help promote researchers' adoption of "epistemological pluralism", and thereby facilitate the movement of a study from being "multidisciplinary" to "transdisciplinary".

Emily Satterwhite

Papers

Substance Use in Rural Central Appalachia: Current Status and Treatment Considerations

Environmental health disparities in the Central Appalachian region of the United States

Dear Appalachia: Readers, Identity, and Popular Fiction since 1878

Imagining Home, Nation, World: Appalachia on the Mall

Building Interdisciplinary Partnerships for Community-Engaged Environmental Health Research in Appalachian Virginia.