How Racism Takes Place

In all Western societies women earn lower wages on average than men The gender wage gap has existed for many years, although there have been some important changes over time This volume of collected papers contains extensive research on progress made by women in the labor market, and the characteristics and causes of remaining gender inequalities It also covers other dimensions of inequality and their interplay with gender, such as family formation, wellbeing, race, and immigrant status The author was awarded the 2010 IZA Prize in Labor Economics for this research Part I comprises an Introduction by the Editors Part II probes and quantifies the explanations for the gender wage gap, including differential choices made in the labor market by men and women as well as labor market discrimination and employment segregation It also delineates how the gender wage gap has decreased over time in the United States and suggests explanations for this narrowing of the gap and the more recent slowdown in wage convergence Part III considers international differences in the gender wage gap and wage inequality and the relationship between the two Part IV considers a variety of indicators of gender inequality and how they have changed over time in the United States, painting a picture of significant gains in women's relative status across a number of dimensions It also considers the trends in female labor supply and what they indicate about changing gender roles in the United States and considers a successful intervention designed to increase the relative success of academic women Part V focuses on inequality by race and immigrant status It considers not only race difference in wages and the differential progress made by African-American women and men in reducing the race wage gap, but also race differences in wealth which are considerably larger than differences in wages It also examines immigrant-native differences in the use of transfer payments, and the impact of gender roles in immigrant source countries on immigrant women's labor market assimilation in the US labor market

Gender, Inequality, and Wages

The Spectacular State explores the production of national identity in post-Soviet Uzbekistan. The main protagonists are the cultural elites involved in the elaboration of new state-sponsored mass-spectacle national holidays: Navro’z (Zoroastrian New Year) and Independence Day. The overall argument is that despite their aspirations to reinvigorate national identity, mass spectacle creators in Uzbekistan have reproduced much of the Soviet cultural production. National identity has been one of the most fraught questions in Central Asia, where nationality was a contradictory and complicated product of the Soviet rule. Although the category of nationality was initiated, produced, and imposed by the Soviet state in the 1920s, it eventually became a source of power and authority for local elites, including cultural producers. The collapse of the Soviet Union opened up possibilities for revising and reversing many understandings manufactured by the socialist regime. Yet, upon her arrival in Tashkent to conduct her research on the renegotiation of national identity in 1995, Laura Adams discovered that instead of embracing newly-found freedom to recover a more authentic history, most Uzbek intellectuals, especially cultural producers working with the state, avoided probing too far in this direction. Rather than entirely discarding the Soviet colonial legacies, they revised their history selectively. Whereas the ideological content of their cultural production shifted from socialism to nationalism, many of the previous cultural ‘‘forms’’ have remained. Similarly, the Uzbek government continued to employ cultural elites to implement the task of reinforcing its nation-building program, thus following the Soviet model of cultural production. The book consists of four chapters. The first chapter delineates the broad themes of national identity building, and the remaining chapters explore mass spectacle creation by distinguishing between three elements: form (Chapter Two), content (Chapter Three), and the mode of production (Chapter Four). The study is based on content analysis of two Olympic Games-style national holidays, interviews with cultural producers, and participation observation of festivals and behind-the-scenes preparation meetings. Although Adams provides a few references to viewers and their attitude toward the public holiday performances, her book does not offer an extended engagement with reception and consumption of these holidays. The comprehensive and multi-layered overview of the process of revising national identity in Uzbekistan is one of the book’s major accomplishments. For Adams, the production of national identity is not a selfevident and seamless production forced by the state but instead a dynamic, complex, and dialogical process of negotiation between various parties (intellectual factions, state officials, mass spectacle producers, etc.). Her account reveals the messy and often contradictory nature of national identity production and thus moves away from the tendency to reify the state and its policies. The book makes a significant contribution to studies of nationalism by suggesting that the production of national identity in Uzbekistan was centrally constituted by the consideration of the ‘‘international audience.’’ Although public holidays, studied by Adams, aimed at fostering national identification, the forms in which these celebrations are performed (including national dances and music) indicate the aspiration of cultural producers to be part of the international community. This kind of national production self-consciously oriented toward the international viewer has been the legacy of the Soviet nationalities policy where all cultural producers had to produce art ‘‘socialist in content, national in form.’’ Notwithstanding the difference in generations or genres,

Shortchanged: Why Women Have Less Wealth and What Can Be Done About It

This paper examines unionism’s relationship to the size of the middle class and its relationship to intergenerational mobility. We use the PSID 1985 and 2011 files to examine the change in the share of workers in a middle-income group (defined by persons having incomes within 50% of the median) and use a shift-share decomposition to explore how the decline of unionism contributes to the shrinking middle class. We also use the files to investigate the correlation between parents’ union status and the incomes of their children. Additionally, we use federal income tax data to examine the geographical correlation between union density and intergenerational mobility. We find: 1) union workers are disproportionately in the middle-income group or above, and some reach middle-income status due to the union wage premium; 2) the offspring of union parents have higher incomes than the offspring of otherwise comparable non-union parents, especially when the parents are low-skilled; 3) offspring from communities with higher union density have higher average incomes relative to their parents compared to offspring from communities with lower union density. These findings show a strong, though not necessarily causal, link between unions, the middle class, and intergenerational mobility.Institutional subscribers to the NBER working paper series, and residents of developing countries may download this paper without additional charge at www.nber.org.

How Does Declining Unionism Affect the American Middle Class and Intergenerational Mobility

We explore the relationship between income and cost of living, two key components of regional economic well-being. Our premise is that if high-income (or low-income) areas are also high-cost (or lo...

A Look at Geographic Differences in Income and Cost of Living

We focus on the association between the institutional factor of union contract coverage rates among workers and the variation in income inequality across a set of sixty-four metropolitan areas of t...

Declining Union Contract Coverage and Increasing Income Inequality in U.S. Metropolitan Areas

Background: Use of internet and transportation to access to healthcare resources are 2 essential and effective ways to promote health outcomes and ameliorate health disparities. Despite general widespread availability of internet and transportation, disparities still exist among specific groups and regions. Little is known about the spatial patterns of extents of 2 access determinants on healthcare resources, nor for their compound effects on patient’s health outcomes.Methods: The study uses 2018 health information national trends survey (HINTS) data, geographic information techniques and multiple ordered logistic regression model were applied.Results: The results show that States in West and Midwest tend to have higher proportions on both perspectives, where states in South and Mideast had a relatively low percentage on the healthcare access determinants. Those states had similar socio-economic patterns with underserved population and low development progress in public healthcare system. Another finding is urban people had outstripped its rural neighbors on both internet (79% vs 57%) and transport (74% vs 62%) access to healthcare resources. Furthermore, our study suggests that, when considering compound effects of internet access for healthcare information and transport access to healthcare service, people who had greater barriers tend to have decreased likelihood (-21.30%) towards their health conditions, compare to those with sufficient accesses.Conclusions: Additional work and policy are needed to ensure that internet and public transportation resources and services are prioritized for underserved populations and areas.

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The impacts of internet and transportation access on patients’ health conditions: a cross-sectional study

Background: Americans had fewer healthcare visits compared to their counterparts in other developed countries. The lack of regular check-ups can contribute to worsening health conditions. Insurance coverage, access to transportation to healthcare services, and having accessed health information via the internet are known to be associated with frequency of healthcare visits. However, there is limited literature detailing the direct and indirect influences of these variables on frequency of patients’ healthcare visits. We aimed to understand the interactive relationship between insurance coverage, access to transportation to healthcare services, and having accessed health information via the internet on frequency of patient healthcare visits.Methods: We used data from the 2018 Health Information National Trends Survey (N=3504), the only survey year providing the source for information on insurance coverage, access to transportation to healthcare services, and having accessed health information via the internet. We used descriptive statistics, random parameter binary logistic regression, and pathway analysis to describe and analyze the associations between these determinants of healthcare access and healthcare visits.Results: Results indicated that access to transportation to healthcare services (18.32%) and having insurance coverage (27.89%) were directly associated with healthcare visit frequency whereas the association between having accessed health information via the internet and reporting a healthcare visit, compare to the former two, was weaken (10.87%). Residential area (rural/urban), health conditions, age, race/ethnicity, employment status were directly associated with visit frequency whereas income status and education level were associated with healthcare visits indirectly through insurance.Conclusions: Better understanding interactive relationships between healthcare access determinants will be key to the development of healthcare access interventions aimed at reducing healthcare disparities.

Pathway analysis to characterize the relationships between healthcare access and healthcare visits in the United States using the health information national trends survey

Emergency Medical Services (EMS) can respond to multiple types of urgent requests from patients demanding urgent healthcare. The total time duration of EMS responding to those requests consists of multiple delays at several stages (e.g., response-to-scene, on-scene, transport). Additionally, the corresponding delay at each stage may correlate with different characteristics (e.g., number of crews/patients, signal priority, acuity). Furthermore, those characteristics can have diversified correlations with EMS response for different urgent requests. To capture the diversified correlations for crash-based and health-based EMS requests, this paper collected EMS call data (2018–2019) from the Alabama Department of Public Health and defined crash-based EMS responses as people who are injured in traffic crashes and health-based EMS response as people who either have heart-related health issues or stroke. To account for unobserved heterogeneity due to limited available data, we use random parameter parametric survival models to explore potential varying correlations of the characteristics associated with delays at different stages for three EMS response types. The results indicate that 108,304, 110,262, and 24,421 EMS responses were requested for traffic crashes, heart problems, and stroke, respectively. The modeling results show that at different stages of EMS responses, the characteristics and their associations with stage delays are diversified. For example, at stage 1, work-related illness or injury is positively correlated with delay for crash- and heart-based EMS responses, but it has a negative association with delay for stroke-based EMS response. Emergency Medical Dispatch (EMD) performed, the number of crews at stage 2, automated signal changing technology at stage 3, additional agency on-scene at stage 4, and stretcher usage at stage 5 are found to correlate with reduced delays at each corresponding stage. This study offers implications about how various EMS response characteristics impact the delay for three types of EMS response: crash-, heart-, and stroke-based. The findings on those key characteristics would help researchers as well as EMS response personnel better understand how they are associated with EMS delays at different stages. 

Analysis and comparison between crash- and health-based emergency medical service response across Alabama

This article describes the availability (defined as number of provider locations) and accessibility (defined as travel impedance between potential patients and provider locations) of primary healthcare services in a rural county in Alabama; identifies geographic healthcare gaps for Latino/a/x populations in this region; and discusses potential strategies to address these healthcare access challenges. The authors believe that this work is timely given that Latinos/as/x are more likely to experience structural barriers, such as travel impedance, to healthcare service access, particularly in emerging Latino regions like the rural US South. Abstract Objectives Alabama’s Latino/a/x population grew 278% from 2000 to 2018. Tuscaloosa County, located in the largely rural region of western Alabama, also experienced a significant influx of Latino/as/x during this time frame. Geographic healthcare access (GHA) to primary care and hospitals is crucial for immigrant Latino/as/x to care for their health, but few studies have characterized it. The goals of this article were to describe the availability (defined as number of provider locations) and accessibility (defined as travel impedance between potential patients and provider locations) of primary healthcare services and to discuss potential strategies to address these healthcare access challenges. Methods We drew data from the US Census Bureau, American Community Survey 5-year estimates, Blue Cross Blue Shield national doctor and hospital finder database, the Alabama Department of Public Health, and Tuscaloosa Transit Authority. We used geographic data, geographic information systems, and spatial analyses to characterize the availability and accessibility of primary care services and hospitals for Latinos/as/x in Tuscaloosa County using ESRI, ArcGIS 10.6.1. We showed the distribution of Latinos/as/x by census tract with choropleth mapping and mapped primary healthcare providers alongside public transit routes and hospital driving times to support our findings. Results This work demonstrated that Latinos/as/x in Tuscaloosa County were concentrated in more rural areas surrounding the county’s city center, presenting significant barriers to GHA. These areas had fewer primary care providers and limited public transit. Many Latinos/as/x in this county had to travel ≥45 minutes to a hospital. Conclusions Outreach and technology-based approaches, including home visit programs, mobile health units, and telemedicine, may be particularly important in bridging the GHA gaps for this and other largely rural populations the southeastern United States. Some of this potential was unlocked during the coronavirus disease 2019 crisis. These gains should be leveraged toward sustainable healthcare access initiatives for rural Latino/a/x populations.

Qinglin Hu

Papers

Declining Union Contract Coverage and Increasing Income Inequality in U.S. Metropolitan Areas

The impacts of internet and transportation access on patients’ health conditions: a cross-sectional study

Pathway analysis to characterize the relationships between healthcare access and healthcare visits in the United States using the health information national trends survey

Analysis and comparison between crash- and health-based emergency medical service response across Alabama

Geographic Access to Primary Healthcare Services among Latinos/as/x in Western Alabama