Health disparities in youth and families: research and applications.
Article Type: Book review
Subject: Books (Book reviews)
Author: Rine, Christine M.
Pub Date: 02/01/2012
Publication: Name: Health and Social Work Publisher: Oxford University Press Audience: Academic; Professional Format: Magazine/Journal Subject: Health; Sociology and social work Copyright: COPYRIGHT 2012 Oxford University Press ISSN: 0360-7283
Issue: Date: Feb, 2012 Source Volume: 37 Source Issue: 1
Topic: NamedWork: Health Disparities in Youth and Families: Research and Applications (Nonfiction work)
Persons: Reviewee: Carlo, Gustavo; Crokett, Lisa J.; Carranza, Miguel A.
Accession Number: 306241024
Full Text: Health Disparities in Youth and Families: Research and Applications. Gustavo Carlo, Lisa J. Crockett, and Miguel A. Carranza (Eds.). New York: Springer, 2011, 173 pages. ISBN: 978-1-4419-7091-6, $129.00 hardcover.

Health Disparities in Youth and Families: Research and Applications is volume 57 of the Nebraska Symposium on Motivation monograph series. This annual publication contains the proceedings of this symposium, which was coordinated by the volume's editors, Gustavo Carlo, Lisa J. Crockett, and Miguel A. Carranza. The Nebraska Symposium on Motivation series is edited by Barbara A. Hope and is supported by the University of Nebraska Foundation through a Department of Psychology endowment. However, the series and this volume are interdisciplinary in nature and aim to present a range of scholarship around a focused topic. This volume spotlights health disparities among youths and families from diverse fields and perspectives.

The book is well organized. It starts with an introductory chapter by the editors, who frame the topic as a whole and the six chapters that follow. The inclusion of distinct and specific aspects of health disparities is well balanced, and the authors reflect expertise in their fields of research. Carlo, Crockett, and Carranza set the stage for what follows in their first chapter, "Understanding Ethnic/Racial Health Disparities in Youth and Families in the US," by providing the reader with a common thread linking the chapters: motivation, as the series title suggests. However, the bridge connecting motivation and health disparities is somewhat lacking. In their first paragraph, the editors assert that theories of motivation play a central role in understanding health outcomes and disparities and promise that this will become evident in the chapters that follow. Although they revisit this link later in a chapter-by-chapter overview, readers would benefit from the enunciation of a more detailed rationale at the start. The editors' introduction successfully presents relevant trends in data and factors associated with health disparities through a review of topical research, which will be particularly helpful to those less familiar with the subject matter and related literature. This first chapter concludes by suggesting that useful models for addressing health disparities are best realized through interdisciplinary and broad-based approaches, which are exemplified in the chapters that follow.

The second chapter is written by Ana Mari Cauce, Rick Cruz, Marissa Corona, and Rand Conger and is titled "The Face of the Future: Risk and Resilience in Minority Youth." The authors quickly grab the reader's attention by using the racially diverse background of President Obama to demonstrate the current, projected, and equally diverse racial make-up of the United States. This chapter poses the following question: "Is the majority-minority future something to look forward to, or something to worry about and fear?" (p. 13). Before clarifying the context of their question, the authors present demographic information that lays the foundation for their overall aim. Specifically, they note that those under 18 years of age who are members of racial/ ethnic minority groups are, in essence, not minorities by numbers. Census data reveal that among this age group, non-Caucasians often constitute more than half of the population. This is the case in many geographic areas currently and is projected to become more common across the United States by 2020. The fear that the authors refer to is never clearly explained; however, it appears to reflect the idea that society is poorly prepared to understand or meet the needs of minority youths. The authors address this challenge by exploring areas of current and potential risk and resilience, with an emphasis on adolescence and a contextual focus on neighborhood, school, and family. Throughout the chapter, President Obama's life experiences are used to illustrate the possible processes of risk and resilience and how they may occur within the life of an individual youth and within his or her family. In conclusion, the authors find that minority youths experience more risk and have fewer positive developmental outcomes than their Caucasian counterparts. The reader's attention is successfully drawn to the importance of cultivation of opportunities for positive youth outcomes, especially for ethnic minority youths in light of their increasing numbers.

Vonnie C. McLoyd provides the next chapter, "How Money Matters for Children's Socioemotional Adjustment: Family Processes and Parental Investment." This chapter explores the association between poverty and child mental health through the lens of the family stress model, which posits that "economic hardship adversely affects children's psychological adjustment through its impact on the parent's behavior toward the child" (p. 34). The author begins by defining and expanding on this model through a review of relevant research that supports the associations between the family stress model and various factors and pathways that affect child mental health outcomes. Particularly striking is the attention given to neighborhood-level links to psychological distress, social support, and parenting. This focus prepares the reader for the remainder of the chapter, which examines an antipoverty, work-based intervention program called "New Hope." This demonstration project used experimental random assignment to assess the strength of the family stress model and to compare program outcomes with those of similar projects, thus providing context for the author's findings that New Hope successfully attained some of its goals, but others were less efficacious. Results showed little support for the family stress model. Furthermore, the author notes that outcomes provided more support for the investment model, which predicts that parental investment of resources such as money, time, and human capital will have positive outcomes for children (Linver, Brooks-Gunn, & Kohen, 2002).

In the fourth chapter, "School Racial/Ethnic Diversity and Disparities in Mental Health and Academic Outcomes," Sandra Graham expands the current foci of health-disparity literature. Rather than assessing disparate health outcomes, Graham focuses on the types of disparities that are observed within school settings. This chapter proposes and aims to support the author's assertion that raising the level of racial/ethnic diversity in classrooms will decrease disparate social, emotional, and academic outcomes for students. Graham examines the demographic composition of public schools in the United States and uses these contextual data as a springboard for an in-depth description of her research agenda. To this end, the remainder of the chapter examines relationships between race/ ethnicity, peer victimization, and the subsequent challenges of diversity in school settings. Overall, this material successfully builds support for the proposal that increased diversity can result in positive youth outcomes. However, because the focus is on peer victimization--including precursors, effects, and mediators--this facet, for clarity, could have been presented among the chapter's aims. Furthermore, despite what the editors promise in their introductory chapter, Graham does not adequately address attributional styles related to academic motivation to connect this material to the focus of the series.

Andrew J. Fuligni asks how adolescents with Asian and Latin American backgrounds "develop a sense of belonging, motivation, and purpose when they consistently encounter both explicit and implicit messages that they are different, limited, devalued" (p. 98). This question is assessed in chapter 5, "Social Identity, Motivation, and Well Being among Adolescents from Asian and Latin American Backgrounds," through exploration of a decade of research conducted by the author and his colleagues, who concluded that the answer is found in their social identifications, ethnic backgrounds, and families. Fuligni clarifies the theoretical basis and operational definitions of these constructs, providing the reader with the necessary foundation to appreciate the two related studies presented to support his assertions. Corresponding respondent anecdotes that relate their personal experiences are interspersed throughout, giving context to the statistical results included. Findings suggest that cultural identity and family identity can aid in understanding the role of ethnicity/race in disparate health outcomes but are unable to predict positive adolescent outcomes in isolation from other variables. Rather, Fuligni uses the term "eudaimonic well-being" to reflect the critical components that need to be fostered, especially for those who face social risks and marginalization (Ryff, Keyes, & Hughes, 2003). Motivation is addressed more in this chapter than in others.

In chapter 6, Les B. Whitbeck examines "The Beginnings of Mental Health Disparities: Emergent Mental Disorders among Indigenous Adolescents." He begins by providing an overview of the strikingly disparate demographic and health data for indigenous people. The author identifies the comparative lack of research regarding mental health disparities among this population by citing that there have only been three such studies to date. He then refers to "the theoretical model that guides this program of research" (p. 122); however, it is unclear to what this refers. A bit further into the chapter, Whitbeck explains his intent: to review exclusive cultural features of child development among indigenous populations. The chapter goes on to examine the cultural context of risk factors, including reservations, family, parent, peers, school, and discrimination; enculturation is viewed as a protective factor. These constructs are then assessed with data from a longitudinal study of indigenous reservations in a northern Midwest reserve and four Canadian First Nation reserves. Results indicate disparate outcomes for indigenous adolescents in many areas. Among the most striking findings, the author reports that by the age of 11, 25.6 percent of children studied had met the criteria for at least one mental disorder. The chapter concludes by suggesting culturally specific interventions, partnerships, and policy initiatives to close the gap in mental health disparities for indigenous children. //// In the final chapter, "Understanding the Hispanic Health Paradox through a Multi-Generation Lens: A Focus on Behaviour Disorders," William A. Vega and William M. Sribney examine behavior disorders through use of the epidemiologic paradox. This model, also known as the "Hispanic health paradox," refers to the supported finding that Hispanic Americans tend to have better or comparable health outcomes than do their Caucasian counterparts. The authors use this theoretical framework, more commonly applied to physical health, to assess behavior disorders among Hispanic families. The context of risk factors for this population lays the groundwork for the authors' research, which uses a representative sample of 3,012 Mexican American adults in California. The primary focus for Vega and Sribney is the identification of intergenerational behavioral health patterns. As predicted by the Hispanic health paradox, behavioral concerns were found to increase across generations in much the same fashion as health problems. Because the results indicate that risk for behavioral problems increases through a familial acculturation process, implications and recommendations for interventions are targeted to the family as a whole. Like others in the volume, these authors note that because the Hispanic population is forecasted to grow, strategies for addressing these behavioral problems are of the utmost importance.

Students and professionals practicing in various disciplines and those who work with children and families would benefit from reading this book. Carlo, Crockett, and Carranza have thoughtfully included a depth and breadth of topics that manages to be both understandable and applicable to the expert and novice alike. Each chapter takes great care to emphasize how the research presented is functional for varied audiences. There is particular applicability and importance to many areas of social work practice. Throughout, various authors suggest the development of opportunities for positive youth outcomes, antipoverty programs, diversity in schools, culturally specific and family--based interventions, organizational partnerships, and policy initiatives. In sum, all authors present recommendations for closing the gap in health disparities for youths through efforts that are within the domain of social work practice.

Advance Access Publication June 29, 2012

REFERENCES

Linver, M. R., Brooks-Gunn, J., & Kohen, D. E. (2002). Family processes as pathways from income to young children's development. Developmental Psychology, 38, 719-734.

Ryff, C. D., Keyes, C. L. M., & Hughes, D. L. (2003). Status inequalities, perceived discrimination, and eudaimonic well-being: Do the challenges of minority life hone purpose and growth? Journal of Health and Social Behavior, 44, 275-291.

doi: 10.1093/hsw/hls006

Christine M. Rine

Plymouth State University, Plymouth, NH
Gale Copyright: Copyright 2012 Gale, Cengage Learning. All rights reserved.