Barr, Donald A. Health Disparities in the United States: Social Class, Race, and Health.

• Author: Quartaroli, Tina A.
• Position: Book review

Barr, Donald A. Health Disparities in the United States: Social Class, Race, and Health. Baltimore, MD: Johns Hopkins University Press, 2008. xv + 289 pages. Cloth, $75; paper, $40.

Fueled, in part, by the Institute of Medicine's (IOM) 2003 report, Unequal Treatment: Confronting Racial and Ethnic Disparities in Healthcare, in part by the corresponding upswing in available research funds, and, in part, by the ongoing national discourse on America's failing health-care system, numerous articles and books focusing on health disparities have hit the street over the past five years.

In Health Disparities in the United States: Social Class, Race, and Health, Donald A. Barr, a practicing medical doctor and a sociology professor at Stanford, follows the IOM and others such as medical sociologist Ivor L. Livingston (Praeger Handbook of Black American Health: Policies and Issues Behind Disparities in Health, 2004), former U.S. Surgeon General David Satcher and internal-medicine professor Rubens Pamies (Multicultural Medicine and Health Disparities, 2006), public-health professor Amy J. Schulz (Gender, Race, Class and Health: Intersectional Approaches, 2005), and health-policy professor Thomas A. LaVeist (Minority Populations and Health: An Introduction to Health Disparities in the U.S., 2005), echoing the primacy of social and economic determinants over biological factors as the principal sources of health disparities among minority populations.

The text is loosely organized around a theoretical framework based on health-related consequences of the socioeconomic history of race in the United States. Geared towards current and future health-care professionals, Health Disparities in the United States labors through an exhaustive review of quantitative medical studies that essentially reify information commonly found in introductory sociology texts: Race- and class-based health disparities do exist; there is a connection between poverty and poor heath; race as a biological factor is not significant in determining a person's health; race is more a social construction than a biological difference; low socioeconomic status is a factor in access to health care; and, physicians may provide a different level of health care to members of minority groups, regardless of economic status, than they provide to whites.

Mirroring the IOM report, Barr concludes that the "principal source of health care disparities based on race/ethnicity stem from differences in the...