This chapter provides an overview of the nonprofit organization in the United States, the main characteristics of nonprofit organizations, and the reality of the nonprofit sector today. It describes the differences between a nonprofit and a for-profit corporation. Nonprofit organizations have existed for many centuries, especially through religious groups or religious-based activities. The nongovernmental sector is growing throughout the world. Increasingly, these organizations are playing key roles in the economic and social contexts of their countries. Unlike private-sector organizations concerned primarily with making a profit, nonprofit organizations are focused on carrying out a specific public-service mission. Successful nonprofit organizations require substantial capability in key areas of management: developing strong boards of directors, recruiting and motivating talented staff and volunteers, creating plans to focus resources on relevant goals and innovative programs, winning the support of diverse stakeholders, raising funds, and wisely managing fiscal and human resources.

This chapter discusses the term “service delivery” and describes a service delivery system in the context of a nonprofit organization. Servitization is the process whereby an organization develops creative and innovative ways to create a product-service system that integrates value-based products and service offerings. The chapter discusses the roles of client-centeredness, decision making, scheduling, priority setting, effective and efficient flow of services or activities, quality assurance, and continuing quality improvement, and how these factors contribute in their own context to influence positively or negatively the financial sustainability of a nonprofit organization. A customer-centric service design is a service delivery system that focuses on providing the best quality service possible to customers or clients or the service target, based on a service concept, a service decision path, service sustainability, and service quality. The chapter explains the relationship between service delivery and financial sustainability.

This chapter defines the concept of social marketing and provides some of the common areas for the use of social marketing by nonprofit organizations. The term “social marketing” has been used for several decades to refer to a systematic process of using marketing strategy to influence current behaviors of a target population into a desired behavior in order to positively change a social or community issue. The chapter describes the contents of a social marketing plan. A social marketing plan is a document that justifies the needs for a social marketing campaign, as well as the process of implementation by outlining a SWOT (strength, weakness, opportunity, threat) analysis, a description of the target population, the goals and objectives, an impact statement, the marketing mix strategies, an implementation plan, an evaluation plan, and a budget. The chapter establishes the relationship between social marketing and financial sustainability.

This chapter demonstrates how social work ethics apply to ethical and legal decision making in forensic social work practice. It discusses the context of social work practice in legal systems. The chapter also details the basic structures of the United States (U.S.) civil and criminal legal systems. It lays the foundation for the criminal and civil court processes in the United States and introduces basic terminology and a description of associated activities and progression through these systems. The chapter focuses on providing an introductory, and overarching, picture of both civil and criminal law in the U.S. and introduces the roles social workers play in these systems. It focuses on the ETHICA model of ethical decision making as a resource and tool that can be used to help forensic social workers process difficult and complex situations across multiple systems.

This chapter explains the theoretical basis for motivational interviewing (MI). It reviews the empirical evidence for the use of MI with diverse populations in forensic settings. MI involves attention to the language of change, and is designed to strengthen personal motivation and commitment to a specific goal by eliciting and exploring the person’s own reasons for change within an atmosphere of acceptance and compassion. It is now internationally recognized as an evidence-based practice intervention for alcohol and drug problems. MI involves an underlying spirit made up of partnership, acceptance, compassion, and evocation. The chapter discusses four key processes involved in MI: engaging, focusing, evoking, and planning. It also describes five key communication microskills used throughout MI: asking open-ended questions, providing affirmations, offering summarizing statements, providing information and advice with permission, and reflective statements.

The concept of risk behaviors became a model for public health interventions in the late 1970s and 1980s. This chapter describes contemporary knowledge on the risk behaviors of gender and sexual minority (GSM) persons. It highlights research findings, with particular attention paid to studies of different GSM subgroups, and evaluates interventions that have sought to modify behaviors in the pursuit of better health outcomes. The chapter then focuses on the potential contributions of other theoretical frameworks to the study of GSM risk behaviors, including opportunities to incorporate disclosure, resilience, intersectionality, and minority stress theories. It also presents recommendations for future directions for researching health risk behaviors among GSM persons, addressing the risk of harming GSM populations, and diverting attention and resources from addressing justice and social determinants of GSM health. The chapter concludes with suggestions for future research and interventions in support of more equitable health outcomes.

As in the non-lesbian, gay, bisexual, and transgender (LGBT) community, gender and sexual minority (GSM) individuals who are also members of one or more racial/ethnic minority populations face unique sociocultural dynamics that impact the ability to achieve and maintain health. This chapter describes the literature that has examined racial/ethnic disparities in a variety of outcomes, and describes what is known regarding the actual impact of intersectionality whenever possible. Reflective of the current literature, the chapter centers on the African American and Hispanic sexual minority male population, HIV, substance use, and mental health as outcomes. It begins with an exploration of barriers to health that reach across outcomes and populations and discusses four specific outcomes with more developed bodies of literature (HIV/sexual health, substance use, mental health/suicide, and victimization). Finally the chapter summarizes the initial evidence from three emerging lines of inquiry (chronic conditions, incarceration, and women’s health).

Using Bronfenbrenner’s Ecological Systems Theory, this chapter highlights the unique strengths and challenges faced by gender and sexual minority (GSM) youth and highlights future directions for research that we believe hold promise in promoting the health and well-being of this special population. It presents a review of the research as applied to physical and mental health disparities that impact GSM youth and discusses the two dominant psychosocial models that explain the contributing factors to these disparities. Notably, public opinion has been shifting toward greater acceptance and inclusion of the lesbian, gay, bisexual, and transgender community, and the 21st century has seen a large increase in the number of protections and rights afforded to GSM individuals. Future research should continue to examine and replicate the impact of minority stress in more recent cohorts of GSM adolescents to determine whether improvements in the social environment result in decreases in health disparities.

Research on the health and health care needs of gender and sexual minority (GSM) people is burgeoning, in part due to increased awareness of the importance of identifying the health care needs of these long-neglected populations. This increase in knowledge related to GSM health is a critical part of improving the quality of GSM people’s health and health care. This chapter considers how practitioners might integrate existing knowledge about GSM health into their clinical work to establish an affirmative context for GSM patients. More contemporary approaches take a more process-oriented view, focused on the appreciation of cultural differences at personal, professional, organizational, and societal levels. These approaches place greater emphasis on training clinicians to think critically about how patients’ cultural backgrounds and identities impact their life experiences. The authors draw on these approaches to provide practical recommendations for providers to deliver competent care to GSM individuals.

This concluding chapter summarizes the major points regarding elder abuse (EA) presented in the preceding chapters. It concludes the chapter by taking one last opportunity to encourage exploration and initiation of system-level efforts to solve a major public health problem. The socioecological framework for violence prevention utilized within domestic and global public health work is applicable and extendable to EA. Throughout this book, the authors have argued that EA is a public health problem and that EA may well be among the most under-recognized and under-resourced population health problems of the early 21st century. Public health has frameworks, tools, approaches, relationships, structures, systems, and a variety of agents and organizations poised to address the problem of EA. The imprimatur of the growing population of older adults and the character of demographic transitions occurring globally provide the perfect rationale for action—now.

The obesity epidemic is even more pronounced in rural America, and is a growing concern as rural adults and children are now more likely to be obese than urban adults and children. People who are overweight or obese are at increased risk for chronic disease and conditions such as hypertension, coronary heart disease, stroke, gallbladder disease, osteoarthritis, and some types of cancers. For women, obesity also is associated with complications of pregnancy, menstrual irregularities, hirsutism, and psychological disorders such as depression. Stress has been linked to obesity in adults and in children, and rural residents are continually subject to the stresses of poverty, limited access to health care, and geographical and social isolation. In rural communities, community organizations and families need to come together to identify common goals related to obesity prevention and identify and mobilize human and community assets to implement strategies they believe will work for their community.

Concurrent with the release of Education and Identity in 1969, the United States was at the nexus of social unrest and expanding funding and support for educational initiatives. The decades of the 1950s and 1960s saw a great increase in research and practice focused on developmental theorists working in the area of higher education. At the forefront of this work was theorist Arthur Chickering. The primary construct of Chickering’s (1969) work is the Seven Vectors of Development. The vectors are: (a) developing competence, (b) managing emotions, (c) moving through autonomy toward interdependence, (d) developing mature interpersonal relationships, (e) establishing identity, (f) developing purpose, and (g) developing integrity. This vector addresses competence across three domains: intellectual, physical and manual, and interpersonal. This chapter briefly outlines Chickering’s life work, and ways in which practitioners can apply his theory to their daily interactions with college students.

This chapter provides new data and a critical look at the comparative assessment of different ethnic groups’ overall levels of savings given their different experiences in the labor market. It focuses on how employers differentially treat minorities to their disadvantage with a multiple regression analysis that identifies the independent negative impact of being a minority on retirement sponsorship and pension plan participation. Minorities have lesser access to employer-sponsored retirement plans because they are particularly affected by the substitution of defined benefit (DB) plan coverage for less secure and less comprehensive defined contribution (DC) plans. Social Security is an important source of retirement income for all Americans. Minorities are disproportionately employed in lower-paid industries and occupations, which have lower rates of retirement account coverage. Qualitative research and interdisciplinary collaborative studies of minority retirement behavior have emerged.

Migrant farmworkers are a distinct population within rural public health. This chapter considers the demographics, health behaviors, health conditions, access barriers, and programs and resources for the mobile poor population. Migrant and seasonal farmworker health issues that warrant special consideration include those related to occupational and environmental health, infectious diseases, mental and behavioral health, food insecurity, housing, and oral health. Present programs in health and education available to migrant farmworkers reach only a minority of farmworker families and need expansion as well as enhancement. Primary care services will be most effective when patient-centered care is coupled with outreach efforts and preventive health coverage. Cancer care, palliative care, and end-of-life care are areas in need of thoughtful program implementation. Public health practitioners and planners will be assisted by understanding the agricultural labor force in their region of concern, and the available resources for social and health services.

This chapter discusses the identification of individual differences in health behaviors and health status among minorities. Sickle cell disease (SCD), a genetic disorder, may serve as an optimal model for understanding issues of aging in minority populations. SCD is an important model of multifactorial conceptualization of genetic-based chronic disease among aging populations. Generally, molecular genetic methodologies are called to mind when people consider the role of genetic factors in health and disease. Behavioral genetic methods will be particularly useful if one begins studying minorities from the perspective that there is significant heterogeneity within populations of minorities. Conceptual and methodological discussions of heterogeneity within minority populations are particularly timely given the changing sociodemographic features of ethnic/racial populations related to health disparities. Socioeconomic status and education have been found to be important variables associated with the development of chronic illness.

Traditionally, there has been a division of labor in higher education between academics and student affairs. This chapter is designed to focus on the plausibility of using theory to facilitate communication across the many departments and divisions of higher education. It is important to remember that the student affairs profession “grew from the campus up, not from theory down”. Early institutions of higher education followed the Oxbridge model with historically based residential living systems in which educators resided in residence halls with the students. This concept of faculty–student integration remains a valuable component in student success today, and is discussed in greater detail in this chapter. One useful “language” for student affairs practitioners is found in Erikson’s stages of psychosocial development. Erik Erikson pioneered a theoretical framework and proposes an eight-staged life-span model through which developing individuals permeate starting at birth and eventually ending with death.

This chapter focuses on the following topics: demography, gender, age at diagnosis/onset of cardiovascular disease (CVD), Medicare usage, work and retirement, social support, social context and neighborhoods, ethnography of families, qualitative research, and social policy. These topics constitute some of the key areas that should be the focus of future research on the sociology of minority aging. The chapter provides a rich description of trends in the ethnic and racial composition of older cohorts to illustrate the dramatic changes that have taken place in the United States in the past century. The rising costs of health care and the increasing older minority population, additional reform will be needed to maintain the sus-tainability of the program. Additional work examining within-race group differences is key to understanding minority aging issues given the large amount of cultural diversity in the United States.

Rural America may seem an unlikely setting for new trends in substance abuse. This chapter compares rural and urban areas and the rural continuum for prevalence of substance use and abuse, efforts to prevent substance abuse, treatment availability and accessibility, and continuing care and long-term support for abstinence. It also presents models of service delivery that address resource limitations common to rural areas. Van Gundy also found that substance abuse rates vary across racial and ethnic groups, though rates differ when socioeconomic status and other factors are considered. Nonmedical use of prescription drugs is a growing national problem and one that heavily impacts rural areas. Societal effects include the strain and economic costs absorbed by emergency rooms, treatment agencies, social service agencies, and the legal and criminal justice systems in coping with the consequences of meth abuse. Treatment models with relevance for rural providers address the shortcomings of existing services.

This chapter presents an illustration of the complexities involved in studying ethnic and racial influences on psychosocial processes and how they are intimately tied to physical outcomes in later life. It focuses on psychology as a discipline, minority aging research during the last several decades has revealed the need for multidisciplinary and intersectional conceptual and research approaches. The chapter also focuses on the age, gender, socioeconomic, cultural, and racial and ethnic graded influences on life course development that eventuate in unequal burdens of psychological and physical health morbidity and mortality for certain groups in late life. No section on psychology could be complete without a discussion of religion and spirituality among racial and ethnic minorities. Generational processes are clearly implicated in ideas about the cyclical nature of poverty and health behaviors that are intricately linked with environmental factors and social influence.

This chapter examines the Older Americans Act (OAA) through the prism of the coming nexus of aging and ethnic/racial diversity. It explains that the OAA can serve as a foundation for building a home- and community-based set of services for all older adults and persons with disabilities and for addressing aging in the 2lst century. The OAA is the primary federal program providing a host of services that enable older persons and their families to live in their homes and communities with a measure of dignity and independence. The OAA, Administration on Aging (AOA), and aging network today provide five major categories of services: access to social and legal services, nutrition, home- and community-based long-term social and supportive services, disease prevention and health promotion, and vulnerable elder rights protections. The OAA and the AOA remain secondary players in national agenda setting for an aging population.

This chapter focuses on informal caregiving among minority groups. It also focuses on context of caregiving and discuss the various specific challenges caregivers of minority older adults face. The chapter examines some of the specific caregiving interventions tailored for families of color and discuss the implications for practice, policy, and research. Medical advances and greater longevity point to healthier and longer lives for many, but both formal and informal caregiving remain a concern as individuals age and develop conditions that require care. Caregivers are often able to realize the positive aspects of caregiving when they are not struggling with financial or social support challenges. Despite the vast literature on caregiving in general, research pertaining to the needs and experiences of racial/ethnic minority older adults and their caregivers is limited, particularly for American Indians, Pacific Islanders, specific Asian American and Latino subgroups, and religious minorities groups such as Muslim Americans.

This chapter presents an integrative approach to the psychological study of minority populations and the reduction of health disparities through positive nonmaterial resources. It provides a brief introduction to positive psychology and to the concept of early life origins of disease, highlighting the value of integrating these seemingly disparate literatures as a lens for studying health and broader aging processes among minority populations. Minority status whether based on ethnicity, gender, socioeconomic status (SES), citizenship, religion, or other factors is a robust determinant of health, well-being, and success across the life span and intergenerationally. Positive psychology is relevant to health and development particularly physiological and psychological adaptation to stress across the life span, and even across multiple generations among humans in general and among minority populations in particular. Health inequalities are the result of unique challenges to successful psychological and physiological adaptation faced by minority group members.

This chapter discusses current thinking in the field of social support and social relationships, and physical and mental health among older racial and ethnic minorities. Social relationships are an important predictor of health and psychological well-being across the life course. Many minority older adults will face the continued challenges of declining functional status due to physical and mental health conditions over the course of their lives. Most empirical studies on social support among older racial and ethnic minority adults explore the association between social support and both physical and mental health. The wealth of studies on social support among minority older adults has much to offer with respect to understanding the correlates of emotional support and patterns of assistance. The biological mechanisms explaining the link between social support and physical health outcomes have been largely unexplored among older racial and ethnic minority groups.

This chapter presents reasons for why many individuals prefer receiving mental health care in a primary care setting. In fact, more persons with a mental health problem or illness are treated by a primary care provider than by a specialty mental health care provider. The chapter also presents the background for integration, including definitions, models, barriers, and evidence from the general integration literature. It describes the history of integration in rural areas and best practices of integrating care in rural areas. The chapter presents practical strategies for integrating care in rural areas. It provides case studies of integrated care in rural communities. The chapter reviews the experience and lessons learned by four rural primary care providers who have successfully integrated care. A number of national trends and policy initiatives are likely to influence access to rural mental health care in the years ahead.

This chapter examines racial and ethnic differences in disability in the United States with a focus on their patterns, trends, and determinants. Disability is responsible for massive social and economic costs to individuals, families, and health care systems. Racial and ethnic differences in health are one of the most widely studied topics in U.S. health disparities research. The risk of disability among older Asians is an understudied area, despite the growth of this population subgroup in recent years due to increased volume of immigration from Asia to the United States. There is an ongoing interest in measuring and understanding the patterns and causes of racial/ethnic differences in disability in the United States. Rising obesity may play an important role in the findings for Hispanic women and for the trend in disability for all race/ethnic groups.

This chapter describes the role of supplementary education–typically, a form of additional structured education that takes place outside of the school classroom–and how it can prepare learners for high academic achievement and effective engagement in the process of learning that is key to academic success. The idea of supplementary education is based on the premise that beyond exposure to the school’s formal academic curriculum, high academic achievement is closely associated with exposure to family and community-based activities and learning experiences that occur outside of school. The chapter presents the rationale and need for supplementary education. Related types of supplementary education include those that are implicit parenting, nutrition, family talk, parental employment, decision making, reading along with the children, socialization and acculturation, social networks, travel, and environmental supports, and those that are explicit (academic development, tutorials, advocacy, remediation, one-on-one tutoring SAT preparation, Saturday academies, specialized services, socio-cultural and child-centered social groups).

This chapter examines the history of long-term services and supports (LTSS) programs to document their racially and ethnically disparate impact, and explain the current research on the access and quality of LTSS used by older adults in communities of color. LTSS are a set of health and social services delivered over a sustained period to people who have lost or never acquired some capacity for personal care. The high costs of LTSS have led a smaller number of low-income older adults to consume a large share of Medicaid expenditures. Cultural beliefs about family responsibility to care for older adults as well as attitudes toward the use of formal and/or public health and long-term care services can shape older adults’ use of LTSS. The coming sociodemographic shift of older minority adults calls attention to other structural and cultural issues that facilitate or inhibit the appropriate use of LTSS.

A growing body of research documents racial and ethnic disparities in physical and mental health among older Americans. This chapter discusses larger stress process literature and reviews research on discrimination as a source of stress that is an influential determinant of racial and ethnic differences in the health status of older Americans. It provides a brief overview of disparities in health among older Americans. The chapter discusses the biology of stress, elaborates on key elements of the general stress process framework, and highlights findings pertinent to the health of older minorities. It reviews the research on personally mediated discrimination and health that includes findings from both age-diverse samples and those specific to older adults. The chapter also reviews the literature on coping with discrimination and the contribution of institutionalized discrimination to health inequalities. Lacking are investigations on the joint impact of perceived discrimination and residential segregation.

Lesbian, gay, and bisexual (LGB) individuals are more likely than their heterosexual peers to experience a variety of mental health and health-related problem behaviors, including emotional distress, suicidality, substance use, and sexual risk behaviors. This chapter investigates potential ethnic/racial differences in gay-related and non-gay-related stress among a sample of Black, Latino, and White LGB youths in New York City. It further examines whether ethnic/racial disparities exist in various mental health and health-related behaviors of LGB youths. The chapter then examine whether gay-related stress may account for the potential ethnic/racial disparities among LGB youths. The chapter reviews the research on sexual orientation disparities in health among LGB youths, followed by a review of what is currently known about potential ethnic/racial disparities in stress and health among LGB youths.

This chapter provides new insights, direction, and applicability of qualitative research methods in social network analysis, with special emphasis on the minority elder population. It describes how specific qualitative approaches may be applied and contribute to increased understanding in social network analysis. The chapter provides a list of suggested future directions to address issues that are void in the literature on social networks and minority elders. The social networks of older adults provide them with the greatest amount of care and support. Any definition of social networks needs to be grounded in both microstructural and macro-structural perspectives. The social networks of minority elders are uniquely shaped by the cultural norms and values associated with the diverse racial and ethnic groups with which they identify. The conceptual guidance from the life course perspective can also inform understanding the structure and function of social networks among minority elders.

Informal and loosely generated models of White identity development began to emerge in the late 1970s and early 1980s; however, the first formal White identity development model, or typology, was proposed by Helms in 1984. This chapter describes her model, followed by an application of the model to the opening vignette. It identifies strategies for educators and student affairs practitioners to work with students like Craig to begin to more fully understand his Whiteness, the sociopolitical realities of race on campus and, in general, increase his multicultural competence, and engage in healthy interracial interactions. The chapter also discusses the summary of the literature examining the steps educators and student affairs practitioners can take to promote their own cross-cultural interactions and multicultural knowledge in order to more effectively work with students struggling with their own racial identity, followed by the strategies to promote healthy interracial interactions among students.

This chapter describes four specific minority groups within rural areas namely African American; Hispanic; lesbian, gay, bisexual, and transgender (LGBT); and American Indian/Alaskan Native. It also describes leading health issues such as diabetes, heart disease, stroke, hypertension, and cancer among rural Hispanics, contributing factors to health disparities among rural Hispanics. The chapter offers recommendations to improve health and eliminate disparities among rural Hispanic populations. For rural African American communities, community-based settings like churches have been found to engender higher participation and retention rates for health promotion programs. Factors such as poverty, health insurance, and having a health care provider contribute to the health disparities among rural Hispanics. Innovations such as telehealth and community-based participatory research hold much promise for advancing health within rural minority groups such initiatives should be encouraged, supported, and appropriately funded to begin to address health inequity in the doubly underserved populations.

Holland theorized six distinct worker personalities (Realistic, Investigative, Artistic, Social, Enterprising, and Conventional). This is often referred to as RIASEC. The theory includes six work environments that correspond to the same personality types (Realistic, Investigative, Artistic, Social, Enterprising, and Conventional). Although people possess aspects of each type, the general thesis of the theory is that salient types (work personalities) will emerge in each individual. Holland’s work represents a significant contribution to career development and counseling. Understanding Holland’s focus on interests as expressions of personality aids career counselors and student development specialists in helping students gain critical self-understanding. Exploring the match between personalities and work environments is a fundamental aspect of applying this theory to student development. Helping students to explore and learn about different careers that may be of interest to them is congruent with the goals of higher education institutions and student development theories.

This chapter presents new paradigms for inclusive health care, articulating the need for both individual patient and population health approaches, while highlighting the role of home-based interactive computer technology in having a wide impact. It describes the high costs of health and mental health behaviors. The chapter explains science’s and health care practices low impact on health and mental health behaviors. It describes higher impact paradigms that can complement current paradigms of research and practice. Integrated health care paradigm is an innovative approach to population health, which would integrate services across biological and behavioral disciplines. The chapter discusses in detail clinician and computer paradigms, clinician and computer-based clinical trials, from single to multiple behavior change paradigms, high specificity vs. high generality, and higher impact science and service.

Integral to theories of moral development is the matter of not only what individuals think but also how they think. Across the life span, moral development is shaped by challenging events that prompt individuals to question the frameworks they have created for finding ways to determine what is good and what is bad. College students encounter new ideas and values that differ from those of their families, in the classroom, in the residence hall, in the dining facility, in the student union, and sometimes on the athletic field or court. In order to illustrate how moral development unfolds within a college student population, this chapter introduces a fictitious character who displays each stage of moral development for two theories–Lawrence Kohlberg’s (1963, 1984) and Carol Gilligan’s (1982) models of moral development. The chapter discusses the underpinnings of two specific moral development theories.

This chapter focuses on more integrated approach or process for developing a health intervention for ethnic minority groups that incorporates accepted principles of medicine and scientific methodology. The changing demographic has led to complex challenges in the U.S. health care system. The delivery of effective health care services hinges on health care professionals’ ability to recognize varied understandings of and approaches to health care across cultures. Health care providers may employ different strategies to increase participation of service users by bridging barriers to communication and understanding that stem from these racial, ethnic, cultural, and linguistic differences. In the context of health or health care improvement, little debate exists concerning the recognized need to help ethnic minority patients maintain and restore health. There are two general approaches for developing culturally appropriate health interventions. The first approach is from science to practice and the second approach is from practice to science.

This chapter discusses the history, organization, development, and the future of Medicare and applies Andersen’s Behavioral Model of Health Services Use to understand utilization among the elderly and conduct a systematic literature review. It analyzes racial/ethnic disparities in health care utilization among the elderly using Andersen’s model and discuss the implications of the current proposals for changes in Medicare for health care utilization especially among minority aging. Racial/ethnic differences in seniors’ use of medical care were sizable before the Medicare program. The focus on deficits and controlling the cost of government has in turn increased the focus on health care and entitlement programs like Medicare. Medicare is important to ensure access to health care for the elderly, particularly the poor and minorities. However, with the rising health care costs and changing demographics, it is clear that Medicare needs some type of reform to ensure its continuing viability.

Many adults understand the pressures of having multiple responsibilities that require attention in a variety of life circumstances. Whether giving attention to work, friends, school, religious activities, romantic relationships, family, or even recreation, adulthood requires the ongoing ability to multitask a variety of expectations and responsibilities. Before reaching adulthood, each person has experienced influences that affect how we think, feel, and react to life’s circumstances. This chapter offers professionals and educators one model for understanding these influences and their impact on college students who oftentimes are transitioning to a new world of adult responsibilities for the first time. Ecological theory originally developed out of the work of Urie Bronfenbrenner (1977) within the field of developmental psychology. The concepts described in Bronfenbrenner’s ecological theory offer a number of important implications for supporting students in a college setting.

This chapter provides selective review of research on religion and spirituality across three groups of racial and ethnic minority older adults African American, Asian American, and Hispanic/Latino. It discusses major denomination and faith traditions, as well as information about types and patterns of participation and their sociodemographic correlates. The chapter examines informal social support provisions within faith communities and the types of assistance exchanged. It also examines associations between religion, spirituality and physical/mental health, and psychological well-being. Religion and spirituality, through a variety of psychosocial mechanisms and pathways are thought to have largely beneficial impacts on physical and mental hea.

Twenty-five years into the epidemic, AIDS remains a significant public health issue that highlights the persistence of health disparities in the United States. This chapter provides an example of the best case scenario outcome: a new emergent evidence-based model for reducing HIV/AIDS risk with serodiscordant couples worthy of dissemination, and adaptation to new culturally distinct populations. It reviews current research on HIV prevention for couples and highlight the rationale for conducting couple-based intervention research. The chapter describes the process of designing Project Connect, a cultural- and gender-specific HIV/STI prevention intervention. It presents theories that guided the study. The chapter describes the content of the intervention and finally discusses the implications of the efficacy of Project Connect for the design and dissemination of culturally-congruent interventions to address the AIDS epidemic among ethnically diverse women and their male partners.

This chapter focuses on aging and health issues in all of America’s major minority populations including African Americans, Hispanics/Latinos, Asian Americans, as well as Native Americans. It addresses the issues of health inequality and health advantage/disadvantage. The chapter introduces relatively new areas of inquiry including long-term care, genetics, nutrition, health interventions, and health policy issues. In addition to possible genetic factors, the literature has emphasized the influence of poverty and socioeconomic status as well as stressors associated with minority group status. The system of long-term care services will need to be restructured to take into account issues affecting minority populations such as health care coverage, housing and income supports, as well as cultural issues as filial piety and trust. The field of minorities, aging, and health has been dominated by a health inequality perspective that has been illustrated by the application of cumulative disadvantage/cumulative inequality theory.

The general racial/ethnic identity theories offer some insight into possible ways to approach diversity education within all aspects of student affairs. Student affairs professionals and faculty could facilitate educational programs, seminars, and workshops that challenge students to confront issues of prejudice and racism as well as to cultivate racial or ethnic pride. These programs should address the external conditions in which students explore their identity and how to make meaning of shifting thoughts as they progress in their racial or ethnic identity development. By looking at diversity through the lens of racial or ethnic orientation, professionals can meet students where they are and help them not only understand other cultures, but also how they fit into their own race/ethnicity. Practitioners might also use these models as a way to gain insight as to where students might be in their racial/ethnic identity development.

This chapter introduces the scope of this volume by reviewing thirteen guiding principles for a new field of equity in health. The thirteen guiding principles are: The drive for a major paradigm shift, the drive for new models of health care and training, the drive for new theories, perspectives, and identities, the drive for evidence-based approaches, the drive for transdisciplinary teams and community-based participatory research, the drive for globalization and global collaboration, the drive for cultural competence and cultural appropriateness, the drive for health literacy and linguistic appropriateness, the drive to ensure the right to health, the drive for social justice and acknowledgment of forces in the social context, the drive to protect and support the most vulnerable, the drive to repair damage, restore trust, and take responsibility, and the drive to redistribute wealth and access to opportunity. These principles provide hope for a future global transformation in health.

At its core, Kolb’s construct of experiential learning is more than simply a theory. Experiential learning theory (ELT) holds that learning is “the process whereby knowledge is created through the transformation of experience”. Although ELT is often used in formal classroom settings, there are many out-of-classroom environments in student affairs that use and benefit from it as well. One way in which colleges and universities use experiential learning is through service-learning courses and projects. Several scholars have reported that using service learning in conjunction with ELT provides students with meaningful ways to engage not only with the community, but also to come to know more about diversity and social justice. Because out-of-classroom learning is such a key component in higher education and in the holistic development of students, using Kolb’s experiential learning model can aid students in meaning making as it facilitates personal growth.

This chapter describes the use of new media designed by education technologists to improve learning. It illustrates the potential of such media to disseminate an evidence-based model for HIV/AIDS risk reduction, enrich the training experience, and expand the possibilities for disseminating content arising from various fields. The chapter describes the Columbia Center for New Media Teaching and Learning (CCNMTL) an organization devoted to providing service to University faculty, who aspire to use digital media as part of their educational efforts. It shows how in conjunction with the Social Intervention Group (SIG) at the Columbia University School of Social Work. CCNMTL developed a multimedia version of Project Connect that may improve its efficacy, exponentially extend its dissemination, and also enhance classroom practice in related fields by repurposing Connect’s assets for classroom use. Lastly, the chapter explains how CCNMTL’s work with SIG led to the development of the Triangle Initiative.

This chapter provides a selective review of research on social support among older African American, Hispanic, Asian American, and Native American adults. It focuses on social support as a dependent variable in relation to different sources and types of aid provided to older African American, Hispanic, Asian American, and Native American adults. The chapter highlights the findings in three specific areas: marriage and romantic relationships, extended family and non-kin as sources of informal social support, and black-white differences in informal social support. Informal social support networks are critical for individuals of all ages but especially for older adults who are dealing with difficult life circumstances. Older African Americans depend on informal social support networks of family and friends for assistance in emergency situations, as well as for help with various tasks of daily life. Elderly Asians often utilize kin and social support networks for a variety of reasons.

The Social Education and Health Advocacy Training (SEHAT) project is a peer-led client-centered participatory program that aims at increasing health awareness and preventive behaviors among the prisoners, with an emphasis on HIV prevention. This chapter discusses the value of peer-led prison-based interventions. It explains the theoretical rationale for the SEHAT intervention, the process of designing SEHAT and developing strategic partnerships. The SEHAT intervention drew upon various theories of health behavior change such as the Health Belief model, Transtheoretical Model, Social Learning Theory, social support, as well as elements of relapse prevention in its skills training sessions. The chapter presents the planning, funding, implementation, and time-lines for the SEHAT program. It also describes the accomplishments and evolution of SEHAT to date, and finally, SEHAT’s future directions and needs.

This chapter focuses on the factors that intersect with race and ethnicity in shaping the experiences of families from racial and ethnic minority communities. It presents a conceptual framework using a Venn diagram that shows the intersection between aging and having a serious mental illness (SMI) or developmental disabilities (DD), limited services for these aging populations, and being a person of color with SMI or DD. People with DD and SMI are now experiencing increased life expectancy due to improved medical and technological advances. However, understanding the needs of aging adults with DD and SMI from diverse communities in the United States and their caregiving families is particularly challenging, because historically, there have been racial and ethnic disparities in the use of specialty health care services. Older adults with DD and SMI from racial minority groups are disadvantaged on multiple domains.

This chapter frames the behavior of patients within a psychosocial model of resilience, underscoring the role of adaptive coping strategies. It presents the results of a study exploring the utility of resilience theory in guiding understanding of the beliefs and practices of African Americans toward colon cancer screening. The chapter proposes that resilience theory will provide a framework for understanding where health-prevention and related behaviors fit in the overall life schemas of persons at risk. The chapter also uses resilience theory to understand the processes that would lead to better access to and actual use of colorectal cancer screening in minority populations. These research findings have potential to guide the development of a targeted intervention to encourage colorectal cancer screening among minority individuals. This study is a first step to explore personal views of key representatives of the African American community, female elders, with regard to colorectal cancer screening.

Mental health professionals play a critical role in enforcing social justice in mental health care service. This chapter discusses various characteristics of and attitudes about mental health services that may serve as barriers to parity in mental health service delivery and services among African Americans. It describes strategies for mental health providers and systems in addressing these service delivery disparities. These strategies improve the quality of mental health services for African American clients, minimize structural barriers in the receipt of mental health care among African Americans, and decreases the stigma associated with counseling use among African Americans and promote more favorable help-seeking attitudes among African Americans. Mental health professionals should work at the individual, community, and institutional levels to address external barriers, differential quality of care, and beliefs that African Americans may bring into their interactions with mental health systems.

This chapter delves into critical issues involved in finding an appropriate balance between scientific and ethical considerations in assessing merits of community health intervention research. It discusses the emerging challenges to the field posed by the recent call for “evidence-based” public health and addresses the need for achieving a sound balance among the demands for collecting the most rigorous scientific evidence possible. The chapter then takes up the question of ethical concerns regarding fair allocation of public resources at National Institutes of Health. It argues that the skew toward individual interventions has resulted in an undue emphasis on individual behavior change as a common yet not necessarily warranted outcome measure in the hierarchy of funded research. It concludes with a recommendation based on the work of Daniels and Sabin (1997) for using a fair procedure, called “accountability for reasonableness”, for making decisions regarding priority of different types of health research.

This chapter recognizes how men who have sex with men (MSM) are currently living at the intersection of two epidemics–one involving HIV/AIDS and another involving methamphetamine (MA) drug use. It offers recommendations for researchers and clinicians working with this special population. The chapter discusses the range of health disparities impacting MSM to place their lives in context. It describes recruitment and study participation issues with MSM communities and clinical treatment issues with MSM using methamphetamine Health care access disparities are more emphasized among MSM of color who may have a more difficult time due to socioeconomic status, insurance status, as well as fear of stigma and disclosure by health care providers. Reaching out to and communicating with MSM communities require cultural sensitivity, cultural competence, and replacing any maladaptive responses with adaptive responses, such as acceptance, respect, and empathy–going well beyond tolerance.

The idea of protecting the health of rural populations, or rural public health if we will, is not new. In reality, however, most public health principles and practices are developed, applied, and evaluated in urban settings. As the field of public health grew beyond infectious disease concerns to encompass areas such as maternal and child health, chronic diseases, and mental health, the shift from an urban focus to a more inclusive view of all geographic diversities did not follow, however. Two of the most pressing challenges faced by rural residents are poverty and access to basic health services. Many researchers agree that one major complication in examining rural health outcomes is the lack of a consistent, objective measure of rurality. Because rural economies often center on agriculture, a highly volatile market, economic uncertainty is almost a staple in rural communities.

The Myers–Briggs type indicator (MBTI) was designed to help people understand themselves and others by helping them appreciate the diverse strengths of different personality types. It has been widely used in counseling as well as business to work on team building and relationships. There is, therefore, room for using this assessment within the field of student affairs to help build teams and groups both for professionals in the field and for students. This chapter discusses the basic information about the MBTI and implications for student affairs. The instrument is considered as a personality assessment for normal individuals designed to assess personality type. The MBTI offers strength-based guidance in every realm of living concerning individual growth to interpersonal relationships, in academic matters to spiritual terrains. From the office of the president to the chaplain, the MBTI is a useful and effective tool on a college campus.

This chapter provides definitions and theoretical perspectives regarding the productive engagement of older adults. It explores the productive engagement of four ethnic minority groups African Americans, Hispanic Americans, Asian Americans, and Native Americans. The chapter discusses programs and policies that will help increase the productive engagement of older adults. It is possible that older adults will be judged by their ability to be productive and expected to be productive. Those older adults who have been disadvantaged across the life course will continue to be disadvantaged in later life when they still face discrimination in access to or support for productive engagement. Both definitions and theoretical perspectives are important to understanding the productive engagement of older racial/ethnic minorities. At the societal level, increasing the productive engagement of older adults, in general, may increase the supply of experienced employees, volunteers, and caregivers.

This chapter focuses on potential new lines of inquiry that emerge from the synthesis of research in ethnic geography, urban studies, race/ethnicity, and age/life course. It emphasizes the importance of integrating work from ethnic geography into studies of minority older adults and their neighborhoods. There has been a long tradition of work on the role of neighborhoods for minority older adults, ranging from their health-protective elements to their challenges for older adults. Research on neighborhood context for minority older adults could benefit from an expanded view of age in studies of place. Research on minority older adults and neighborhoods could also benefit from an expanded focus on place in studies of age, namely integrating research from ethnic geography. Integrating research from multiple levels of context, ranging from cross-national migration to attachment to place, opens a new vista of inquiry on minority aging and neighborhoods.

This chapter describes the impact of intersecting identities that affect lesbian and bisexual (LB) women of color. It discusses the communication and legal concerns that may lead to complex and difficult diagnostic and treatment considerations and problems of access to health care, and offers recommendations for health care researchers and practitioners. The chapter refers to the concept of multiple identities or the notion that most patients have more than one important locus of identity and that they may include more than one identity that is disadvantaged. This is particularly relevant for LB women of color. The Communication and legal issues are illustrated via two brief cases, which demonstrate a number of communication issues that often arise in the acquisition of important medical information from LB women of color. Sexism and heterosexism affect women of color and White women differently. Racism affects African American heterosexual, lesbian, and bisexual women differently.

This chapter provides an overview of key theoretical considerations that are important to understanding mortality and longevity differences across groups. It focuses on the historical and social contexts as well as the life course processes that are most important in understanding patterns and trends of race/ethnicity, aging, and mortality/longevity in the United States. The chapter provides a new empirical analysis of race/ethnicity and U.S. adult mortality risk, focusing on key demographic and socioeconomic factors that influence mortality differentials across groups. It also focuses on critical research needs and on the ways that social and health policy might effectively influence future mortality and longevity trends for all race/ethnic subgroups in an increasingly diverse and aging society. The understanding of race/ethnic patterns and trends of mortality and longevity must also consider the ways in which the life course unfolds in unique ways across groups.

This chapter provides a comprehensive overview of the challenges involved in eliminating health disparities. The U.S. Department of Health and Human Services (HHS, 1985) Secretary’s Task Force report on Black and Minority Health was a landmark document with regards to minority health. The report identified a number of important categories of diseases that caused the overwhelming majority of excess death in minority populations. Despite signs of tremendous medical progress, minority racial and ethnic groups continue to experience an unequal burden of serious illnesses, premature death, and disability in the United States (Zerhouni, 2005). The illnesses that make up the burden described are “complex” or “multifactorial diseases”, as they arise from combined actions of many genes, environmental risk factors, including socioeconomic factors and risk-conferring behaviors. Another environmental consideration is social and behavioral determinants of disease and disability.

The study of human development, broad in scope and diverse in nature, has been the focus of research by psychologists, sociologists, educators, human ecologists, and many others since the early to mid-20th century. This chapter provides an overview of identity development in young adults. Initial theories across multiple domains of development (e.g., cognitive, psychological) have focused primarily on child and adolescent changes based on the assumption that most development slowed considerably or crystallized and stopped completely after late adolescence. As a result, developmental issues in young adulthood (approximately ages 18–24 years) received greater scrutiny, and theoretical frameworks for understanding these aspects emerged. The chapter examines some of the issues and theories that impact identity development during this period in life. Psychosocial developmental theories offer frameworks for conceptualizing the issues individuals encounter at various points across the life span and have provided structure for more recent research as well.

Identity development operates on two simultaneous continuums, level of exploration and level of commitment. High levels of exploration and high levels of commitment suggest identity achievement, denoting the active process of developing an identity. With social identity groups, identity encompasses several unique facets because of the influence of the sociopolitical context (i.e., privilege and oppression) associated with social identity. Understanding oneself as a gay person is not simply understanding one’s attractions and sexual/affectional orientation, but also understanding that identity within a context, in which one might face marginalization from the larger community, institutional discrimination, and internalized homonegativity. In the same way, lesbian, bisexual, transgender, gender nonconforming, and queer identities also experience stigmatization. For lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals, emergence of identity development begins with an initial questioning of one’s heterosexuality or gender conformity.

This chapter provides definitions and scope of the problem of eliminating disparities in end-of-life (EOL) care. It provides a translation of the theories and research that can be used to guide social work practice with minority older adults. The chapter suggests that when working with minority elderly, the psychosocial needs of the patient and family become even more critical in decisions that may affect the timing of death. The term end-of-life care traditionally refers to the last phases of an illness before death; however, experiences across the earlier course of the illness are critical to shaping the anticipation, expectations, and preparedness for care during the terminal phases of illness. In terms of EOL care decision making and the disparity in hospice utilization across racial groups, Critical Race Theory (CRT) offers insight for looking at race relations in a broader context than the traditional perspective.

Improved nutritional status is an important component of efforts to improve the health of older adults, whose ability to consume a healthy diet is affected by comorbidities and behavioral, cognitive, and psychological factors. In addition to genetics and nutrition intake, nutritional status of the elderly could be affected by socioeconomic factors, such as education and income levels, and environmental factors, such as proximity to stores and transportation, that can affect food variety and availability. Nutrition and aging are connected inseparably because eating patterns affect progress of many chronic and degenerative diseases associated with aging. Anthropometric measurements are often used for nutritional assessment of older adults and are reliable across ethnicities. The Mini-Nutritional Assessment (MNA) tool was developed to evaluate the risk of malnutrition among frail older adults. Dietary patterns may better capture the multifaceted effects of diet on body composition than individual nutrients or foods.

This chapter examines conceptual frameworks and theories on racial and ethnic health disparities that can apply to cardiovascular diseases (CVD) among middle-age and older age adults; investigate age at onset/diagnosis of CVD as it varies by race and ethnicity, with some explanations as to why these disparities exist; understand difficulties with CVD self-care/management by race and ethnicity, with some explanations as to why these disparities exist; and discuss future directions, considering data, prevention, and intervention, and policy needs. Several conceptual models and theories can address racial and ethnic CVD disparities among middle-age and older age adults, including the social determinants of health (SDOH) model, the social-ecological model, and life course theory. An earlier age at onset/diagnosis of CVD for racial and ethnic minorities potentially leads to earlier health declines and earlier death because of access to care and self-management difficulties.

This chapter focuses on the racial identity development of Black or African American college students and of students who identity as biracial or multiracial. Although racial identity development theories do not support biological distinction between racial groups in the United States, they recognize how different conditions of domination or oppression of various groups have influenced their construction of self. In this chapter Black is used to refer to the racial identity of U.S.-born persons of African descent who may categorize themselves as Black, Black American, African American, or Afro Caribbean. The term biracial is used to describe persons with two parents of differing monoracial or multiracial descents. It is worth noting that some individuals may claim Black racial identity although neither of their parents identify as Black, such as the case of civil rights activist Rachel Dolezal. This chapter goes in depth into such alternative experiences of Black identity development.

This chapter describes, toward the goal of closing the academic achievement and health gaps, an example of a supplementary education program rooted in an academic, community and faith-based coalition. It presents the context for and subsequent development, implementation, evaluation, and refinement of a supplementary education program. The chapter presents the process, and the results of an evaluation of the supplementary education model for its 5 year anniversary. It describes the key theories guiding Goldquest program development. Key program features include ensuring effective engagement in the learning process via the use of marbles given to reward/shape behavior, and youth involvement in community service via the National Association for the Advancement of Colored People (NAACP). The twelve key program components are: Marbles, Practice SAT, Math of the Day, Word of the Day, Math Game, Word Game, Deep Breathing, The Radio Show, Activity Sheets, Peer Tutoring, NAACP Peer Teaching, and NAACP Membership.

This chapter focuses on the changing health care policy climate. These changes can either reduce current barriers or create new challenges to health care. The Patient Protection and Affordable Care Act (ACA) has reformed the Medicare payment system and incorporated the voice of older minority adults in shaping the performance of their local health care delivery system. Health care access inequity and policy-based remedies have historic roots in U.S. civil rights legislation. The civil rights of older adults and their access to health care were resolved through Medicare. ACA policy creates an opportunity to reframe health disparities research as a consumer issue. However, the terms health disparities, older minorities, and barriers to care are not usually viewed as consumer issues. Standardization of health care practice creates research opportunities for social gerontologists to evaluate policy and its impact on health care access disparities.

This chapter outlines the process of successful grant-writing to obtain funds to support community-based health disparities research and services. It provides background information intended to clarify common conceptual elements of community-based participatory research (CBPR) that influence the development of community-based projects and proposals. The primary focus is on an academic/community model for health disparity community-based initiatives, which often serves as the foundation for proposal and project development. The chapter includes recommended strategies for initiating and maintaining community partnerships for effective proposal development and program sustainability based on the historical and collective experience of Morehouse School of Medicine. It argues the fundamental importance of community participation in all aspects of proposal development–from the definition of the problem or need to outcome evaluation.

Sociocultural theories situate learning and development as embedded within cultural, institutional, and historical contexts. Within these contexts, the focus is on how individual learning and development is mediated by social interactions and culturally organized activities. The goal within a sociocultural approach is to understand the relationship among cultural, institutional, and historical situations and their influences on human cognition. This chapter provides an overview of the history and development of sociocultural theories. It discusses two specific sociocultural theories: Cultural-Historical Activity Theory (CHAT) and communities of practice. Communities of practice, the central component of another sociocultural theory, developed out of the work of Jean Lave and Etienne Wenger on situated learning that focused on the role of participation in a community and social learning. The chapter concludes with a discussion of the application of sociocultural theories and closing vignettes.

This chapter summarizes and discusses the findings of the predictors of nursing home admissions and the issues regarding access among four groups of racial/ethnic minority older adults: blacks/African Americans; Hispanics/Latinos; Asians/Pacific Islanders; and American Indians/Native Americans. It provides a summary of the need for providing culturally competent nursing home care and future directions for alleviating racial/ethnic disparities and segregation in nursing home care. Minority older adults were once disproportionately underrepresented among nursing home residents. With the demographic revolution among racial/ethnic minorities and older adults, the number of racial/ethnic minority nursing home residents will continue to increase. Improvement in the quality of nursing home care for racial/ethnic minorities also requires culturally competent care. In providing culturally competent nursing home care, nursing home administrators and staff should involve community representatives from faith/spiritual communities and from civic and cultural organizations in the facility’s planning, monitoring, and quality-improvement meetings.

Transition is a process that takes place over time rather than at one point in time, and every transition begins with an ending. Schlossberg (2008) explained that each phase of the transition allows for a way of viewing and navigating the transition. Building student programming efforts around Schlossberg’s Transition Model adds an important foundation to any transitional program. Taking stock is a process by which transitioners examine their situation and coping resources for the situation. Taking stock consists of analyzing four domains: (1) Situation - the situation at the time of the transition; (2) Support - the people and assets that strengthen and encourage the student; (3) Self - who the student is (identity), his or her optimism level, and dealing with ambiguity; (4) Strategies - ways and functions of coping. Incorporating the Four Ss as standard components ensures a holistic approach in bolstering student success and retention.

This chapter provides a review of public policy and public programs related to important aspects of the welfare state in the United States, with particular attention to the impact of various policies and programs related to income support, health care, and housing on low-income and minority Americans. It focuses on the guiding principles that motivate the various parties in today’s welfare state debates and investigate how the basic structure of the way social welfare is guaranteed in the United States affects low-income and minority individuals. The chapter also focuses on the general features of our economic, political, and social systems that place minority Americans at serious risk of poverty and ill health throughout life, including its waning years. The welfare state represents a relatively late development in human social, economic, and political history. Social Security is particularly important for minority Americans.

This chapter considers aging in place both within larger community and societal contexts as well as through description of the unique experiences of older Latinos or Hispanics, African Americans, Asian Americans, Native Americans, and Pacific Islanders. In addition to racial and ethnic status, aging in place may also be influenced by changes in longevity, family demographics, caregiving, and household structures. Most considerations of aging in place emphasize the importance of the fit between the physical environment and the individual to successfully age. The recent addition to the model of the individual life course and historical change now offers a means to recognize three particularly influential components of aging in place relevant for African Americans, Latinos, Asian Americans, Native Americans, and Native Hawaiian/Pacific Islanders: social capital, the impact of the social environment, and acculturation. The characteristics of assisted-living residences or assisted-living facilities vary across the United States.

This chapter presents pertinent historical background on the Children’s Health Fund (CHF) and details on the partnerships allowing the work of the Children’s Health Fund’s Childhood Asthma Initiative (CAI) to go forth, both at the South Bronx Health Center for Children and Families (SBHCCF) and the New York Children’s Health Project (NYCHP). It offers three case studies of asthmatic patients and their parents that highlight the contemporary asthma education challenge. The chapter describes the work of the CAI and our models of interactive community asthma education. It introduces the CAI model for integrating asthma education into the public school literacy and science curriculums, and also presents emergent principles and recommendations for others to follow for creating a comprehensive community-wide health education initiative. The chapter introduces an innovative model of interactive comprehensive community-wide health education focused on increasing asthma awareness via partnerships, community collaborations, and the public school curriculum.

This chapter presents a case for examining aging in the United States through an inter-sectionality lens. It begins by presenting age, gender, and race/ethnicity as social constructions, followed by a conceptual overview of intersectionality to highlight strengths as well as challenges in this approach, particularly as it relates to health. The chapter reviews the most current thinking on gender and minority health, with special attention to social roles and contextual factors, and methodological approaches. The social construction of gender has been widely addressed in the sociological literature, with identified insights for better understanding health and the aging process. Research on gender and physical health outcomes draws much greater scholarly attention than mental health in later life. The intersectionality paradigm has provided new directions for identifying the importance of gender as a key element for predicting health across the life course.

This chapter discusses new policies to counter those that have been destructive to communities, led to the incessant displacement of communities, and effectively created the social context for the emergence of health disparities. The chapter uses interviews and observations collected as part of a study of urban renewal to suggest that these seemingly discrete policies have interacted to create a set of disadvantages that contribute to the spread of AIDS and as well as other health and social problems. It proposes that incessant displacement is at the root of America’s health disparities. The chapter analyzes interviews for comments specific to the policies of segregation, redlining, urban renewal, planned shrinkage/catastrophic disinvestment, gentrification, HOPE VI, and mass incarceration. In addition, the chapter examines the movement of populations over time in the Newark, NJ area using methods from population, community, and ecosystem ecology and quantitative geography.

As diverse student populations gain visibility in colleges and universities across the United States, higher education counselors and student affairs professionals aim to effectively serve and meet the needs of these students. Individuals with disabilities (IWDs) represent one of these previously segregated diverse voices and perspectives that have recently experienced positive developments from inclusive college experiences. College students with disabilities represent an important segment of the growing student population. In 1997, Gill proposed a Disability Identity Integration Model (DIIM) for people with disabilities at the individual and group levels. The DIIM model aims to understand the integration process for people with disabilities into society in a process that involves identity development as part of the disabled minority group. The DIIM offers four types of integration: (a) coming to feel we belong, (b) coming home, (c) coming together, and (d) coming out. This integration process promotes personal empowerment and disability rights.

This chapter describes the unique issues of HIV prevention and treatment in rural areas in the United States. The associated cultural factors can serve as barriers to accessing HIV prevention and treatment services, such as lack of insurance coverage and provider shortages in rural areas. Barriers to receiving health care include provider shortages and inexperience, lack of consistent primary care provider contact despite available Ryan White funds, lack of social support, and stigma. Fear of disclosure, lack of health care and support services, and limited treatment options are barriers to effective prevention and treatment in many rural areas across the country. Rural midwestern communities are characterized by limited access to primary care, self-care education, mental health and family support services, and community educational programs. Online health promotion interventions could be particularly useful for men who have sex with men (MSM) living in rural areas who are at risk for HIV/AIDS.

Perry’s theory of development has had a significant impact on the field of psychology and is essential to understanding the cognitive development of college students. This chapter provides an overview of Perry’s theory and describes the ways in which it still applies to college students on a diverse, pluralistic college campus. The chapter discusses how Perry’s theory continues to apply to the diversified college student population common in modern American institutions of higher education. It outlines the ways in which Perry’s scheme applies to Fatima, the contextual and pluralistic challenges faced at each position, and future development, should Fatima continue to courageously accept responsibility for her moral development and overcome the ambiguities of relativism. The chapter describes utilizing Perry’s scheme as a lens through which to view Fatima’s development, anticipate deflections from growth, and identify strategies and campus and community resources to foster inclusivity, personal exploration, and continued development.

This chapter discusses various factors that influence cognitive aging in racial/ethnic minority groups. It presents evidence regarding the relationships between cognition and self-rated health, cardiovascular disease, hypertension, and mortality. The chapter explains the role of language and bilingualism as it relates to minority cognitive aging. To advance the current knowledge regarding cognitive aging in minorities, appropriate research designs are vitally important. Cross-group research has generated literature on cognitive aging in racial/ethnic minority groups. The cognitive aging advantages of improved educational quality associated with desegregation appear to have been diminished by negative aspects of the school environment, such as racism experienced by African American students. The inclusion of racial/ethnic minorities in cognitive aging research challenges scientists to use appropriate research designs and broaden research questions by examining within-group variability to better describe the diverse aging population.

This chapter discusses the kind of classroom-based interventions that hold the promise of closing the gap, or reducing academic disparities between low-and high-income students. At the core of interventions is the learn unit–which can be measured as the key component of effective engagement for learning. The chapter discusses the research on learn units and its implications for improving academic outcomes for low-income students. It recommends that teachers present learn units more frequently by modifying their current instructional behaviors, and by using curricula and tactics such as Direct Instruction, Precision Teaching, and response cards, which all increase learn units. The chapter also reviewes components of programs that effectively use learn units to instruct students. It highlights models of schooling that measure learn units and/or academic engagement, including the Comprehensive Application of Behavior Analysis to Schooling, Juniper Gardens Children’s Project, and the Morningside Academy.

Social work is an applied discipline with a long tradition of using the theories and methods of social sciences to enhance practice, policy, and research. In their professional roles, social workers practice work with minority older adults and their families in diverse community-based and institutional settings that encompass social and health services. The conduct of social work practitioners and researchers in working with human populations is guided by the Code of Ethics of the National Association of Social Workers. A more sustained and concerted effort is required to ensure that there is a sufficient supply of gerontologically trained social workers to meet the growing demands of a more aged and diverse society. Social work researchers and practitioners will need to be responsive to the impact of government social spending cuts on the availability and delivery of services to their elderly clients who are most in need.

This chapter explores health disparities impacting people with disabilities, underscoring the need for future global health leaders to embrace the value of pursuing equity in health for all within a movement that also represents the needs of the special population of people with disabilities. It defines the complexity of understanding health disparities for people with disabilities and describes the relationship between disability and health. The chapter explores the access to health care inequities that exist for people with disabilities. It describes the relationship between unemployment and the benefits that are and are not available to people with disabilities such as Social Security, Supplemental Security, Medicare, and Medicaid. The chapter discusses the future research and policy changes that are necessary for improving access to health care for people with disabilities.

Student developmental models that can be used to understand various students in groups and their development include identity models, such as Chickering and Reisser’s model, as well as Levinson’s model; psychosocial models, such as Erikson’s model; intellectual and ethical developmental models, such as Perry’s model; moral developmental models, such as Kohlberg’s model; cognitive models, such as Piaget’s and Vygotsky’s models; and experiential models, such as Kolb’s model. For a broad and universal understanding, these and other student developmental theories are integrated into the group theory. This chapter provides a discussion of group theory in relation to various salient student development theories. It addresses a brief introduction about the need for inclusion and multicultural awareness for students and student groups. The chapter discusses aspects for understanding successful student group development regarding group types, group leader guidelines, group processes, and learning reflection of student groups through a multicultural lens.

This chapter introduces the online multimedia peer education smoking cessation program for Korean youth. It begins with a presentation of the three empirically derived models in which the program is rooted and from which the training curriculum arises. The chapter presents the training outline and program flow-chart/time-line for the overall online multimedia peer-education smoking cessation program. It provides a sample script of the kind deemed desirable for submission within the planned contest, illustrating the links between the curriculum content and what trained peer educators should produce in their scripts to achieve desired effectiveness. The chapter presents an analysis of the script, highlighting how the script reflects the program’s roots in the three evidence-based theories and concludes by offering key ingredients to success of the proposed program. The program reflects contemporary social trends and interests among Korean youth, integrating an interactive Internet intervention, peer-led education, and the use of multimedia.

This chapter provides an overview of recent population estimates, trends, and projections of older adults, with a specific focus on minority populations. It explains aging trends among several specific minority groups and discusses their different profiles in general demographic terms. The chapter focuses on older immigrants from Latin America and Asia, although there are significant streams of immigration from Europe, the Middle East, Africa, and other regions of the world. Minority elders represent the fastest growing segment of the older population in the United States, and as a result, the older adult population is becoming racially and ethnically more diverse. In addition to race and ethnic minority classifications, persons immigrating to the United States may be considered a minority group. The sex ratio among minority elders differs substantially from that of the total population, due to gender imbalances in immigration patterns and variability in the female survivorship advantage across groups.

Health professionals and consumers increasingly rely on various types of health-related data and information to support a broad range of functions ranging from public policy, research, service planning, and delivery through consumption. Informatics, the science of information management in health care, offers applications that can be used to support each of these functions and more. This chapter describes a role for health informatics and information technology (HIIT) in shaping a global research agenda to eliminate health disparities, covering international developments. HIIT can be useful in many ways to address disease burden and disparities. For example, it can support surveillance of disease and health threats, manage services and resource allocations, track service utilization, document epidemiological and etiological relationships in disease processes, facilitate clinical decision making, and organize patient health information.

Students may enter higher education with a strong set of ideals, firm models of career options, and certain confidence in their ultimate direction; however, it is not uncommon for students to begin college unprepared for life after graduation, let alone housing assignments and first semester coursework. This chapter focuses on the difficulties surrounding the major choice, the factors that influence decision making, career theories in student affairs, and campus and community resources available to assist students in gathering important data about their major and career choices. Selecting a college major and making career decisions are not easy, and require self-knowledge, self-examination, and research on what is available in the world of work. Essential to student success is the ability of student affairs professionals to accurately recognize when students are struggling and make an appropriate referral for career counseling, academic support services, or personal counseling.

This chapter reviews the evidence to date from the hypertension (HTN) literature that addresses three major components of the conceptual framework described in the Institute of Medicine (IOM) report as an umbrella to frame the mechanisms for hypertension-related disparities between African Americans and Whites. Relevant patient-related factors in hypertension literature include poorer responsiveness to treatment; poorer rates of adherence to prescribed antihypertensive medications; and patient preferences and beliefs about HTN and its treatment. At provider-level, disparities may result from poor doctor-patient communication in the medical encounter due to a racial/ethnic mismatch between the patient and physician; greater rates of clinical inertia; differential rates of prescribing behavior; and stereotypic beliefs about African American patients due to low levels of cultural competency. Problems at the level of health care system include a lack of access to and quality of health care; and changes in the financing and delivery of health care services.

Scholarship on ethnic minority families and aging has wrestled implicitly or explicitly with the understanding of a theoretical dichotomy not uncommon in the field of sociology as a whole: the role that culture plays as either an epiphenomenon and/or as an integral element of the social structure. Interpretations of that basic structural versus cultural duality may derive from broader ideological perspectives, but they may also reflect a superficial framing of the concept of culture in scholarly analyses of ethnic minority families. This chapter presents a review of ethnographic literature on minority families and aging that is grounded in both racial/ethnic and feminist perspectives. It discusses three major topics that emerged as most salient in recent ethnographic studies: the concepts of familism, family obligations, and filial piety; the role of living arrangements, urban/rural space, and the neighborhood context on family experiences; and intergenerational relations, health, and caregiving.

One of the more comprehensive and enduring theories of psychosocial development was created by Erik Erikson (Erikson, 1968). He developed a map of human psychosocial development that covered the crises and touch points humans experience from birth to death. This chapter provides brief descriptions of each stage of Erikson’s chronologically organized model. Erikson’s model of sequential development implies that incomplete resolution of one developmental crisis may hinder future developmental progress regardless of an individual’s chronological age. Thus, “arrested development” may lead to a variety of concerns, behavioral problems, or adverse events for students, regardless of their ages. Awareness of the role that psychosocial development can play in a student’s maturity level or his or her adherence to rules and expectations can help student affairs professionals recognize and respond to student issues. The chapter outlines the ways in which obstructed development may create challenges for students on campus.

This chapter studies the quality of health and health inequality among racial/ethnic groups as well as across geographic areas of the State of New York, and focuses on income-related health inequality. The chapter generates a continuous measure of health by modeling the five-category self-assessed health (SAH) as an Ordered Probit Model conditioned by several objective determinants including different diseases, behavioral risk factors, and socio-demographic characteristics. It is organized as follows: The estimation procedures-the methods to calculate quality of health; describes income related health inequality and their determinant; documents the data used in the empirical analysis is documented; presents the results; and finally summarizes the conclusions. The chapter uses an ordered response model to transform the order scale variable into a cardinal variable. It offers New York health policy makers certain guidelines to eliminate health disparity in the population.

This chapter attempts to evaluate the expected utility of two approaches to racial disparities, one based on race as a social construct and the other based on race as a proxy for geographic ancestry and genetics. Current social and political discourse favors individual-level and technology-based solutions over extensions of social contract implicit in American politics. The first “ethnic drug”, BiDil, was approved by FDA for treatment of heart failure specifically in African Americans. Birth weight, is the most important determinant of infant mortality differences between Whites and African Americans. The chapter explores “healthy immigrant” hypothesis in a study of birth weight patterns emerging in the generation after women migrated from African or Caribbean countries. It discusses the importance of eliminating racial disparities for reducing white infant mortality. The chapter suggests that a redirection of disparities research will come as part of a more profound change involving the whole society.

This chapter describes how cardiovascular health disparities were addressed via the Chinese-American Healthy Heart Coalition, while distilling principles for effective collaborations that others may follow. It emphasizes the use of a community-wide multipronged integrated approach to providing culturally competent and linguistically appropriate health education and health care services for medically underserved Chinese immigrants, as well as use of an asset-based community development intervention approach focused on increasing social capital. It discusses innovative strategies used by the Healthy Heart Coalition in addressing cardiovascular diseases among Chinese Americans in New York City. In addition, the discussion covers the process involved in capacity building, sustaining and managing a coalition, as well as lessons learned through this collaborative venture. The chapter presents a case study, which illustrates the substantial resources, time, and effort required in forming such partnerships, and discusses strategies that the Healthy Heart Coalition used to counter some of the major challenges.

A number of strategies have been developed to address the problems faced by rural populations in achieving a healthy mental status. Many of these approaches directly counteract some of the barriers to maintaining mental health or receiving mental health services that rural residents face. Two of the most promising approaches are integrated care services and telehealth technologies. Currently, licensure restrictions limit the ability of telehealth to meet the demand for services, and policy advocacy to expand scope of practice to allow for more widespread use of tele-mental health services would help directly address the provider shortages seen in rural settings. By becoming familiar with the unique needs, mental health burdens, and cultural influences of rural populations and combining that knowledge with the latest information on evidence-based approaches to address barriers to care in rural areas, mental health professionals can begin to make a difference in the lives of rural populations.

This chapter identifies how psychological frameworks can be integrated into a cohesive, multigenerational intervention to connect children with their incarcerated parents. It describes scenarios through which televisiting develops resiliency in children. The chapter delineates how geographic, financial, temporal, and intergenerational barriers can be reduced or removed via televisiting. It describes supportive televisiting services as an innovative, psychologist-directed, multidisciplinary program that connects children and teenagers with their incarcerated parents via secure, live, interactive video teleconferencing. The chapter also discusses the seven main pillars that make up the theoretical foundation of the televisiting program: child-focused; the attachment theory; trauma-informed care; resilience and strengths-based perspective; mental health challenges; the developmental, life-span, and intergenerational approach; and yellow flag not red flag policy.

This chapter introduces the theoretical basis for restorative justice (RJ). It assesses the empirical evidence for RJ programs, and explores the challenges and opportunities associated with applying core competencies. The chapter describes competencies of specific interest which include: engaging diversity and difference in practice, and engaging with individuals, families, groups, organizations, and communities. It also discusses skills essential to the success of RJ which include supporting processes that value the experiences of people associated with a crime or harm. The chapter suggests the importance of practical and context-specific knowledge and skills relevant when individuals, families, groups, organizations, and communities find themselves in conflict and require support. Programs that rely upon restorative principles have been used at a variety of points in the criminal justice process. The chapter discusses a practice, a family group conference, which was first developed in New Zealand involving social workers considerably.

This chapter discusses the concepts, underlying principles, benefits, and challenges of using “whole-family” approaches in social work. It articulates the theory and skills associated with family engagement as part of a human rights and social justice framework for social work practice in forensic settings. The chapter describes the ethical imperatives and evidence base supporting the use of family group decision making (FGDM) in regulatory settings. It engages whole families as partners in the use of FGDM in child protection and youth justice. The chapter also describes the theory, empirical support, and skills in use of FGDM, or family group conferencing (FGC). It concluded with an example of how alert forensic social workers must be to the potential for their best intentions to collide with the tenants of responsive practice and a quote from a child protection social worker who worked closely with the author on a pilot project using FGC.

This chapter presents ways in which forensic social workers respond flexibly, collaboratively, and effectively to situations of domestic violence. It describes ways to engage men who abuse in becoming better fathers and partners. The chapter examines how social workers can foster culturally respectful partnerships with and around families that safeguard all family members. Few services are available for men who abuse to learn how to become responsible parents, and evaluations of these programs are even more limited. Two exceptions are a Canadian program called Caring Dads and a North Carolina program called Strong Fathers. These responsible fatherhood programs seek to raise the men’s awareness of the deleterious impact of children’s exposure to domestic violence and to enhance the men’s skills in communicating and parenting.

This chapter emphasizes the importance of improving health literacy. It describes the incorporation of cultural competence standards in forensic social work practice perspectives. The chapter also explains how to promote engagement of informal support networks in promoting health and well-being among diverse groups. Disadvantaged racial and ethnic minorities in the United States have long been overrepresented in the criminal justice systems. The elimination of health care disparities and ensuring the health care delivery system is responsive to minority groups is a social justice issue. The roles and function of forensic social workers that provide services to persons with these cultural norms can be expanded using a broader ecological framework and the applied social care model to develop intervention strategies and care plans with incarceration persons. Identifying and incorporating culturally appropriate practice approaches are challenging, yet necessary undertakings for forensic social workers.