It is widely assumed that the use of medical care will lead to improvements in health, yet questions remain about the medical system's contributions to health disparities. In this review, we examine these issues with a specific focus on how health care systems may actually generate or exacerbate health disparities. We review current knowledge about inequality and bias in the health care system, including the epidemiology of such patterns and their underlying mechanisms. Over the past three decades, we observe growth in our knowledge about provider cognitive and psychological processing, including the development of precision measuring tools to analyze provider bias, racial and otherwise. In the same timeframe we observe decreased emphasis on social, interactional, organizational, and structural factors that shape variation in medical treatment. We frame our discussion within a modified social ecological model and discuss tools for moving forward and reinvigorating sociological presence in this important research area.

Members of structurally disadvantaged social groups report more frequent exposure to a variety of negative life events and chronic strains, yet little research has examined whether similar patterns exist for anticipatory stressors, or challenging circumstances that loom as potential threats in the future. This study uses data collected as part of a national survey of college seniors (N = 995) to examine how anticipatory stress regarding economic and residential security, exposure to traumatic events, and experiences of discrimination vary by gender identity, race-ethnicity, sexual orientation, and first-generation college student status. Consistent with stress theory, anticipatory stressors are more commonly reported by members of disadvantaged groups. Notably, variation in anticipatory stressors explains a nontrivial proportion of differences in depressive symptoms found across gender identity and sexual orientation categories. Findings signal the necessity of incorporating anticipatory stressors into research in the stress paradigm to further disentangle the contributions of social stressors to health disparities.

No abstract

Objectives To investigate the relationship between mental health issues and medical career interest among undergraduate premedical students, and to explore whether this association varies by gender. Methods A longitudinal survey of freshman and sophomore premedical students at Indiana University was conducted during the 2015-16 academic year. Survey data were collected from 390 respondents via an online questionnaire (response rate=14%) in September 2015, and 292 of these respondents participated in the follow-up survey in April 2016 (retention rate=75%). Multi-level regression models were used to estimate the associations among depressive symptoms, burnout, and medical career interest. Results Respondents who experienced more depressive symptoms (ß = -.07, z =-2.49, p =.013) and higher levels of burnout (ß = -.50, z =-3.98, p <.001) reported significant reductions in medical career interest over the study period. These associations remained consistent after controlling for socio-demographic characteristics and prior academic achievement. Depressive symptoms were associated with steeper declines in medical career interest among women compared to men (ß = -.09, z =-2.01, p =.045), though the relationship between burnout and medical career interest did not significantly vary by gender. Conclusions Results provide evidence that premeds who experience more depressive symptoms and higher levels of burnout become less interested in entering the medical profession. The negative association between depressive symptoms and medical career interest was even more pronounced among premedical women compared to men. Findings suggest that colleges and universities in the United States should implement programs aimed at safeguarding the mental health of premedical students.

The training of effective instructors and future faculty members is a critical component of doctoral programs in sociology. Many universities and departments have instituted a single course, course sequence, or certification program dedicated to the preparation of future academic faculty. This article evaluates the efficacy of one such program, and asks two questions: (1) What are the most useful aspects of the Preparing Future Faculty (PFF) program? (2) Is participation in the PFF program associated with greater job satisfaction, confidence, or competence? Qualitative data from Indiana University alumni suggest that the program is beneficial for exposing students to pedagogical knowledge, encouraging professionalization, and providing institutionalized support in the form of peer and faculty mentorship. Quantitative data indicate that although PFF participants were not significantly more satisfied or confident than their nonparticipating peers, the PFF program did appear to help to make participants feel more competent in their first jobs.