Seth Hannah

Graduate Student in Sociology

Biographical Note

Seth Hannah, a native of San Bernardino, California, received his B.A. Summa Cum Laude from the University of California, Riverside in 1998 with a joint major in Ethnic Studies and Sociology and a minor in Political Science. After working for two years as a substitute teacher and freelance graphic designer, Seth came to Harvard to start his Ph.D. in Sociology in the year 2000. Seth's academic interests are in the intersection of racial inequality and public policy, with a particular focus on racial and ethnic disparities in health and health care. His dissertation is a study of multiculturalism in the organizational culture of three psychiatric hospitals in the Boston area. Seth holds Doctoral Fellowships with the National Institute of Mental Health (NIMH) at the Department of Social Medicine at Harvard Medical School, and The Multidisciplinary Program in Inequality & Social Policy at the Kennedy School.

10/06/2008

Research Interests

Race and Ethnic Relations, Medical Sociology, Racial and Ethnic Disparities in Health, Race and Politics.

Qualifying Paper Title

Neighborhood Racial Context and White Racial Attitudes

Committee

Lawrence Bobo, William Julius Wilson, Michael Dawson

Abstract

This paper examines how the racial attitudes of Whites vary with the racial composition of their neighborhoods. A large body of research has found that White’s views of Blacks become increasingly negative as the proportion of Black residents in their metropolitan area increases. This finding is usually attributed to the increased political or economic threat posed by large numbers of Blacks. However, few studies have examined whether large Black populations at the neighborhood level inspire similar feelings of threat and lead to more negative attitudes. Using data from the Multi-City Study of Urban Inequality and the 1990 Census, this study finds that Whites who live in neighborhoods with larger numbers of Blacks tend to express lower levels of threat from Blacks, fewer anti-Black stereotypes, and greater support for affirmative action than those residing in less integrated neighborhoods. Further tests reveal that feelings of political and economic threat do not mediate the relationship between racial context and racial attitudes. On the contrary, independent of racial context, political and economic threat are associated with more negative views of Blacks. The findings of this study suggest that while feelings of political and economic threat are important determinants of racial attitudes, they are not concurrently tied to neighborhood racial context.

Prospectus Title

The Organizational Culture of Multiculturalism in Three Psychiatric Hospitals

Committee

Mary-Jo Delvecchio Good, William Julius Wilson, Michele Lamont

Abstract

My dissertation, “The Organizational Culture of Multiculturalism in Three Psychiatric Hospitals,” uses ethnographic observation and over 150 in-depth interviews with patients and staff at three psychiatric hospitals to examine the differing ways that health care institutions deal with growing racial/ethnic/immigrant/class diversity in their patient populations. I compare the ideologies, values, and practices of care in these psychiatric facilities to examine the degree to which they incorporate ideas of race, ethnicity, and culture into way they provide care. I show that each clinic has developed unique styles of care that I refer to as generic, multicultural, and ethnically specific, and that these styles of care greatly impact the way that diverse groups of patients experience care. By ethnographically examining the clinical environment, I reveal that negative racial attitudes and prejudice can impact the quality of doctor-patient interactions and that minority patients are often stigmatized and labeled as “problematic” and “challenging.” These forces combine to produce inferior quality care for minority patients and contribute to disparities in diagnosis and care. On the intervention side, one of the ways health care organizations have sought to improve the quality of care for minority patients is through the advent of “cultural competence” training. However, it is not clear exactly what these programs teach and whether they appropriately and effectively address the problem. By ethnographically examining the clinical environment, I reveal variation in the social construction of cultural competence across professional categories and clinic sites. I identify two broadly distinctive approaches to cultural competence and their weaknesses. Knowledge based approaches stress teaching clinicians about cultural traits of patients that can potentially impact their experience care. These are often crudely misapplied by clinicians and often devolve into stereotypes. Skills based approaches involve building self-awareness, an openness to learn about any cultural differences that may exist, and viewing the patient as an individual rather than an ethnic group member. This reduces cultural competence to the more general phenomena of “patient-centered care” and leads to an over individualized system that overlooks important cultural factors. Furthermore, I find that effort to enact cultural competency often goes against the dominant medical culture, which prioritizes practical information over “soft-skills,” and prioritizes efficiency and productivity. By revealing these problems, I suggest ethnographically informed improvements to the concept of cultural competence that balance these factors and develop a more integrative approach.

Contact

617-432-6793 (Phone)
617-496-5794 (FAX)

Department of Social Medicine 643 Huntington Ave. Boston, MA 02115