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• A Research Guide
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40 Social Issues Research Paper Topics

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List of 40 Social Issues Topics for College Students

• Religious gatherings and rituals
• Country-wide strikes and protest
• LGBTQ+ prides
• Worldwide flashmobs
• Social stratification
• Gender discrimination and anti-harassment movements
• The issues of orphanage kids
• Pornography and AI sex dolls
• Sex work or paid rape?
• Virtual reality
• Information overload: the society is overstressed with the amount of data
• Demographic crisis
• Beauty standards
• Social isolation of people with HIV/AIDS
• The fight against animal testing
• Internet safety
• Humanitarian missions
• Fighting racism
• The rights of ethnic minorities and native people
• Internet safety and cybercrimes
• The necessity of the death penalty
• Fighting poverty in the world
• Access to the drinking water in third world countries
• Free education for everyone: shall it be implemented?
• National identity versus globalization
• Women rights and trans people rights
• Obesity as an obstacle in social life. Fatshaming
• Civil rights: shall they be expanded?
• Abuse and neglect in asylums, orphanages, and care homes
• Church and state: shall they remain separate?
• The problem of bigotry in modern society
• Immigration and resocialization of the immigrants
• Sustainable consumption on a worldwide scale
• School violence
• Legalizing drugs: basic rights to choose or a danger to society?
• Social isolation. The hikikomori phenomenon
• Bullying at schools and colleges
• Kids transitioning: shall it be allowed?
• Advertisements: are they becoming too powerful?
• The global impact of the third world countries

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• v.40(1); Jan-Apr 2022

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Social Consequences of the COVID-19 Pandemic. A Systematic Review *

Consecuencias sociales de la pandemia de covid-19. una revisión sistemática, consequências sociais da pandemia de covid-19. uma revisão sistemática, pouya hosseinzadeh.

1 Student Research Committee. Email: [email protected] Urmia Branch, Islamic Azad University, Urmia, Iran , Islamic Azad University, Islamic Azad University, Urmia , Iran, moc.liamg@gh7991m

Mordali Zareipour

2 Assistant Professor. Khoy University of Medical Sciences, Khoy, Iran. Email: [email protected]., Islamic Azad University, Khoy University of Medical Sciences, Khoy , Iran, [email protected]

Esfandyar Baljani

3 Ph.D. Assistant Professor. Email: [email protected] Urmia Branch, Islamic Azad University, Urmia, Iran , Islamic Azad University, Islamic Azad University, Urmia , Iran, moc.liamg@seinajlab

Monireh Rezaee Moradali

4 Ph.D. Professor. Email: [email protected]. Urmia Branch, Islamic Azad University, Urmia, Iran , Islamic Azad University, Islamic Azad University, Urmia , Iran, [email protected]

To provide a systematic review of the social consequences of COVID-19 pandemic.

In the present study, articles indexed in Persian and Latin databases (Web Of Science, Scopus, PubMed, Embase, Google Scholar and Magiran). 43 documents published in the last 3 years in Persian or English language were reviewed. The research steps were performed according to PRISMA writing standard and the quality assessment was done by two researchers independently with Newcastle Ottawa Scale tools for observational studies according to the inclusion criteria.

Measures to break the chain of virus transmission and to control the COVID-19 pandemic have caused major problems in the economic, social, political and psychological spheres and have affected billions of people worldwide. The COVID-19 pandemic crisis has caused widespread unrest in society and unprecedented changes in lifestyle, work and social interactions, and increasing social distance has severely affected human relations.

Conclusion.

The COVID-19 pandemic has social consequences in certain groups can exacerbate their unfavorable situation. Special groups in crisis situations should be given more attention, and clear and precise policies and programs should be developed to support them.

Realizar una revisión sistemática de las consecuencias sociales de la pandemia de COVID-19.

Métodos.

En el presente estudio se revisaron los artículos indexados en bases de datos latinas y persas (Web Of Science, Scopus, PubMed, Embase, Google Scholar y Magiran), luego de lo cual se recuperaron 43 documentos publicados en los últimos 3 años en persa o en inglés. Los pasos de la revisión se realizaron según el protocolo PRISMA y, para reducir el sesgo en la evaluación de la calidad, los artículos seleccionados se evaluaron cualitativamente por dos investigadores de forma independiente con la herramienta de Newcastle Ottawa Scale.

Resultados.

Las medidas para romper la cadena de transmisión del virus y para el control de la pandemia de COVID-19 han causado importantes problemas en las esferas económica, social, política y psicológica y han afectado a miles de millones de personas en el mundo. La crisis por la pandemia ha provocado un malestar generalizado en la sociedad y cambios sin precedentes en el estilo de vida, el trabajo y las interacciones sociales. El aumento de la distancia social ha afectado gravemente las relaciones humanas.

Conclusión.

La pandemia de COVID-19 tiene consecuencias sociales que pueden agravar la situación desfavorable de grupos vulnerables. Se debe brindar más atención a los colectivos especiales en situaciones de crisis y desarrollar políticas y programas claros y precisos para apoyarlos.

Realizar uma revisão sistemática das consequências sociais da pandemia de COVID-19.

No presente estudo, os artigos indexados nas bases de dados latinas e persas (Web Of Science, Scopus, PubMed, Embase, Google Scholar e Magiran) foram revisadas, logo se recuperaram 43 documentos publicados nos últimos 3 anos em persa ou em inglês. Os passos da revisão se realizaram segundo o protocolo PRISMA e, para reduzir o viés na avaliação da qualidade, os artigos selecionados foram avaliados qualitativamente por dois investigadores de forma independente com a ferramenta de Newcastle Ottawa Scale.

As medidas para romper a cadeia de transmissão do vírus e para o controle da pandemia de COVID-19 há causado importantes problemas nas esferas económica, social, política e psicológica e há afetado a milhares de pessoas no mundo. A crise pela pandemia de COVID-19 há provocado um mal-estar generalizado na sociedade e câmbios sem precedentes no estilo de vida, no trabalho e nas interações sociais. O aumento da distância social há afetado gravemente às relações humanas.

Conclusão.

A pandemia de COVID-19 tem consequências sociais que podem agravar a situação desfavorável de grupos vulneráveis. Se deve brindar mais atenção aos coletivos especiais nas situações de crise e desenvolver políticas e programas claros e precisos para apoiá-los.

Introduction

In late December 2019, an outbreak of a new viral disease belonging to the coronavirus family was reported in Wuhan, the capital of Hubei, China.( 1 ) The new COVID-19 belongs to the same group of coronaviruses as acute respiratory syndrome (SARS) and Middle East Respiratory Syndrome (MERS), which has caused two outbreaks in recent years.( 2 ) The new virus is mainly transmitted by respiratory droplets and contact( 3 ) and affects all age groups.( 4 ) On December, 2021, due to the rapid spread of the virus and the increase in infections, followed by alarming death tolls from the disease was declared an epidemic by the World Health Organization.( 5 ) According to the WHO, as of December 6, 2021, 269 559 230 people worldwide have been infected and 530 5337 people have died from the virus. Also in Iran, as of December 6 in 2021, 6 137 821 people have been infected and 130 277 people have died due to this virus.( 6 , 7 )

The COVID-19 pandemics crisis has caused great unrest in society and unprecedented changes in lifestyle, work and social interactions.( 8 ) The implementation of policies such as social distancing and the closure of gathering and interaction centers such as parks, cafes, shrines, schools, universities, etc., has had certain social consequences.( 9 ) Prolonged stay at home, in a society with a patriarchal lifestyle, will increase the pressure for women to do housework. The economic and psychological dimensions of COVID-19 also affect family members. The issue of increasing domestic violence, including child abuse, spousal abuse, elder abuse, and disability abuse following the COVID-19 pandemics crisis, is such that the Secretary-General of the United Nations has also expressed concern.( 10 ) The closure of schools and universities will deprive millions of children, teenagers and young people of social educational activities for a long time, after which it may not be easy to compensate.( 11 , 12 ) Travel restrictions by different countries have reduced social relations in external areas and led to the isolation of individuals. Because COVID-19 affects all aspects of human life, it has increased divorce and reduced marriage in many countries.( 13 ) In couples' lives, we have witnessed a decrease in marital relationships due to fear of contracting or transmitting the disease.( 14 ) COVID-19 has also challenged and damaged public transport.( 15 , 16 )

The COVID-19 greatly affects people's lives. Everyone in the world directly or indirectly faces the severe consequences of this disease. Due to severe isolation and cessation of some social affairs, this disease causes problems such as social anxiety, panic due to insecurity, economic recession and severe psychological stress, which requires coordinated efforts to prevent and control them, and people should follow the advice and the suggestions of government officials and the World Health Organization to make the necessary and at the same time contrary to the internal desire in their daily plan.( 17 ) Given that previous studies have evaluated the psychological and social consequences of other respiratory illnesses; few studies have been performed to evaluate the results of the current epidemic of COVID-19. Therefore, this review study will be conducted with the aim of estimating the social consequences of COVID-19 in order to identify them and take the necessary preventive measures to reduce the problems caused by these consequences. The present study sought to answer the following question: What are the social consequences of COVID-19 disease?

Search strategy. All stages of this research were performed based on the writing standard of systematic studies, PRISMA meta-analysis. The study population in this study included articles on the social consequences of COVID-19 that were indexed on one of the Internet sites. The Web of Science, Scopus, PubMed, Embase, and Magiran databases were searched as international databases, and the Google Scholar search engine was searched in Persian and English between 2000 and 2020. To find related articles in Persian and English language databases, the words searched in line with the research topic and based on mesh and syntax were the following items that were combined using AND and OR operators. The searching strategy used in Medline was: “(COVID-19[tiab] OR Coronavirus[tiab] OR Coronaviruses[tiab] OR Deltacoronavirus[tiab] OR Deltacoronaviruses[tiab] OR “Munia coronavirus HKU13”[tiab] OR “Coronavirus HKU15”[tiab] OR (Coronavirus[tiab] AND Rabbit[tiab]) OR “Rabbit Coronavirus*” [tiab] OR (Coronaviruses[tiab] AND Rabbit[tiab]) OR “Bulbul coronavirus HKU11”[tiab] OR “Thrush coronavirus HKU12”[tiab] OR (“Coronavirus 229E”[tiab] AND Human[tiab]) OR (“Coronavirus NL63”[tiab] AND Human[tiab]) OR “Middle East Respiratory Syndrome Coronavirus”[tiab] OR “SARS Virus”[tiab]) AND (“Social Behavior”[tiab] OR (Behavior[tiab] AND Social[tiab]) OR (Behaviors[tiab] AND Social[tiab]) OR “Social Behaviors”[tiab] OR “Competitive Behavior”[tiab] OR “Cooperative Behavior”[tiab] OR Self-Control[tiab] OR “Social Adjustment”[tiab] OR “Social Distance”[tiab] OR “Social Isolation”[tiab] OR “Social Skills”[tiab] OR “Social Stigma”[tiab] OR (Psychology[tiab] AND Social[tiab]))”.

Selection of studies. In total, in this study, systematic review with the above keywords was initially studied in 912 articles and reports, protocols by reputable health organizations and considering the entry and exit criteria of articles in the relevant databases. After studying the titles and abstracts of articles by the authors of the article and removing similar and unrelated items, the relevant items were selected as research. Due to the widespread and increasing prevalence of the disease and the change in the statistics related to the prevalence, the statistics presented in this study are until July 23, 2020. Criteria for selecting articles are: (i) Descriptive, analytical, interventional and review articles related to the last 5 years; (ii) Persian and English language articles published in scientific research journals inside and outside the country, the full text of which was available; and, (iii) Articles related to the study of the social consequences of COVID-19.

Criteria for deleting articles were: articles that did not have a full text, articles that did not have a clear implementation method, and articles that focused solely on the social consequences of the disease. To review the articles obtained in the search of databases, were evaluated and evaluated according to the inclusion and exit criteria in the working method, four research colleagues participated. After reviewing the inclusion and exclusion criteria of the study, 43 articles and 4 protocols and reports in accordance with the above criteria entered the final quality assessment stage ( Figure 1 ).

Quality control. The quality of the papers selected by the two individuals was assessed independently using the Newcastle Ottawa Scale (NOS). This scale examines articles in terms of selection process (including four sections: sample expediency and sample size, non-response and measurement tools, comparability (control of confounders and influencing factors) and results (evaluation of results and statistical tests). Based on this scale, articles are rated from zero (weakest study) to 10 (strongest study). In this study, studies that scored above 4 were considered as quality studies. Therefore, according to the quality results of the reviewed articles, all articles selected at this stage had a score higher than 4 (optimal level).

Extracting the data: After evaluating the quality, to extract data from the text of articles eligible to enter to the study of two researchers independently by the researcher form, information about each article by name of authors, year of publication, type of research, place of research, Sample size and specificity of samples, standardization of research tools, main findings were extracted. In case of need for review and doubt in the method of reviewing articles, the help of a third researcher was sought ( Table 1 ).

In late 2019, the world faced a global crisis called COVID-19, which was a threatening epidemic. In addition to increasing the incidence and mortality of this epidemic, it caused significant other economic, social, political, and psychological problems. Social isolation by quarantining billions of people at home to disrupt the virus transmission chain has created many crises in various dimensions,( 18 ) here are some of them:

Scope of knowledge and education. COVID-19 has disrupted students' lives in different ways and it has provided anxious times for students and parents.( 19 ) According to UNESCO, more than 1.5 billion students in about 165 countries have been affected by the restrictions on schools and universities. As a result, schools, colleges and universities were forced to turn to online learning. This has caused students to continue their education at home.( 20 ) Closing schools and accepting distance education may negatively affect students' learning through four main channels: spending less time learning, stress symptoms, changes in how students interact, and lack of motivation to learn. Most formal child learning takes place in schools, and closing schools and moving to a distance learning environment may cause children to spend less time learning.( 21 ) Students who stay home because of COVID-19 are more likely to develop acute stress, maladaptation, and PTSD. The possibility of dropping out of school due to mental health problems also increases.( 22 ) Attendance at schools increases the interaction between students and teachers and strengthens social skills and increases self-esteem and other skills necessary for the social environment. However, due to quarantine proceedings and the closure of schools, these social interactions have decreased.( 21 ) Also, some teachers or students are not familiar enough with the world of the Internet and distance education, and this has disrupted the educational process. On the other hand, due to the lack of access to online education tools for all students such as phones or laptops or the lack of Internet access in less developed areas, problems in distance education have been created for them.( 23 )

Family scope. With the announcement of the epidemic of COVID-19 and the application of various restrictions in the community, some jobs were closed, which increased the financial and economic burden on the family and increased the couple's dissatisfaction, as well as disputes and even divorce. Also, due to the constraints and economic problems caused by COVID-19, weddings and bonds between people have decreased.( 24 , 25 ) With the closure of schools and the presence of students in homes and the closure of businesses due to social constraints, it has increased psychological problems in families, abuse and violence between family members.( 26 ) This has a very important impact on people's lifestyle, the short-term consequences of which can be seen in health. These restrictions have led to decreased physical activity, weight gain, changes in diet, changes in smoking and alcohol consumption habits, changes in lifestyle, and ultimately quality of life and well-being.( 27 , 28 ) Also, different degrees of quarantine measures have reduced people's access to healthy food, inequality between communities, increased anxiety and stress, and impaired sleep quality. Some people also used drugs and alcohol to alleviate the fear and anxiety of COVID-19.( 29 )

Judicial scope. By imposing social distancing and various restrictions, individuals may resist these commands. The increasing burden of social distance in daily life has led to violence, bad temper, conflict, theft, murder, suicide, sabotage, and disregard for the law.( 30 ) Social distance at the court level has also disrupted the proceedings and the presence of parties and witnesses in court.( 31 ) The sale of illicit drugs, the distribution and consumption of drugs and alcohol, cybercrime, as well as the sale and purchase of firearms are among the crimes that are on the rise during COVID-19.( 32 ) The outbreak of COVID-19 and the need for social isolation have also hampered the normal process of prisons. The temporary release of many prisoners in some countries has caused anxiety at the community level, and due to the lack of adequate space for solitary confinement, the possibility of increasing the incidence of COVID-19 among prisoners has become even more significant. Also, in some countries, the possibility of COVID-19 disease is higher among prisoners due to lack of adequate hygiene.( 33 )

Sexual scope. Anxiety about the state of the world, along with constant exposure to images of illness and death, has severely affected everyone's emotional stability. Daily turmoil, restriction of freedom and loss of sense of usefulness in society create a feeling of helplessness and overload in human beings. This has also affected the sexual sphere. Fear of these conditions has reduced physical contact in couples from simple kissing to full sexual intercourse and has weakened the bond between husband and wife.( 34 ) Further depression and anxiety can reduce the level of sexual desire. With the closure of schools and the constant presence of children at home, sexual relations between individuals have also been overshadowed.( 35 ) With the restrictions imposed, the tendency to have sex online has increased. Fear of infection has led single people to masturbate, have sex on the phone, and use of sexual means, which in turn has increased their desire for pornography and visits to pornographic sites and movies.( 22 , 36 )

Scope of transportation. Restrictions imposed by the government have halted public transport, restricted travel and activities abroad. The change of direction to personal transportation by individuals has intensified traffic on the roads and reduced the overall air quality in the urban environment. With the application of social distance, we are witnessing an increase in queues at bus and metro stations.( 37 , 38 ) Air travel has also decreased significantly. COVID-19 has also led to the closure of many transportation agencies around the world due to a sharp drop in demand and a heavy economic burden on the people and the government. Violations and accidents on the road and in the city have also increased due to the use of private vehicles by the people.( 16 )

Cyberspace scope. This epidemic has played an important role in disseminating information in a news cycle.( 39 ) The COVID-19 epidemic has not only posed significant challenges to the health care system worldwide, but has also played an important role in increasing rumors, deception and misinformation about the disease, its consequences, prevention and treatment. With so much news coming from different sources, there are many concerns about fake news. People are constantly following the news of COVID-19 and may experience high anxiety while doing things.( 40 ) Comprehensive media exposure during the 24-hour news cycle can also lead the viewer to inaccurate and threatening information. These stress reactions may also have long-term consequences for physical and mental health.( 41 ) It may even reduce the function of the immune system and upset the balance of their natural physiological mechanisms.( 42 )

The social effects of the changes resulting from the COVID-19 pandemic crisis are not yet well known. We know that due to the implementation of social distance policy, many of the usual activities of society in the economic, social and political spheres have been closed or suspended.( 43 ) As a result, many people in areas such as business, family relationships, and education have experienced the changes and effects of this policy. Many sectors were forced to adjust their workforce and increase the number of unemployed to reduce costs.( 44 ) The heavy economic burden and unemployment caused by the COVID-19 epidemic have caused anxiety thoughts, anxiety, and ultimately an increase in crimes such as theft, strife, domestic disputes, fraud, and etc. To prevent such crimes, the government can adopt policies that can include livelihood support, management and organization of Internet businesses, and low-interest lending.( 45 ) In the policy of social distancing, the situation of certain social groups such as immigrants, refugees and addicts has been ignored and the problems of this group of people have intensified.( 46 ) Civil society and voluntary groups of people are full of initiatives, innovations and resources that can be used in times of crisis. Internet infrastructures and modern communication tools have transcended the physical limitations of communication and enabled virtual social interactions that can be used to maintain connections.( 47 )

It should be noted that the lack of management and monitoring of the virtual world can impose irreparable damage on society in the long time.( 3 ) Social distancing, despite its problems, has a significant impact on reduction of casualties from the disease and reducing its negative consequences, but ultimately it is the level of public trust in the government that ensures the success of policies and measures. It is necessary to provide more freedom of action for the media to provide accurate, transparent information in this regard. The development of information infrastructure, especially in the less developed regions of the country, must be seriously on the agenda. Necessary requirements for equipping students in need of teaching aids such as tablets.( 11 , 48 ) The need for public transportation in any society is an indisputable need. Therefore, the government should take action to provide the desired service in accordance with social distance.( 49 ) Increasing the number of public vehicles, regular disinfection and the use of social distance labels can revitalize this vital sector and meet the needs of the community and prevent pollution. Also, providing brochures and educational materials in public transportation can help reduce anxiety and increase public literacy.( 16 , 50 )

One must be careful about the social consequences of COVID-19 for certain groups. Ignoring this issue can cause COVID-19 to exacerbate the unfavorable situation of these groups. Groups such as addicts in crisis situations should be given more attention and clear and precise policies and programs should be developed to support this group. Immigrants and refugees also have their own circumstances, and their fate in the context of the COVID-19 pandemic crisis cannot be ignored. Doing all of the above means that a small part of the social issues created by the COVID-19 pandemic crisis require capacities of trust, cross-sectoral cooperation, coordination, transparency and joint action. Capacities that many of them may not have looked good under normal circumstances.( 51 , 52 )

Limitations of the study: In this study, due to the lack of proficiency of researchers in languages other than English and Persian, articles in other languages were excluded from the study, which can be a limitation of the study.

Conclusion: In this review study, the effect of coronavirus on some aspects of people's lives was briefly discussed. Unfortunately, in the current epidemic and control of the corona virus, while becoming a crisis of health in the world, it is considered as such that it still has various aspects. In recent months, the world has been going through one of the most severe crises in the field of health and without a doubt one of the most important consequences of its epidemic and social ills. In fact, anxiety factors related to the risk of contracting the disease, future employment status, and sources of income for individuals and families, as well as long-term quarantine, can be kept at home for a long time.

Implications of the results for nursing practice. Considering the psychological consequences of the COVID-19 outbreak, the design and planning of intervention and supportive strategies to reduce the negative effects are suggested. In fact, it is necessary to identify the factors that cause the danger to the psychological health of different people in the society in order to use appropriate treatment methods.

* How to cite this article : Hosseinzadeh P, Zareipour M, Baljani E, Rezaee Moradali M. Social Consequences of the COVID-19 Pandemic: A Systematic Review. Invest. Educ. Enferm. 2022; 40(1):e10.

300 Social Issues Research Topics to Impress Your Professor and Get A

Researching social issues holds immense importance in our quest for knowledge and progress. It allows us to delve deeper into the complexities of society, unraveling the underlying causes, impacts, and potential solutions. However, the significance of a good research topic must be considered, which sets the stage for a high-scoring and impactful research endeavor. If you have difficulty finding a good social issue research topic, check out these lists from the experts working with a professional  paper writing services  provider.

Table of Contents

Comprehensive list of Unique Social Issue Research Topics

Scroll down and go through our list of unique topics and pick one that sparks your interest. Here you go with the first one: 

Women’s Social Issues Research Topics 

It’s crucial to look into the various aspects of women’s social issues if we want to get a better understanding of gender inequality. Here are some ideas to help you dig deeper into this topic.

• Prejudice against women in corporate culture
• Problems of pregnant women working in the corporate
• Harassment in educational institutes against women
• What strategies can governments adopt to ensure equal rights for women?
• Raising awareness of the problems of pregnant women
• How to develop a respectful attitude towards women and gender minorities in companies?
• Ill-treatment of women in the government sector
• Writing on essay topics related to problems with Syrian female immigrants
• The Role of Women in economic life and the World of Work
• Women’s political and electoral training
• Women in old homes: Research and Interviews for Problems and Concerns
• Toxic Masculinity in the Workplace: what can women do?
• Developing a workplace culture for fair treatment of every gender
• Role of Government in solving problems related to Women
• The economy of the United States: Income inequality in the U.S.
• Building a world where women have equal opportunities and fair treatment
• Essay Topics Related to Problems of Women in New York
• Financial problems for single mothers
• Women dealing with social issues in New Mexico
• Condition of Mexican immigrant women in the United States
• Women’s health: Key performance indicators, problems and obstacles
• Securing Women’s Rights with the Help of international law
• Education of women: The rights and responsibilities
• Better living conditions for older women
• A research study of the problems of pregnant women in California
• Health and welfare of older people, especially women
• Improving the quality of life for single mothers with better opportunities

Children’s Social Issues Research Topics 

It’s important to tackle the social issues that affect kids to create a better, more nurturing future for the next generation. Here are some interesting topics on this subject to get started with  writing your research paper . 

• School Bullying and social networks
• Problems and issues with children with a single parent
• A research study on the problems of children in foster homes
• How can we make foster care better and safer for children?
• Delinquency trends in children among marginalized communities
• modernity and technology at the cost of the destruction of childhood
• Issues that children from Mexican households in America have to face
• What are the advantages of multiculturalism in kindergarten?
• Problems of Assault and Molestation of Children
• Why Are Young People Committing Crimes These Days?
• Cyberbullying and Toxicity on social media
• Violence among children and young people
• Rehabilitation of juvenile offenders and improving their lives
• Illness and disability among kids living in developing countries
• The lack of tolerance among the teenagers
• Child labor in developing countries
• Psychology of kindergarten education
• School is a chance for every kid to learn tolerance and harmony
• Children facing with lack of empathy and bullying on social media
• The use of new technologies in education and adaptability in children
• Problems of immigrant children
• Child development and behavior

Social Issues Research Topics About Labor Rights

It’s essential to look into the social issues surrounding workers’ rights and fight for their well-being. Labor rights are the foundation of having fair and decent working conditions. Here are some topics if you want to research such subjects.

• The legal responsibility of entrepreneurs
• Workplace accident management
• Increased flexibility via remote working options
• Mental health problems caused by workers after the COVID pandemic
• The principle of equality today is related to labor rights
• Change wages or salaries
• Labor problems caused by the Covid pandemic
• Employees having to deal with additional work pressures
• Role of labor unions in social justice for Laborers
• Mental health problems in the Workplace
• What can we do to offer ideas for improvements in labor laws
• The desire to maintain a healthy work-life balance
• Hate speech and domestic violence against marginalized groups in large companies
• Academic paper for immigration disruptions in Canada and USA
• The employer’s right to manage employees and the abuse of it
• Role of human resources in identifying and solving problems of labor
• The job of the government and schools is to offer their members better career prospects
• Problems and issues related to a minimum period of employment
• The technology skills gap leads to problems with the laborers
• Improving the well-being of the company for its members
• Change wages or salaries impact and consequences
• How the global pandemic and Working from home changed the World
• Recruiting methods from passive to active: how to prepare
• Global labor shortages: problems and consequences
• What are the reasons for the labor shortage?
• Writing assignment about laborers dealing with the effects of long Covid
• Why is it essential for companies to take a public stand for social issues
• Mental health problems for workers in the field
• Relevant examples of social issues related to labor and employment
• How to empower workers against social injustice?

Social Issues Research Topics for the Environment

It’s important to dig into how social issues and the environment are connected when we’re trying to handle big problems like climate change, running out of resources, etc. Here are some  research topics  to think about.

• Health risks associated with the general environment and their perception and representation
• Climate change knowledge and expertise on health risks
• Health inequalities resulting from environmental and social factors
• What Role can environmental law play in protecting the environment at sea?
• Deforestation and chronic pollution are destroying biodiversity
• Importance of green energy conversion
• The Law of the Environment and sustainable development
• The Management of Pollution in Environmental Law
• Toward a better understanding of atmospheric pollution
• Utilizing environmental technologies and learning about them
• Waste and material resources of the World
• The destruction of ozone affects the environment and health
• Nature’s resources are being destroyed. What can we do as researchers to prevent this?
• Is it still imperative to preserve the environment during wartime?
• Combating armed conflict while preserving the environment
• The tourism industry and pollution management
• Environmental factors that affect cancer risk
• Cost-benefit analysis of the action based on legal or socioeconomic criteria
• Analyzing how different environmental factors contribute to the risk
• Investigating a variety of environmental issues and sectors
• Regions and specific areas of environmental perception
• The effects of climate change and global warming
• Factors contributing to a healthy environment
• The relationship between human rights and environmental law
• In environmental law, pollution management is a constant
• Worldwide implementation of sustainable development
• How consumption trends and international news can help the environmental cause

Social Issues Research Topics Related to Covid Pandemic

The Covid-19 pandemic has changed how we live and has spotlighted all kinds of social issues that need to be looked into and solved. So, if you would like to research social issues related to the recent pandemic, check out this list for current social issues for research paper:

• Social panic caused after the COVID-19 breakdown
• Problems and social issues caused by the COVID-19 pandemic
• COVID-19 and financial problems on the rise
• Impact of COVID-19 on the people with middle class
• Police Procedure and criminal justice during the COVID-19
• The aftermath of COVID-19 has resulted in a social dilemma and economic disruption
• An influential aspect of the pandemic is mental health
• The Impact of social and territorial inequalities on health
• The ethical issues raised by the pandemic
• Writing research papers on social media’s Role during COVID-19
• Children and adolescents’ mental condition during the pandemic
• Problems in healthcare and Management of chronic diseases
• Disruption in modern society by the COVID-19
• How our social media accounts helped us during the darkest hours of covid
• Ensuring the delivery of criminal justice during covid
• Impact of COVID-19 on family life
• Role of the Pandemic in the Promotion of remote education
• Avoiding social media addiction during the quarantine

Social Issue Topics Related to American Society

Checking out the social problems in the U.S. gives us a great understanding of how complicated, varied and hard they can be for people and different communities. Here is another list of topics on social issues. 

• Environment perception in specific areas and regions
• Climate change and global warming effects
• The factors that contribute to a healthy environment
• Cancer risk factors in the environment
• Workplace toxic masculinity: what can women do?
• The global labor shortage: problems and consequences
• Why does the U.S. have a shortage of labor?
• Workers dealing with the effects of Covid
• Problems related to mental issues among field workers
• Law and human rights concerning the environment
• Management of pollution is a constant concern in environmental law
• Impacts and consequences of changes in wages or salaries
• How to prepare for passive to active recruitment
• The problem of child labor in developing countries
• Kindergarten Education and Psychology
• Tolerance and harmony can be learned in school by every child
• Lack of empathy and bullying on social media among children
• Technology in Education and Children’s Adaptability
• Legal or socioeconomic cost-benefit analysis of the action
• A major social issue in the modern age is poverty
• Government’s Role in solving social problems
• Sustainable Development of the World
• Trafficking in drugs and Mexican cartels
• A culture of fair treatment for all genders in the Workplace
• Nature’s resources are being depleted.
• Management of pollution in the tourism industry
• How can we use social media to improve society and resolve social problems?
• A lack of respect for marginalized communities in the professional environment can be seen in several ways.
• Understanding social issues and the problems associated with them
• Materials and waste from around the World and the Impact they have on the environment
• The depletion of ozone is detrimental to the environment and human health
• Insights into the political and electoral training of women
• Taking a closer look at Women’s Problems and Concerns in old homes: Research and Interviews
• Issues and problems related to the minimum period of employment and the minimum wage
• The technological skills gap is causing labor shortages shortly
• Enhancing the well-being of the members of the company as a whole

Interesting Social Injustice Topics for College Students

As college students, exploring and engaging with interesting social issues topics expands our intellectual horizons and empowers us to become agents of change in our communities and beyond. Particularly when you include social problems examples. Here is another list of interesting topics.

• Developing better relationships with public institutions to solve problems
• The Role of social work in the Management of health problems
• Corporations discriminate against marginalized communities in the U.S.
• Sociology of the popular classes
• The reasons for the low human development index in African countries
• Social issues caused by class differences
• Drugs and anarchist behaviors
• Religious Differences and biased approaches to employment strategies
• Mexican cartels and the problem of drug trafficking
• Poverty is one of the most significant social issues in the Modern World
• Role of the Government in solving social issues
• How can we use social media to improve society and solve social issues?
• Prejudice against marginalized communities in the professional environment
• Understanding the problems related to social issues
• Role of problem-solving and understanding the root cause of social issues
• Major social issues in developing countries
• Role of Education in ending violence in Society
• Class Differences and the Impact on the human development index
• Differences in health facilities for different classes
• Social Norms and the Role of the Community
• Causes and solutions to human trafficking on the Mexican borders
• Human development index in India
• How to solve the poverty problem?
• What is the problem of social media bullying, and how to avoid it?
• How does financial illiteracy lead to a lack of development in developing countries?
• Impact of Terrorism on Society
• How to solve the terrorism problem?
• Mafia problems in the USA and how to deal with them
• Biased treatment of marginalized communities in the government sector
• The increasing problem of drug addiction
• Ethics and Artificial Intelligence: Emerging social issues
• Role of social media in increasing social issues

Police and Social Justice Research Papers Topics

Let’s unveil a curated collection of current social issues for a research paper. Here’s the list:

• Children’s safety and protection: The security job is of the utmost importance
• School bullying is a serious issue that needs to be addressed
• A few heartrending social issues examples 
• Using the Internet to disseminate terrorist content: a serious issue related to Cybersecurity
• Digital Platform Security Certification – A Guide to Cybersecurity Certifications
• The protection of minors in alcohol-serving establishments
• Concerns regarding cyber security in the United States
• An analysis of the spatial pattern of terrorism in the USA over the past two decades
• New York crime analysis, a look at the crime situation in the City
• Security technologies face several obstacles when it comes to their implementation
• Having the versatility to specialize and the specialization to be versatile in security matters
• Investigative requisitions from the judicial police
• Relationships between the police and the public: The need for improvement
• Conflict Management and Prevention in Communities
• The principle of secularism in sports must be respected
• Stopping the illicit trade in tobacco products
• Towns with small populations and cybersecurity
• Taking care of historical monuments
• Providing support to victims of aggression
• An analysis of the roadside check system in developing countries
• The challenges of reception at a police station for public security
• A system for protecting housing from illegal encroachment
• Anti-abuse and anti-fraud measures
• A diversity of expectations and feedback from the inhabitants
• Taking public security work seriously in terms of its relational dimension
• The issue of external assistance in the area of internal security
• Putting social networks to the test in terms of police ethics

As you have reached the conclusion paragraph of the blog post, you must have picked a topic or two to work for your social issue research paper. Most of the lists have focused on social issues today as they could be very interesting for the readers. Plus, there are a plethora of good topics for you to count on. Just remember that a good research subject must be able to answer, what is a social problem, what is a social issue, and more. Still if you are struggling with picking up a good topic, feel free to count on the expertise of  our writers .

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1.4 Doing Research on Social Problems

Learning objectives.

• List the major advantages and disadvantages of surveys, observational studies, and experiments.
• Explain why scholars who study social problems often rely on existing data.

Sound research is an essential tool for understanding the sources, dynamics, and consequences of social problems and possible solutions to them. This section briefly describes the major ways in which sociologists gather information about social problems. Table 1.2 “Major Sociological Research Methods” summarizes the advantages and disadvantages of each method.

Table 1.2 Major Sociological Research Methods

The survey is the most common method by which sociologists gather their data. The Gallup poll is perhaps the most well-known example of a survey and, like all surveys, gathers its data with the help of a questionnaire that is given to a group of respondents . The Gallup poll is an example of a survey conducted by a private organization, but sociologists do their own surveys, as does the government and many organizations in addition to Gallup. Many surveys are administered to respondents who are randomly chosen and thus constitute a random sample . In a random sample, everyone in the population (whether it be the whole US population or just the population of a state or city, all the college students in a state or city or all the students at just one college, etc.) has the same chance of being included in the survey. The beauty of a random sample is that it allows us to generalize the results of the sample to the population from which the sample comes. This means that we can be fairly sure of the behavior and attitudes of the whole US population by knowing the behavior and attitudes of just four hundred people randomly chosen from that population.

Some surveys are face-to-face surveys, in which interviewers meet with respondents to ask them questions. This type of survey can yield much information, because interviewers typically will spend at least an hour asking their questions, and a high response rate (the percentage of all people in the sample who agree to be interviewed), which is important to be able to generalize the survey’s results to the entire population. On the downside, this type of survey can be very expensive and time consuming to conduct.

Surveys are very useful for gathering various kinds of information relevant to social problems. Advances in technology have made telephone surveys involving random-digit dialing perhaps the most popular way of conducting a survey.

plantronicsgermany – Encore520 call center man standing – CC BY-ND 2.0.

Because of these drawbacks, sociologists and other researchers have turned to telephone surveys. Most Gallup polls are conducted over the telephone. Computers do random-digit dialing, which results in a random sample of all telephone numbers being selected. Although the response rate and the number of questions asked are both lower than in face-to-face surveys (people can just hang up the phone at the outset or let their answering machine take the call), the ease and low expense of telephone surveys are making them increasingly popular. Surveys done over the Internet are also becoming more popular, as they can reach many people at very low expense. A major problem with web surveys is that their results cannot necessarily be generalized to the entire population because not everyone has access to the Internet.

Surveys are used in the study of social problems to gather information about the behavior and attitudes of people regarding one or more problems. For example, many surveys ask people about their use of alcohol, tobacco, and other drugs or about their experiences of being unemployed or in poor health. Many of the chapters in this book will present evidence gathered by surveys carried out by sociologists and other social scientists, various governmental agencies, and private research and public interest firms.

Experiments

Experiments are the primary form of research in the natural and physical sciences, but in the social sciences they are for the most part found only in psychology. Some sociologists still use experiments, however, and they remain a powerful tool of social research.

The major advantage of experiments, whether they are done in the natural and physical sciences or in the social sciences, is that the researcher can be fairly sure of a cause-and-effect relationship because of the way the experiment is set up. Although many different experimental designs exist, the typical experiment consists of an experimental group and a control group , with subjects randomly assigned to either group. The researcher does something to the experimental group that is not done to the control group. If the two groups differ later in some variable, then it is safe to say that the condition to which the experimental group was subjected was responsible for the difference that resulted.

Most experiments take place in the laboratory, which for psychologists may be a room with a one-way mirror, but some experiments occur in the field, or in a natural setting ( field experiments ). In Minneapolis, Minnesota, in the early 1980s, sociologists were involved in a much-discussed field experiment sponsored by the federal government. The researchers wanted to see whether arresting men for domestic violence made it less likely that they would commit such violence again. To test this hypothesis, the researchers had police do one of the following after arriving at the scene of a domestic dispute: They either arrested the suspect, separated him from his wife or partner for several hours, or warned him to stop but did not arrest or separate him. The researchers then determined the percentage of men in each group who committed repeated domestic violence during the next six months and found that those who were arrested had the lowest rate of recidivism, or repeat offending (Sherman & Berk, 1984). This finding led many jurisdictions across the United States to adopt a policy of mandatory arrest for domestic violence suspects. However, replications of the Minneapolis experiment in other cities found that arrest sometimes reduced recidivism for domestic violence but also sometimes increased it, depending on which city was being studied and on certain characteristics of the suspects, including whether they were employed at the time of their arrest (Sherman, 1992).

As the Minneapolis study suggests, perhaps the most important problem with experiments is that their results are not generalizable beyond the specific subjects studied. The subjects in most psychology experiments, for example, are college students, who obviously are not typical of average Americans: They are younger, more educated, and more likely to be middle class. Despite this problem, experiments in psychology and other social sciences have given us very valuable insights into the sources of attitudes and behavior. Scholars of social problems are increasingly using field experiments to study the effectiveness of various policies and programs aimed at addressing social problems. We will examine the results of several such experiments in the chapters ahead.

Observational Studies

Observational research, also called field research , is a staple of sociology. Sociologists have long gone into the field to observe people and social settings, and the result has been many rich descriptions and analyses of behavior in juvenile gangs, bars, urban street corners, and even whole communities.

Observational studies consist of both participant observation and nonparticipant observation . Their names describe how they differ. In participant observation, the researcher is part of the group that she or he is studying, spends time with the group, and might even live with people in the group. Several classical social problems studies of this type exist, many of them involving people in urban neighborhoods (Liebow, 1967; Liebow, 1993; Whyte, 1943). In nonparticipant observation, the researcher observes a group of people but does not otherwise interact with them. If you went to your local shopping mall to observe, say, whether people walking with children looked happier than people without children, you would be engaging in nonparticipant observation.

Similar to experiments, observational studies cannot automatically be generalized to other settings or members of the population. But in many ways they provide a richer account of people’s lives than surveys do, and they remain an important method of research on social problems.

Existing Data

Sometimes sociologists do not gather their own data but instead analyze existing data that someone else has gathered. The US Census Bureau, for example, gathers data on all kinds of areas relevant to the lives of Americans, and many sociologists analyze census data on such social problems as poverty, unemployment, and illness. Sociologists interested in crime and the criminal justice system may analyze data from court records, while medical sociologists often analyze data from patient records at hospitals. Analysis of existing data such as these is called secondary data analysis . Its advantage to sociologists is that someone else has already spent the time and money to gather the data. A disadvantage is that the data set being analyzed may not contain data on all the topics in which a sociologist may be interested or may contain data on topics that are not measured in ways the sociologist might prefer.

The Scientific Method and Objectivity

This section began by stressing the need for sound research in the study of social problems. But what are the elements of sound research? At a minimum, such research should follow the rules of the scientific method . As you probably learned in high school and/or college science classes, these rules—formulating hypotheses, gathering and testing data, drawing conclusions, and so forth—help guarantee that research yields the most accurate and reliable conclusions possible.

An overriding principle of the scientific method is that research should be conducted as objectively as possible. Researchers are often passionate about their work, but they must take care not to let the findings they expect and even hope to uncover affect how they do their research. This in turn means that they must not conduct their research in a manner that helps achieve the results they expect to find. Such bias can happen unconsciously, and the scientific method helps reduce the potential for this bias as much as possible.

This potential is arguably greater in the social sciences than in the natural and physical sciences. The political views of chemists and physicists typically do not affect how an experiment is performed and how the outcome of the experiment is interpreted. In contrast, researchers in the social sciences, and perhaps particularly in sociology, often have strong feelings about the topics they are studying. Their social and political beliefs may thus influence how they perform their research on these topics and how they interpret the results of this research. Following the scientific method helps reduce this possible influence.

Key Takeaways

• The major types of research on social problems include surveys, experiments, observational studies, and the use of existing data.
• Surveys are the most common method, and the results of surveys of random samples may be generalized to the populations from which the samples come.
• Observation studies and existing data are also common methods in social problems research. Observation studies enable the gathering of rich, detailed information, but their results cannot necessarily be generalized beyond the people studied.
• Research on social problems should follow the scientific method to yield the most accurate and objective conclusions possible.

For Your Review

• Have you ever been a respondent or subject in any type of sociological or psychological research project? If so, how did it feel to be studied?
• Which type of social problems research method sounds most interesting to you? Why?

Liebow, E. (1967). Tally’s corner . Boston, MA: Little, Brown.

Liebow, E. (1993). Tell them who I am: The lives of homeless women . New York, NY: Free Press.

Sherman, L. W., & Berk, R. A. (1984). The specific deterrent effects of arrest for domestic assault. American Sociological Review, 49 , 261–272.

Sherman, L. W. (1992). Policing domestic violence: Experiments and dilemmas . New York, NY: Free Press.

Whyte, W. F. (1943). Street corner society: The social structure of an Italian slum . Chicago, IL: University of Chicago Press.

Social Problems Copyright © 2015 by University of Minnesota is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License , except where otherwise noted.

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100+ Social Issues Research Paper Topics

There are many issues in society to write about, making social issue essay topics some of the most fun. However, choosing a social topic for an essay isn’t as easy as it sounds, especially when there are several social essay topics. The secret to choosing the best among the many social topics is knowing what makes the best social topics for an essay, the best.

This article will give you workable tips for choosing a great topic on specific social issues, argumentative essay topics , and social topics. We will also throw in 100 topics on social issues; they can serve as your social topic or inspiration for choosing.

What Are Top Tips for Choosing Social Topics to Write About?

What characterizes the best social issue topics, social issue topics list, fascinating research topics on social issues, interesting social commentary topics, interesting social issues on social media, ideas of social issues essay topics on health, socially significant topics to write on, social issues research topics for a professional paper on the environment, top-rated socially relevant topics, cool social issues to research on criminal justice, social problem topics for college students, issues in america to write about, argumentative essay topics on social issues, unique social issues to write a research paper on.

When it comes to social problems essay topics, the list is endless; there are so many social issues to talk about. However, not all social problem topics will make a great paper, and the wrong social issue topic can reduce your grade. Below are the top practical tips for choosing social issues topics for presentation.

• Choose easy social issues to write about – avoid trying to impress your professor by choosing complex social problems topics you can’t do justice to.
• Choose social problem topics or social media research topics that your audience can relate to and find interesting.
• When choosing from the myriads of social problems to write about, choose those with sufficient information. Also, you don’t want social problem essay topics you’ll have to walk miles to gather information on.
• Pick as many good social issues to write about as possible; chances are you will change issues essay topics midway. You don’t have to return to searching for current issues to write about.
• Source for articles that address problems in society to write about for an idea on how to write yours.

The “best” social topics, like social commentary essay topics, are those you’re passionate about. It would help if you cared about the social issue ideas you’ve decided to write on to do real justice to the paper. Writing an essay on them will be torture if you don’t care or know anything about social commentary ideas. Also, if your audience is clueless about a particular topic, consider omitting technical and social significance topics.

Interesting social topics are not hard to find if you know where to look. We will give you a social issues topics list here, but you can still find social issues ideas all over the internet. Find our social topics list below containing interesting and uncommon social issues for a distinction-worthy paper.

• Political polarization
• Racism in modern society’s healthcare
• Ageism: the new racism?
• The fairness of labor laws
• Fat-shaming in the corporate world
• Recovering addicts and social injustice
• Child pornography
• Prisoner rights violations: the types
• Making vaccinations mandatory
• Online education impact on obesity
• Increasing employment: the solution to poverty?
• Accessibility of healthcare in mobile clinics
• Women empowerment
• Social development in developing countries
• Overpopulation: a threat?
• How social networks impact friendship
• Age restriction on Instagram
• Social media effect on dependency
• Business Facebook accounts and digital ethics
• Cancel culture and mental health
• Restricting children from social media
• How to stay safe on the internet
• Freedom of speech on Twitter
• High cost of medical procedures
• Obesity in developed countries
• Abortion: legal or illegal?
• Drug addiction
• Hospices: should they be free?
• Why HIV in seniors remains unrecognized
• Dying with dignity
• Pro-life movement origins
• The social acceptance of autism
• Effect of malnourishment on children’s psyche
• Impact of fad diets
• Discrimination against older adults
• Acceptability of homeopathic treatment for children
• The scarcity of and state of available healthcare facilities in rural areas
• Poverty and health problems
• Ensuring global access to drinking water
• Implementing sustainable technology in agriculture
• Benefits of studying the environment
• Urban gardening and food security
• Deteriorating environment effect on labor conditions
• Religion and nature
• Global warming impact on South America
• Effect of racial profiling
• Prevalence of hate speech
• Discrimination against the LGBT community
• Modern feminism: the negative impact on society
• Pregnancy termination: morality vs. legality
• Food culture
• Emotional intelligence: impact on family life
• Harmful effects of financial illiteracy
• The perception of “Defund the police.”
• Evidence of structural racism
• The internet’s influence on human trafficking
• Legalizing prostitution
• Civil disobedience goals
• The consequences of restoring prisoners to society
• Influence of prejudices on criminal justice mechanics
• Prominent civil rights violations in developing countries
• Gender blindness
• Gender dysphoria
• The Khmer Rouge
• Social media and racist bias
• Justification of human rights limitations during a crisis
• How governments can secure freedom of speech
• Can satire be harmful?
• Protection of stateless persons
• Can illegal immigrants be pardoned?
• War on drugs: the negative side effects
• The importance of bipartisan cooperation
• College loans: are they worth it?
• Fake news: a severe problem?
• Charter schools vs. public schools
• The Great New Deal: pros and cons
• Gentrification in America
• Ableism effects in the US
• Death penalty: a just punishment?
• Healthcare: a fundamental human right?
• The right to own a gun
• Does history repeat itself?
• Commercials in kids’ programs
• Fiction vs. nonfiction: which is the better read?
• Video games should be a sport
• Hot dogs: have they caused more harm than good?
• Eating dessert before dinner
• Homework: is it too much?
• Should gym classes be required?
• The essentiality of feminism
• Free healthcare for everyone
• Exploring space: is it worth it?
• Parents’ role in childhood obesity
• Woman vs. man: who is more emotional?
• The effects of campaign finance reform
• Should illegal immigrants be granted residency?

With this list of social topics and others you’ll find on the internet, you can’t be short of social issues to talk about. Choosing the best social issues topics is essential for writing a great research paper,or write dissertation for me ranging from social change topics to social awareness topics. Considering the vast amount of community issues to write about, our tips on choosing from the best social relevance topics will come in handy. If you need professional writing services, you can contact our experts.

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Writing Your Analysis of A Social Problem Paper

Paper Structure

Your paper should be typed, double spaced, with a title and reference section . Cite your sources every time you use them in the paper.

Research papers should have an introduction, a body, and a conclusion :

1. Introduction : summarizes what you will write and puts it into context. Should consist of 3 parts:

• "What You're Studying": start with a thesis statement about your social problem which includes background contextualizing it
• "So What?": demonstrate why your social problem is important and why your reader should care about it
• "Game Plan": outline the main points of your paper and the order in which you will address them

2. Body : presents the main points of the paper, with each paragraph representing one aspect of the paper's main focus. Prioritize and organize your main points and paragraphs to logically build your arguments to a compelling conclusion. Each paragraph should include a topic sentence, evidence, analysis, and a transition sentence:

• The topic sentence summarizes the paragraph's main idea
• Use evidence from your research sources to support or make the argument for your assertions about your main idea
• Analyze your evidence to show how it links to your broader thesis
• Include a transition sentence at the end of each paragraph to connect what you discussed in that paragraph with the main idea of the next paragraph

3. Conclusion : summarizes what you wrote and what you learned

• Restate your thesis from the introduction in different words
• Briefly summarize your main points or arguments and pull them together into the paper's main thesis
• End with a strong, final statement that ties the whole paper together and makes it clear the paper has come to an end
• No new ideas should be introduced in the conclusion, it should only review and analyze the main points from the body of the paper (with the exception of suggestions for further research)

4.  References list : a list of the sources you cited 

• Cite your sources in APA or ASA Style
• Format your References list in APA or ASA Style

For more writing help, contact  the Writing Center   and  make an online appointment  to meet with one of their consultants.

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A research problem is a definite or clear expression [statement] about an area of concern, a condition to be improved upon, a difficulty to be eliminated, or a troubling question that exists in scholarly literature, in theory, or within existing practice that points to a need for meaningful understanding and deliberate investigation. A research problem does not state how to do something, offer a vague or broad proposition, or present a value question. In the social and behavioral sciences, studies are most often framed around examining a problem that needs to be understood and resolved in order to improve society and the human condition.

Bryman, Alan. “The Research Question in Social Research: What is its Role?” International Journal of Social Research Methodology 10 (2007): 5-20; Guba, Egon G., and Yvonna S. Lincoln. “Competing Paradigms in Qualitative Research.” In Handbook of Qualitative Research . Norman K. Denzin and Yvonna S. Lincoln, editors. (Thousand Oaks, CA: Sage, 1994), pp. 105-117; Pardede, Parlindungan. “Identifying and Formulating the Research Problem." Research in ELT: Module 4 (October 2018): 1-13; Li, Yanmei, and Sumei Zhang. "Identifying the Research Problem." In Applied Research Methods in Urban and Regional Planning . (Cham, Switzerland: Springer International Publishing, 2022), pp. 13-21.

Importance of...

The purpose of a problem statement is to:

• Introduce the reader to the importance of the topic being studied . The reader is oriented to the significance of the study.
• Anchors the research questions, hypotheses, or assumptions to follow . It offers a concise statement about the purpose of your paper.
• Place the topic into a particular context that defines the parameters of what is to be investigated.
• Provide the framework for reporting the results and indicates what is probably necessary to conduct the study and explain how the findings will present this information.

In the social sciences, the research problem establishes the means by which you must answer the "So What?" question. This declarative question refers to a research problem surviving the relevancy test [the quality of a measurement procedure that provides repeatability and accuracy]. Note that answering the "So What?" question requires a commitment on your part to not only show that you have reviewed the literature, but that you have thoroughly considered the significance of the research problem and its implications applied to creating new knowledge and understanding or informing practice.

To survive the "So What" question, problem statements should possess the following attributes:

• Clarity and precision [a well-written statement does not make sweeping generalizations and irresponsible pronouncements; it also does include unspecific determinates like "very" or "giant"],
• Demonstrate a researchable topic or issue [i.e., feasibility of conducting the study is based upon access to information that can be effectively acquired, gathered, interpreted, synthesized, and understood],
• Identification of what would be studied, while avoiding the use of value-laden words and terms,
• Identification of an overarching question or small set of questions accompanied by key factors or variables,
• Identification of key concepts and terms,
• Articulation of the study's conceptual boundaries or parameters or limitations,
• Some generalizability in regards to applicability and bringing results into general use,
• Conveyance of the study's importance, benefits, and justification [i.e., regardless of the type of research, it is important to demonstrate that the research is not trivial],
• Does not have unnecessary jargon or overly complex sentence constructions; and,
• Conveyance of more than the mere gathering of descriptive data providing only a snapshot of the issue or phenomenon under investigation.

Bryman, Alan. “The Research Question in Social Research: What is its Role?” International Journal of Social Research Methodology 10 (2007): 5-20; Brown, Perry J., Allen Dyer, and Ross S. Whaley. "Recreation Research—So What?" Journal of Leisure Research 5 (1973): 16-24; Castellanos, Susie. Critical Writing and Thinking. The Writing Center. Dean of the College. Brown University; Ellis, Timothy J. and Yair Levy Nova. "Framework of Problem-Based Research: A Guide for Novice Researchers on the Development of a Research-Worthy Problem." Informing Science: the International Journal of an Emerging Transdiscipline 11 (2008); Thesis and Purpose Statements. The Writer’s Handbook. Writing Center. University of Wisconsin, Madison; Thesis Statements. The Writing Center. University of North Carolina; Tips and Examples for Writing Thesis Statements. The Writing Lab and The OWL. Purdue University; Selwyn, Neil. "‘So What?’…A Question that Every Journal Article Needs to Answer." Learning, Media, and Technology 39 (2014): 1-5; Shoket, Mohd. "Research Problem: Identification and Formulation." International Journal of Research 1 (May 2014): 512-518.

Structure and Writing Style

I.  Types and Content

There are four general conceptualizations of a research problem in the social sciences:

• Casuist Research Problem -- this type of problem relates to the determination of right and wrong in questions of conduct or conscience by analyzing moral dilemmas through the application of general rules and the careful distinction of special cases.
• Difference Research Problem -- typically asks the question, “Is there a difference between two or more groups or treatments?” This type of problem statement is used when the researcher compares or contrasts two or more phenomena. This a common approach to defining a problem in the clinical social sciences or behavioral sciences.
• Descriptive Research Problem -- typically asks the question, "what is...?" with the underlying purpose to describe the significance of a situation, state, or existence of a specific phenomenon. This problem is often associated with revealing hidden or understudied issues.
• Relational Research Problem -- suggests a relationship of some sort between two or more variables to be investigated. The underlying purpose is to investigate specific qualities or characteristics that may be connected in some way.

A problem statement in the social sciences should contain :

• A lead-in that helps ensure the reader will maintain interest over the study,
• A declaration of originality [e.g., mentioning a knowledge void or a lack of clarity about a topic that will be revealed in the literature review of prior research],
• An indication of the central focus of the study [establishing the boundaries of analysis], and
• An explanation of the study's significance or the benefits to be derived from investigating the research problem.

NOTE :   A statement describing the research problem of your paper should not be viewed as a thesis statement that you may be familiar with from high school. Given the content listed above, a description of the research problem is usually a short paragraph in length.

II.  Sources of Problems for Investigation

The identification of a problem to study can be challenging, not because there's a lack of issues that could be investigated, but due to the challenge of formulating an academically relevant and researchable problem which is unique and does not simply duplicate the work of others. To facilitate how you might select a problem from which to build a research study, consider these sources of inspiration:

Deductions from Theory This relates to deductions made from social philosophy or generalizations embodied in life and in society that the researcher is familiar with. These deductions from human behavior are then placed within an empirical frame of reference through research. From a theory, the researcher can formulate a research problem or hypothesis stating the expected findings in certain empirical situations. The research asks the question: “What relationship between variables will be observed if theory aptly summarizes the state of affairs?” One can then design and carry out a systematic investigation to assess whether empirical data confirm or reject the hypothesis, and hence, the theory.

Interdisciplinary Perspectives Identifying a problem that forms the basis for a research study can come from academic movements and scholarship originating in disciplines outside of your primary area of study. This can be an intellectually stimulating exercise. A review of pertinent literature should include examining research from related disciplines that can reveal new avenues of exploration and analysis. An interdisciplinary approach to selecting a research problem offers an opportunity to construct a more comprehensive understanding of a very complex issue that any single discipline may be able to provide.

Interviewing Practitioners The identification of research problems about particular topics can arise from formal interviews or informal discussions with practitioners who provide insight into new directions for future research and how to make research findings more relevant to practice. Discussions with experts in the field, such as, teachers, social workers, health care providers, lawyers, business leaders, etc., offers the chance to identify practical, “real world” problems that may be understudied or ignored within academic circles. This approach also provides some practical knowledge which may help in the process of designing and conducting your study.

Personal Experience Don't undervalue your everyday experiences or encounters as worthwhile problems for investigation. Think critically about your own experiences and/or frustrations with an issue facing society or related to your community, your neighborhood, your family, or your personal life. This can be derived, for example, from deliberate observations of certain relationships for which there is no clear explanation or witnessing an event that appears harmful to a person or group or that is out of the ordinary.

Relevant Literature The selection of a research problem can be derived from a thorough review of pertinent research associated with your overall area of interest. This may reveal where gaps exist in understanding a topic or where an issue has been understudied. Research may be conducted to: 1) fill such gaps in knowledge; 2) evaluate if the methodologies employed in prior studies can be adapted to solve other problems; or, 3) determine if a similar study could be conducted in a different subject area or applied in a different context or to different study sample [i.e., different setting or different group of people]. Also, authors frequently conclude their studies by noting implications for further research; read the conclusion of pertinent studies because statements about further research can be a valuable source for identifying new problems to investigate. The fact that a researcher has identified a topic worthy of further exploration validates the fact it is worth pursuing.

III.  What Makes a Good Research Statement?

A good problem statement begins by introducing the broad area in which your research is centered, gradually leading the reader to the more specific issues you are investigating. The statement need not be lengthy, but a good research problem should incorporate the following features:

1.  Compelling Topic The problem chosen should be one that motivates you to address it but simple curiosity is not a good enough reason to pursue a research study because this does not indicate significance. The problem that you choose to explore must be important to you, but it must also be viewed as important by your readers and to a the larger academic and/or social community that could be impacted by the results of your study. 2.  Supports Multiple Perspectives The problem must be phrased in a way that avoids dichotomies and instead supports the generation and exploration of multiple perspectives. A general rule of thumb in the social sciences is that a good research problem is one that would generate a variety of viewpoints from a composite audience made up of reasonable people. 3.  Researchability This isn't a real word but it represents an important aspect of creating a good research statement. It seems a bit obvious, but you don't want to find yourself in the midst of investigating a complex research project and realize that you don't have enough prior research to draw from for your analysis. There's nothing inherently wrong with original research, but you must choose research problems that can be supported, in some way, by the resources available to you. If you are not sure if something is researchable, don't assume that it isn't if you don't find information right away--seek help from a librarian !

NOTE:   Do not confuse a research problem with a research topic. A topic is something to read and obtain information about, whereas a problem is something to be solved or framed as a question raised for inquiry, consideration, or solution, or explained as a source of perplexity, distress, or vexation. In short, a research topic is something to be understood; a research problem is something that needs to be investigated.

IV.  Asking Analytical Questions about the Research Problem

Research problems in the social and behavioral sciences are often analyzed around critical questions that must be investigated. These questions can be explicitly listed in the introduction [i.e., "This study addresses three research questions about women's psychological recovery from domestic abuse in multi-generational home settings..."], or, the questions are implied in the text as specific areas of study related to the research problem. Explicitly listing your research questions at the end of your introduction can help in designing a clear roadmap of what you plan to address in your study, whereas, implicitly integrating them into the text of the introduction allows you to create a more compelling narrative around the key issues under investigation. Either approach is appropriate.

The number of questions you attempt to address should be based on the complexity of the problem you are investigating and what areas of inquiry you find most critical to study. Practical considerations, such as, the length of the paper you are writing or the availability of resources to analyze the issue can also factor in how many questions to ask. In general, however, there should be no more than four research questions underpinning a single research problem.

Given this, well-developed analytical questions can focus on any of the following:

• Highlights a genuine dilemma, area of ambiguity, or point of confusion about a topic open to interpretation by your readers;
• Yields an answer that is unexpected and not obvious rather than inevitable and self-evident;
• Provokes meaningful thought or discussion;
• Raises the visibility of the key ideas or concepts that may be understudied or hidden;
• Suggests the need for complex analysis or argument rather than a basic description or summary; and,
• Offers a specific path of inquiry that avoids eliciting generalizations about the problem.

NOTE:   Questions of how and why concerning a research problem often require more analysis than questions about who, what, where, and when. You should still ask yourself these latter questions, however. Thinking introspectively about the who, what, where, and when of a research problem can help ensure that you have thoroughly considered all aspects of the problem under investigation and helps define the scope of the study in relation to the problem.

V.  Mistakes to Avoid

Beware of circular reasoning! Do not state the research problem as simply the absence of the thing you are suggesting. For example, if you propose the following, "The problem in this community is that there is no hospital," this only leads to a research problem where:

• The need is for a hospital
• The objective is to create a hospital
• The method is to plan for building a hospital, and
• The evaluation is to measure if there is a hospital or not.

This is an example of a research problem that fails the "So What?" test . In this example, the problem does not reveal the relevance of why you are investigating the fact there is no hospital in the community [e.g., perhaps there's a hospital in the community ten miles away]; it does not elucidate the significance of why one should study the fact there is no hospital in the community [e.g., that hospital in the community ten miles away has no emergency room]; the research problem does not offer an intellectual pathway towards adding new knowledge or clarifying prior knowledge [e.g., the county in which there is no hospital already conducted a study about the need for a hospital, but it was conducted ten years ago]; and, the problem does not offer meaningful outcomes that lead to recommendations that can be generalized for other situations or that could suggest areas for further research [e.g., the challenges of building a new hospital serves as a case study for other communities].

Alvesson, Mats and Jörgen Sandberg. “Generating Research Questions Through Problematization.” Academy of Management Review 36 (April 2011): 247-271 ; Choosing and Refining Topics. Writing@CSU. Colorado State University; D'Souza, Victor S. "Use of Induction and Deduction in Research in Social Sciences: An Illustration." Journal of the Indian Law Institute 24 (1982): 655-661; Ellis, Timothy J. and Yair Levy Nova. "Framework of Problem-Based Research: A Guide for Novice Researchers on the Development of a Research-Worthy Problem." Informing Science: the International Journal of an Emerging Transdiscipline 11 (2008); How to Write a Research Question. The Writing Center. George Mason University; Invention: Developing a Thesis Statement. The Reading/Writing Center. Hunter College; Problem Statements PowerPoint Presentation. The Writing Lab and The OWL. Purdue University; Procter, Margaret. Using Thesis Statements. University College Writing Centre. University of Toronto; Shoket, Mohd. "Research Problem: Identification and Formulation." International Journal of Research 1 (May 2014): 512-518; Trochim, William M.K. Problem Formulation. Research Methods Knowledge Base. 2006; Thesis and Purpose Statements. The Writer’s Handbook. Writing Center. University of Wisconsin, Madison; Thesis Statements. The Writing Center. University of North Carolina; Tips and Examples for Writing Thesis Statements. The Writing Lab and The OWL. Purdue University; Pardede, Parlindungan. “Identifying and Formulating the Research Problem." Research in ELT: Module 4 (October 2018): 1-13; Walk, Kerry. Asking an Analytical Question. [Class handout or worksheet]. Princeton University; White, Patrick. Developing Research Questions: A Guide for Social Scientists . New York: Palgrave McMillan, 2009; Li, Yanmei, and Sumei Zhang. "Identifying the Research Problem." In Applied Research Methods in Urban and Regional Planning . (Cham, Switzerland: Springer International Publishing, 2022), pp. 13-21.

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• Published: 02 April 2022

A qualitative study of rural healthcare providers’ views of social, cultural, and programmatic barriers to healthcare access

• Nicholas C. Coombs 1 ,
• Duncan G. Campbell 2 &
• James Caringi 1  

BMC Health Services Research volume  22 , Article number:  438 ( 2022 ) Cite this article

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Ensuring access to healthcare is a complex, multi-dimensional health challenge. Since the inception of the coronavirus pandemic, this challenge is more pressing. Some dimensions of access are difficult to quantify, namely characteristics that influence healthcare services to be both acceptable and appropriate. These link to a patient’s acceptance of services that they are to receive and ensuring appropriate fit between services and a patient’s specific healthcare needs. These dimensions of access are particularly evident in rural health systems where additional structural barriers make accessing healthcare more difficult. Thus, it is important to examine healthcare access barriers in rural-specific areas to understand their origin and implications for resolution.

We used qualitative methods and a convenience sample of healthcare providers who currently practice in the rural US state of Montana. Our sample included 12 healthcare providers from diverse training backgrounds and specialties. All were decision-makers in the development or revision of patients’ treatment plans. Semi-structured interviews and content analysis were used to explore barriers–appropriateness and acceptability–to healthcare access in their patient populations. Our analysis was both deductive and inductive and focused on three analytic domains: cultural considerations, patient-provider communication, and provider-provider communication. Member checks ensured credibility and trustworthiness of our findings.

Five key themes emerged from analysis: 1) a friction exists between aspects of patients’ rural identities and healthcare systems; 2) facilitating access to healthcare requires application of and respect for cultural differences; 3) communication between healthcare providers is systematically fragmented; 4) time and resource constraints disproportionately harm rural health systems; and 5) profits are prioritized over addressing barriers to healthcare access in the US.

Conclusions

Inadequate access to healthcare is an issue in the US, particularly in rural areas. Rural healthcare consumers compose a hard-to-reach patient population. Too few providers exist to meet population health needs, and fragmented communication impairs rural health systems’ ability to function. These issues exacerbate the difficulty of ensuring acceptable and appropriate delivery of healthcare services, which compound all other barriers to healthcare access for rural residents. Each dimension of access must be monitored to improve patient experiences and outcomes for rural Americans.

Peer Review reports

Unequal access to healthcare services is an important element of health disparities in the United States [ 1 ], and there remains much about access that is not fully understood. The lack of understanding is attributable, in part, to the lack of uniformity in how access is defined and evaluated, and the extent to which access is often oversimplified in research [ 2 ]. Subsequently, attempts to address population-level barriers to healthcare access are insufficient, and access remains an unresolved, complex health challenge [ 3 , 4 , 5 ]. This paper presents a study that aims to explore some of the less well studied barriers to healthcare access, particularly those that influence healthcare acceptability and appropriateness.

In truth, healthcare access entails a complicated calculus that combines characteristics of individuals, their households, and their social and physical environments with characteristics of healthcare delivery systems, organizations, and healthcare providers. For one to fully ‘access’ healthcare, they must have the means to identify their healthcare needs and have available to them care providers and the facilities where they work. Further, patients must then reach, obtain, and use the healthcare services in order to have their healthcare needs fulfilled. Levesque and colleagues critically examined access conceptualizations in 2013 and synthesized all ways in which access to healthcare was previously characterized; Levesque et al. proposed five dimensions of access: approachability, acceptability, availability, affordability and appropriateness [ 2 ]. These refer to the ability to perceive, seek, reach, pay for, and engage in services, respectively.

According to Levesque et al.’s framework, the five dimensions combine to facilitate access to care or serve as barriers. Approachability indicates that people facing health needs understand that healthcare services exist and might be helpful. Acceptability represents whether patients see healthcare services as consistent or inconsistent with their own social and cultural values and worldviews. Availability indicates that healthcare services are reached both physically and in a timely manner. Affordability simplifies one’s capacity to pay for healthcare services without compromising basic necessities, and finally, appropriateness represents the fit between healthcare services and a patient’s specific healthcare needs [ 2 ]. This study focused on the acceptability and appropriateness dimensions of access.

Before the novel coronavirus (SARS-CoV-2; COVID-19) pandemic, approximately 13.3% of adults in the US did not have a usual source of healthcare [ 6 ]. Millions more did not utilize services regularly, and close to two-thirds reported that they would be debilitated by an unexpected medical bill [ 7 , 8 , 9 ]. Findings like these emphasized a fragility in the financial security of the American population [ 10 ]. These concerns were exacerbated by the pandemic when a sudden surge in unemployment increased un- and under-insurance rates [ 11 ]. Indeed, employer-sponsored insurance covers close to half of Americans’ total cost of illness [ 12 ]. Unemployment linked to COVID-19 cut off the lone outlet to healthcare access for many. Health-related financial concerns expanded beyond individuals, as healthcare organizations were unequipped to manage a simultaneous increase in demand for specialized healthcare services and a steep drop off for routine revenue-generating healthcare services [ 13 ]. These consequences of the COVID-19 pandemic all put additional, unexpected pressure on an already fragmented US healthcare system.

Other structural barriers to healthcare access exist in relation to the rural–urban divide. Less than 10% of US healthcare resources are located in rural areas where approximately 20% of the American population resides [ 14 ]. In a country with substantially fewer providers per capita compared to many other developed countries, persons in rural areas experience uniquely pressing healthcare provider shortages [ 15 , 16 ]. Rural inhabitants also tend to have lower household income, higher rates of un- or under-insurance, and more difficulty with travel to healthcare clinics than urban dwellers [ 17 ]. Subsequently, persons in rural communities use healthcare services at lower rates, and potentially preventable hospitalizations are more prevalent [ 18 ]. This disparity often leads rural residents to use services primarily for more urgent needs and less so for routine care [ 19 , 20 , 21 ].

The differences in how rural and urban healthcare systems function warranted a federal initiative to focus exclusively on rural health priorities and serve as counterpart to Healthy People objectives [ 22 ]. The rural determinants of health, a more specific expression of general social determinants, add issues of geography and topography to the well-documented social, economic and political factors that influence all Americans’ access to healthcare [ 23 ]. As a result, access is consistently regarded as a top priority in rural areas, and many research efforts have explored the intersection between access and rurality, namely within its less understood dimensions (acceptability and appropriateness) [ 22 ].

Acceptability-related barriers to care

Acceptability represents the dimension of healthcare access that affects a patient’s ability to seek healthcare, particularly linked to one’s professional values, norms and culture [ 2 ]. Access to health information is an influential factor for acceptable healthcare and is essential to promote and maintain a healthy population [ 24 ]. According to the Centers for Disease Control and Prevention, health literacy or a high ‘health IQ’ is the degree to which individuals have the ability to find, understand, and use information and services to inform health-related decisions and actions for themselves and others, which impacts healthcare use and system navigation [ 25 ]. The literature indicates that lower levels of health literacy contribute to health disparities among rural populations [ 26 , 27 , 28 ]. Evidence points to a need for effective health communication between healthcare organizations and patients to improve health literacy [ 24 ]. However, little research has been done in this area, particularly as it relates to technologically-based interventions to disseminate health information [ 29 ].

Stigma, an undesirable position of perceived diminished status in an individual’s social position, is another challenge that influences healthcare acceptability [ 30 ]. Those who may experience stigma fear negative social consequences in relation to care seeking. They are more likely to delay seeking care, especially among ethnic minority populations [ 31 , 32 ]. Social media presents opportunities for the dissemination of misleading medical information; this runs further risk for stigma [ 33 ]. Stigma is difficult to undo, but research has shown that developing a positive relationship with a healthcare provider or organization can work to reduce stigma among patients, thus promoting healthcare acceptability [ 34 ].

A provider’s attempts to engage patients and empower them to be active decision-makers regarding their treatment has also been shown to improve healthcare acceptability. One study found that patients with heart disease who completed a daily diary of weight and self-assessment of symptoms, per correspondence with their provider, had better care outcomes than those who did not [ 35 ]. Engaging with household family members and involved community healers also mitigates barriers to care, emphasizing the importance of a team-based approach that extends beyond those who typically provide healthcare services [ 36 , 37 ]. One study, for instance, explored how individuals closest to a pregnant woman affect the woman’s decision to seek maternity care; partners, female relatives, and community health-workers were among the most influential in promoting negative views, all of which reduced a woman’s likelihood to access care [ 38 ].

Appropriateness-related barriers to care

Appropriateness marks the dimension of healthcare access that affects a patient’s ability to engage, and according to Levesque et al., is of relevance once all other dimensions (the ability to perceive, seek, reach and pay for) are achieved [ 2 ]. The ability to engage in healthcare is influenced by a patient’s level of empowerment, adherence to information, and support received by their healthcare provider. Thus, barriers to healthcare access that relate to appropriateness are often those that indicate a breakdown in communication between a patient with their healthcare provider. Such breakdown can involve a patient experiencing miscommunication, confrontation, and/or a discrepancy between their provider’s goals and their own goals for healthcare. Appropriateness represents a dimension of healthcare access that is widely acknowledged as an area in need of improvement, which indicates a need to rethink how healthcare providers and organizations can adapt to serve the healthcare needs of their communities [ 39 ]. This is especially true for rural, ethnic minority populations, which disproportionately experience an abundance of other barriers to healthcare access. Culturally appropriate care is especially important for members of minority populations [ 40 , 41 , 42 ]. Ultimately, patients value a patient-provider relationship characterized by a welcoming, non-judgmental atmosphere [ 43 , 44 ]. In rural settings especially, level of trust and familiarity are common factors that affect service utilization [ 45 ]. Evidence suggests that kind treatment by a healthcare provider who promotes patient-centered care can have a greater overall effect on a patient’s experience than a provider’s degree of medical knowledge or use of modern equipment [ 46 ]. Of course, investing the time needed to nurture close and caring interpersonal connections is particularly difficult in under-resourced, time-pressured rural health systems [ 47 , 48 ].

The most effective way to evaluate access to healthcare largely depends on which dimensions are explored. For instance, a population-based survey can be used to measure the barrier of healthcare affordability. Survey questions can inquire directly about health insurance coverage, care-related financial burden, concern about healthcare costs, and the feared financial impacts of illness and/or disability. Many national organizations have employed such surveys to measure affordability-related barriers to healthcare. For example, a question may ask explicitly about financial concerns: ‘If you get sick or have an accident, how worried are you that you will not be able to pay your medical bills?’ [ 49 ]. Approachability and availability dimensions of access are also studied using quantitative analysis of survey questions, such as ‘Is there a place that you usually go to when you are sick or need advice about your health?’ or ‘Have you ever delayed getting medical care because you couldn’t get through on the telephone?’ In contrast, the remaining two dimensions–acceptability and appropriateness–require a qualitative approach, as the social and cultural factors that determine a patient’s likelihood of accepting aspects of the services that are to be received (acceptability) and the fit between those services and the patient’s specific healthcare needs (appropriateness) can be more abstract [ 50 , 51 ]. In social science, qualitative methods are appropriate to generate knowledge of what social events mean to individuals and how those individuals interact within them; these methods allow for an exploration of depth rather than breadth [ 52 , 53 ]. Qualitative methods, therefore, are appropriate tools for understanding the depth of healthcare providers’ experiences in the inherently social context of seeking and engaging in healthcare.

In sum, acceptability- and appropriateness-related barriers to healthcare access are multi-layered, complex and abundant. Ensuring access becomes even more challenging if structural barriers to access are factored in. In this study, we aimed to explore barriers to healthcare access among persons in Montana, a historically underserved, under-resourced, rural region of the US. Montana is the fourth largest and third least densely populated state in the country; more than 80% of Montana counties are classified as non-core (the lowest level of urban/rural classification), and over 90% are designated as health professional shortage areas [ 54 , 55 ]. Qualitative methods supported our inquiry to explore barriers to healthcare access related to acceptability and appropriateness.

Participants

Qualitative methods were utilized for this interpretive, exploratory study because knowledge regarding barriers to healthcare access within Montana’s rural health systems is limited. We chose Montana healthcare providers, rather than patients, as the population of interest so we may explore barriers to healthcare access from the perspective of those who serve many persons in rural settings. Inclusion criteria required study participants to provide direct healthcare to patients at least one-half of their time. We defined ‘provider’ as a healthcare organization employee with clinical decision-making power and the qualifications to develop or revise patients’ treatment plans. In an attempt to capture a group of providers with diverse experience, we included providers across several types and specialties. These included advanced practice registered nurses (APRNs), physicians (MDs and DOs), and physician assistants (PAs) who worked in critical care medicine, emergency medicine, family medicine, hospital medicine, internal medicine, pain medicine, palliative medicine, pediatrics, psychiatry, and urgent care medicine. We also included licensed clinical social workers (LCSWs) and clinical psychologists who specialize in behavioral healthcare provision.

Recruitment and Data Collection

We recruited participants via email using a snowball sampling approach [ 56 ]. We opted for this approach because of its effectiveness in time-pressured contexts, such as the COVID-19 pandemic, which has made healthcare provider populations hard to reach [ 57 ]. Considering additional constraints with the pandemic and the rural nature of Montana, interviews were administered virtually via Zoom video or telephone conferencing with Zoom’s audio recording function enabled. All interviews were conducted by the first author between January and September 2021. The average length of interviews was 50 min, ranging from 35 to 70 min. There were occasional challenges experienced during interviews (poor cell phone reception from participants, dropped calls), in which case the interviewer remained on the line until adequate communication was resumed. All interviews were included for analysis and transcribed verbatim into NVivo Version 12 software. All qualitative data were saved and stored on a password-protected University of Montana server. Hard-copy field notes were securely stored in a locked office on the university’s main campus.

Data analysis included a deductive followed by an inductive approach. This dual analysis adheres to Levesque’s framework for qualitative methods, which is discussed in the Definition of Analytic Domains sub-section below. Original synthesis of the literature informed the development of our initial deductive codebook. The deductive approach was derived from a theory-driven hypothesis, which consisted of synthesizing previous research findings regarding acceptability- and appropriateness-related barriers to care. Although the locations, patient populations and specific type of healthcare services varied by study in the existing literature, several recurring barriers to healthcare access were identified. We then operationalized three analytic domains based on these findings: cultural considerations, patient-provider communication, and provider-provider communication. These domains were chosen for two reasons: 1) the terms ‘culture’ and ‘communication’ were the most frequently documented characteristics across the studies examined, and 2) they each align closely with the acceptability and appropriateness dimensions of access to healthcare, respectively. In addition, ‘culture’ is included in the definition of acceptability and ‘communication’ is a quintessential aspect of appropriateness. These domains guided the deductive portion of our analysis, which facilitated the development of an interview guide used for this study.

Interviews were semi-structured to allow broad interpretations from participants and expand the open-ended characterization of study findings. Data were analyzed through a flexible coding approach proposed by Deterding and Waters [ 58 ]. Qualitative content analysis was used, a method particularly beneficial for analyzing large amounts of qualitative data collected through interviews that offers possibility of quantifying categories to identify emerging themes [ 52 , 59 ]. After fifty percent of data were analyzed, we used an inductive approach as a formative check and repeated until data saturation, or the point at which no new information was gathered in interviews [ 60 ]. At each point of inductive analysis, interview questions were added, removed, or revised in consideration of findings gathered [ 61 ]. The Standards for Reporting Qualitative Research (SRQR) was used for reporting all qualitative data for this study [ 62 ]. The first and third authors served as primary and secondary analysts of the qualitative data and collaborated to triangulate these findings. An audit approach was employed, which consisted of coding completed by the first author and then reviewed by the third author. After analyses were complete, member checks ensured credibility and trustworthiness of findings [ 63 ]. Member checks consisted of contacting each study participant to explain the study’s findings; one-third of participants responded and confirmed all findings. All study procedures were reviewed and approved by the Human Subjects Committee of the authors’ institution’s Institutional Review Board.

Definitions of Analytic Domains

Cultural considerations.

Western health systems often fail to consider aspects of patients’ cultural perspectives and histories. This can manifest in the form of a providers’ lack of cultural humility. Cultural humility is a process of preventing imposition of one’s worldview and cultural beliefs on others and recognizing that everyone’s conception of the world is valid. Humility cultivates sensitive approaches in treating patients [ 64 ]. A lack of cultural humility impedes the delivery of acceptable and appropriate healthcare [ 65 ], which can involve low empathy or respect for patients, or dismissal of culture and traditions as superstitions that interfere with standard treatments [ 66 , 67 ]. Ensuring cultural humility among all healthcare employees is a step toward optimal healthcare delivery. Cultural humility is often accomplished through training that can be tailored to particular cultural- or gender-specific populations [ 68 , 69 ]. Since cultural identities and humility have been marked as factors that can heavily influence patients’ access to care, cultural considerations composed our first analytic domain. To assess this domain, we asked participants how they address the unique needs of their patients, how they react when they observe a cultural behavior or attitude from a patient that may not directly align with their treatment plan, and if they have received any multicultural training or training on cultural considerations in their current role.

Patient-provider communication

Other barriers to healthcare access can be linked to ineffective patient-provider communication. Patients who do not feel involved in healthcare decisions are less likely to adhere to treatment recommendations [ 70 ]. Patients who experience communication difficulties with providers may feel coerced, which generates disempowerment and leads patients to employ more covert ways of engagement [ 71 , 72 ]. Language barriers can further compromise communication and hinder outcomes or patient progress [ 73 , 74 ]. Any miscommunication between a patient and provider can affect one’s access to healthcare, namely affecting appropriateness-related barriers. For these reasons, patient-provider communication composed our second analytic domain. We asked participants to highlight the challenges they experience when communicating with their patients, how those complications are addressed, and how communication strategies inform confidentiality in their practice. Confidentiality is a core ethical principle in healthcare, especially in rural areas that have smaller, interconnected patient populations [ 75 ].

Provider-Provider Communication

A patient’s journey through the healthcare system necessitates sufficient correspondence between patients, primary, and secondary providers after discharge and care encounters [ 76 ]. Inter-provider and patient-provider communication are areas of healthcare that are acknowledged to have some gaps. Inconsistent mechanisms for follow up communication with patients in primary care have been documented and emphasized as a concern among those with chronic illness who require close monitoring [ 68 , 77 ]. Similar inconsistencies exist between providers, which can lead to unclear care goals, extended hospital stays, and increased medical costs [ 78 ]. For these reasons, provider-provider communication composed our third analytic domain. We asked participants to describe the approaches they take to streamline communication after a patient’s hospital visit, the methods they use to ensure collaborative communication between primary or secondary providers, and where communication challenges exist.

Healthcare provider characteristics

Our sample included 12 providers: four in family medicine (1 MD, 1 DO, 1 PA & 1 APRN), three in pediatrics (2 MD with specialty in hospital medicine & 1 DO), three in palliative medicine (2 MDs & 1 APRN with specialty in wound care), one in critical care medicine (DO with specialty in pediatric pulmonology) and one in behavioral health (1 LCSW with specialty in trauma). Our participants averaged 9 years (range 2–15) as a healthcare provider; most reported more than 5 years in their current professional role. The diversity of participants extended to their patient populations as well, with each participant reporting a unique distribution of age, race and level of medical complexity among their patients. Most participants reported that a portion of their patients travel up to five hours, sometimes across county- or state-lines, to receive care.

Theme 1: A friction exists between aspects of patients’ rural identities and healthcare systems

Our participants comprised a collection of medical professions and reported variability among health-related reasons their patients seek care. However, most participants acknowledged similar characteristics that influence their patients’ challenges to healthcare access. These identified factors formed categories from which the first theme emerged. There exists a great deal of ‘rugged individualism’ among Montanans, which reflects a self-sufficient and self-reliant way of life. Stoicism marked a primary factor to characterize this quality. One participant explained:

True Montanans are difficult to treat medically because they tend to be a tough group. They don’t see doctors. They don’t want to go, and they don’t want to be sick. That’s an aspect of Montana that makes health culture a little bit difficult.

Another participant echoed this finding by stating:

The backwoods Montana range guy who has an identity of being strong and independent probably doesn’t seek out a lot of medical care or take a lot of medications. Their sense of vitality, independence and identity really come from being able to take care and rely on themselves. When that is threatened, that’s going to create a unique experience of illness.

Similar responses were shared by all twelve participants; stoicism seemed to be heavily embedded in many patient populations in Montana and serves as a key determinant of healthcare acceptability. There are additional factors, however, that may interact with stoicism but are multiply determined. Stigma is an example of this, presented in this context as one’s concern about judgement by the healthcare system. Respondents were openly critical of this perception of the healthcare system as it was widely discussed in interviews. One participant stated:

There is a real perception of a punitive nature in the medical community, particularly if I observe a health issue other than the primary reason for one’s hospital visit, whether that may be predicated on medical neglect, delay of care, or something that may warrant a report to social services. For many of the patients and families I see, it’s not a positive experience and one that is sometimes an uphill barrier that I work hard to circumnavigate.

Analysis of these factors suggest that low use of healthcare services may link to several characteristics, including access problems. Separately, a patient’s perceived stigma from healthcare providers may also impact a patient’s willingness to receive services. One participant put it best by stating

Sometimes, families assume that I didn’t want to see them because they will come in for follow up to meet with me but end up meeting with another provider, which is frustrating because I want to maintain patients on my panel but available time and resource occasionally limits me from doing so. It could be really hard adapting to those needs on the fly, but it’s an honest miss.

When a patient arrives for a healthcare visit and experiences this frustration, it may elicit a patient’s perceptions of neglect or disorganization. This ‘honest miss’ may, in turn, exacerbate other acceptable-related barriers to care.

Theme 2: Facilitating access to healthcare requires application of and respect for cultural differences

The biomedical model is the standard of care utilized in Western medicine [ 79 , 80 ]. However, the US comprises people with diverse social and cultural identities that may not directly align with Western conceptions of health and wellness. Approximately 11.5% of the Montana population falls within an ethnic minority group. 6.4% are of American Indian or Alaska Native origin, 0.5% are of Black or African American origin, 0.8% are of Asian origin and 3.8% are of multiple or other origins. [ 81 ]. Cultural insensitivity is acknowledged in health services research as an active deterrent for appropriate healthcare delivery [ 65 ]. Participants for this study were asked how they react when a patient brings up a cultural attitude or behavior that may impact the proposed treatment plan. Eight participants noted a necessity for humility when this occurs. One participant conceptualized this by stating:

When this happens, I learn about individuals and a way of life that is different to the way I grew up. There is a lot of beauty and health in a non-patriarchal, non-dominating, non-sexist framework, and when we can engage in such, it is really expansive for my own learning process.

The participants who expressed humility emphasized that it is best to work in tandem with their patient, congruently. Especially for those with contrasting worldviews, a provider and a patient working as a team poses an opportunity to develop trust. Without it, a patient can easily fall out of the system, further hindering their ability to access healthcare services in the future. One participant stated:

The approach that ends up being successful for a lot of patients is when we understand their modalities, and they have a sense we understand those things. We have to show understanding and they have to trust. From there, we can make recommendations to help get them there, not decisions for them to obey, rather views based on our experiences and understanding of medicine.

Curiosity was another reaction noted by a handful of participants. One participant said:

I believe patients and their caregivers can be engaged and loving in different ways that don’t always follow the prescribed approach in the ways I’ve been trained, but that doesn’t necessarily mean that they are detrimental. I love what I do, and I love learning new things or new approaches, but I also love being surprised. My style of medicine is not to predict peoples’ lives, rather to empower and support what makes life meaningful for them.

Participants mentioned several other characteristics that they use in practice to prevent cultural insensitivity and support a collaborative approach to healthcare. Table 1 lists these facilitating characteristics and quotes to explain the substance of their benefit.

Consensus among participants indicated that the use of these protective factors to promote cultural sensitivity and apply them in practice is not standardized. When asked, all but two participants said they had not received any culturally-based training since beginning their practice. Instead, they referred to developing skills through “on the job training” or “off the cuff learning.” The general way of medicine, one participant remarked, was to “throw you to the fire.” This suggested that use of standardized cultural humility training modules for healthcare providers was not common practice. Many attributed this to time constraints.

Individual efforts to gain culturally appropriate skills or enhance cultural humility were mentioned, however. For example, three participants reported that they attended medical conferences to discuss cultural challenges within medicine, one participant sought out cultural education within their organization, and another was invited by Native American community members to engage in traditional peace ceremonies. Participants described these additional efforts as uncommon and outside the parameters of a provider’s job responsibilities, as they require time commitments without compensation.

Additionally, eight participants said they share their personal contact information with patients so they may call them directly for medical needs. The conditions and frequency with which this is done was variable and more common among providers in specialized areas of medicine or those who described having a manageable patient panel. All who reported that they shared their personal contact information described it as an aspect of rural health service delivery that is atypical in other, non-rural healthcare systems.

Theme 3: Communication between healthcare providers is systematically fragmented

Healthcare is complex and multi-disciplinary, and patients’ treatment is rarely overseen by a single provider [ 82 ]. The array of provider types and specialties is vast, as is the range of responsibilities ascribed to providers. Thus, open communication among providers both within and between healthcare systems is vital for the success of collaborative healthcare [ 83 ]. Without effective communication achieved between healthcare providers, the appropriate delivery of healthcare services may be become compromised. Our participants noted that they face multiple challenges that complicate communication with other providers. Miscommunication between departments, often implicating the Emergency Department (ED), was a recurring point noted among participants. One participant who is a primary care physician said:

If one of my patients goes to the ER, I don’t always get the notes. They’re supposed to send them to the patient’s primary care doc. The same thing happens with general admissions, but again, I often find out from somebody else that my patient was admitted to the hospital.

This failure to communicate can negatively impact the patient, particularly if time sensitivity or medical complexity is essential to treatment. A patient’s primary care physician is the most accurate source of their medical history; without an effective way to obtain and synthesize a patient’s health information, there may be increased risk of medical error. One participant in a specialty field stated:

One of the biggest barriers I see is obtaining a concise description of a patient’s history and needs. You can imagine if you’re a mom and you’ve got a complicated kid. You head to the ER. The ER doc looks at you with really wide eyes, not knowing how to get information about your child that’s really important.

This concern was highlighted with a specific example from a different participant:

I have been unable to troubleshoot instances when I send people to the ER with a pretty clear indication for admission, and then they’re sent home. For instance, I had an older fellow with pretty severe chronic kidney disease. He presented to another practitioner in my office with shortness of breath and swelling and appeared to have newly onset decompensated heart failure. When I figured this out, I sent him to the ER, called and gave my report. The patient later came back for follow up to find out not only that they had not been admitted but they lost no weight with outpatient dialysis . I feel like a real opportunity was missed to try to optimize the care of the patient simply because there was poor communication between myself and the ER. This poor guy… He ended up going to the ER four times before he got admitted for COVID-19.

In some cases, communication breakdown was reported as the sole cause of a poor outcome. When communication is effective, each essential member of the healthcare team is engaged and collaborating with the same information. Some participants called this process ‘rounds’ when a regularly scheduled meeting is staged between a group of providers to ensure access to accurate patient information. Accurate communication may also help build trust and improve a patient’s experience. In contrast, ineffective communication can result in poor clarity regarding providers’ responsibilities or lost information. Appropriate delivery of healthcare considers the fit between providers and a patient’s specific healthcare needs; the factors noted here suggest that provider-provider miscommunication can adversely affect this dimension of healthcare access.

Another important mechanism of communication is the sharing of electronic medical records (EMRs), a process that continues to shift with technological advances. Innovation is still recent enough, however, for several of our study participants to be able to recall a time when paper charts were standard. Widespread adoption and embrace of the improvements inherent in electronic medical records expanded in the late 2000’s [ 84 ]. EMRs vastly improved the ability to retain, organize, safeguard, and transfer health information. Every participant highlighted EMRs at one point or another and often did so with an underlying sense of anger or frustration. Systematic issues and problems with EMRs were discussed. One participant provided historical context to such records:

Years back, the government aimed to buy an electronic medical record system, whichever was the best, and a number of companies created their own. Each were a reasonable system, so they all got their checks and now we have four completely separate operating systems that do not talk to each other. The idea was to make a router or some type of relay that can share information back and forth. There was no money in that though, so of course, no one did anything about it. Depending on what hospital, clinic or agency you work for, you will most likely work within one of these systems. It was a great idea; it just didn’t get finished.

Seven participants confirmed these points and their impacts on making coordination more difficult, relying on outdated communication strategies more often than not. Many noted this even occurs between facilities within the same city and in separate small metropolitan areas across the state. One participant said:

If my hospital decides to contract with one EMR and the hospital across town contracts with another, correspondence between these hospitals goes back to traditional faxing. As a provider, you’re just taking a ‘fingered crossed’ approach hoping that the fax worked, is picked up, was put in the appropriate inbox and was actually looked at. Information acquisition and making sure it’s timely are unforeseen between EMRs.

Participants reported an “astronomic” number of daily faxes and telephone calls to complete the communication EMRs were initially designed to handle. These challenges are even more burdensome if a patient moves from out of town or out of state; obtaining their medical records was repeatedly referred to as a “chore” so onerous that it often remains undone. Another recurring concern brought up by participants regarded accuracy within EMRs to lend a false sense of security. They are not frequently updated, not designed to be family-centered and not set up to do anything automatically. One participant highlighted these limitations by stating:

I was very proud of a change I made in our EMR system [EPIC], even though it was one I never should have had to make. I was getting very upset because I would find out from my nursing assistant who read the obituary that one of my patients had died. There was a real problem with the way the EMR was notifying PCP’s, so I got an EPIC-level automated notification built into our EMR so that any time a patient died, their status would be changed to deceased and a notification would be sent to their PCP. It’s just really awful to find out a week later that your patient died, especially when you know these people and their families really well. It’s not good care to have blind follow up.

Whether it be a physical or electronic miscommunication between healthcare providers, the appropriate delivery of healthcare can be called to question

Theme 4: Time and resource constraints disproportionately harm rural health systems

Several measures of system capacity suggest the healthcare system in the US is under-resourced. There are fewer physicians and hospital beds per capita compared to most comparable countries, and the growth of healthcare provider populations has stagnated over time [ 15 ]. Rural areas, in particular, are subject to resource limitations [ 16 ]. All participants discussed provider shortages in detail. They described how shortages impact time allocation in their day-to-day operations. Tasks like patient intakes, critical assessments, and recovering information from EMRs take time, of which most participants claimed to not have enough of. There was also a consensus in having inadequate time to spend on medically complex cases. Time pressures were reported to subsequently influence quality of care. One participant stated:

With the constant pace of medicine, time is not on your side. A provider cannot always participate in an enriching dialogue with their patients, so rather than listen and learn, we are often coerced into the mindset of ‘getting through’ this patient so we can move on. This echoes for patient education during discharge, making the whole process more arduous than it otherwise could be if time and resources were not as sparse.

Depending on provider type, specialty, and the size of patient panels, four participants said they have the luxury of extending patient visits to 40 + minutes. Any flexibility with patient visits was regarded as just that: a luxury. Very few providers described the ability to coordinate their schedules as such. This led some study participants to limit the number of patients they serve. One participant said:

We simply don’t have enough clinicians, which is a shame because these people are really skilled, exceptional, brilliant providers but are performing way below their capacity. Because of this, I have a smaller case load so I can engage in a level of care that I feel is in the best interest of my patients. Everything is a tradeoff. Time has to be sacrificed at one point or another. This compromise sets our system up to do ‘ok’ work, not great work.

Of course, managing an overly large number of patients with high complexity is challenging. Especially while enduring the burden of a persisting global pandemic, participants reflected that the general outlook of administering healthcare in the US is to “do more with less.” This often forces providers to delegate responsibilities, which participants noted has potential downsides. One participant described how delegating patient care can cause problems.

Very often will a patient schedule a follow up that needs to happen within a certain time frame, but I am unable to see them myself. So, they are then placed with one of my mid-level providers. However, if additional health issues are introduced, which often happens, there is a high-risk of bounce-back or need to return once again to the hospital. It’s an inefficient vetting process that falls to people who may not have specific training in the labs and imaging that are often included in follow up visits. Unfortunately, it’s a forlorn hope to have a primary care physician be able to attend all levels of a patient’s care.

Several participants described how time constraints stretch all healthcare staff thin and complicate patient care. This was particularly important among participants who reported having a patient panel exceeding 1000. There were some participants, however, who praised the relationships they have with their nurse practitioners and physician’s assistants and mark transparency as the most effective way to coordinate care. Collectively, these clinical relationships were built over long standing periods of time, a disadvantage to providers at the start of their medical career. All but one participant with over a decade of clinical experience mentioned the usefulness of these relationships. The factors discussed in Theme 4 are directly linked to the Availability dimension of access to healthcare. A patient’s ability to reach care is subject to the capacity of their healthcare provider(s). Additionally, further analysis suggests these factors also link to the Appropriateness dimension because the quality of patient-provider relationships may be negatively impacted if a provider’s time is compromised.

Theme 5: Profits are prioritized over addressing barriers to healthcare access in the US.

The US healthcare system functions partially for-profit in the public and private sectors. The federal government provides funding for national programs such as Medicare, but a majority of Americans access healthcare through private employer plans [ 85 ]. As a result, uninsurance rates influence healthcare access. Though the rate of the uninsured has dropped over the last decade through expansion of the Affordable Care Act, it remains above 8 percent [ 86 ]. Historically, there has been ethical criticism in the literature of a for-profit system as it is said to exacerbate healthcare disparities and constitute unfair competition against nonprofit institutions. Specifically, the US healthcare system treats healthcare as a commodity instead of a right, enables organizational controls that adversely affect patient-provider relationships, undermines medical education, and constitutes a medical-industrial complex that threatens influence on healthcare-related public policy [ 87 ]. Though unprompted by the interviewer, participants raised many of these concerns. One participant shared their views on how priorities stand in their practice:

A lot of the higher-ups in the healthcare system where I work see each patient visit as a number. It’s not that they don’t have the capacity to think beyond that, but that’s what their role is, making sure we’re profitable. That’s part of why our healthcare system in the US is as broken as it is. It’s accentuated focus on financially and capitalistically driven factors versus understanding all these other barriers to care.

Eight participants echoed a similar concept, that addressing barriers to healthcare access in their organizations is largely complicated because so much attention is directed on matters that have nothing to do with patients. A few other participants supported this by alluding to a “cherry-picking” process by which those at the top of the hierarchy devote their attention to the easiest tasks. One participant shared an experience where contrasting work demands between administrators and front-line clinical providers produces adverse effects:

We had a new administrator in our hospital. I had been really frustrated with the lack of cultural awareness and curiosity from our other leaders in the past, so I offered to meet and take them on a tour of the reservation. This was meant to introduce them to kids, families and Tribal leaders who live in the area and their interface with healthcare. They declined, which I thought was disappointing and eye-opening.

Analysis of these factors suggest that those who work directly with patients understand patient needs better than those who serve in management roles. This same participant went on to suggest an ulterior motive for a push towards telemedicine, as administrators primarily highlight the benefit of billing for virtual visits instead of the nature of the visits themselves.

This study explored barriers and facilitators to healthcare access from the perspective of rural healthcare providers in Montana. Our qualitative analysis uncovered five key themes: 1) a friction exists between aspects of patients’ rural identities and healthcare systems; 2) facilitating access to healthcare requires application of and respect for cultural differences; 3) communication between healthcare providers is systematically fragmented; 4) time and resource constraints disproportionately harm rural health systems; and 5) profits are prioritized over addressing barriers to healthcare access in the US. Themes 2 and 3 were directly supported by earlier qualitative studies that applied Levesque’s framework, specifically regarding healthcare providers’ poor interpersonal quality and lack of collaboration with other providers that are suspected to result from a lack of provider training [ 67 , 70 ]. This ties back to the importance of cultural humility, which many previous culture-based trainings have referred to as cultural competence. Cultural competence is achieved through a plethora of trainings designed to expose providers to different cultures’ beliefs and values but induces risk of stereotyping and stigmatizing a patient’s views. Therefore, cultural humility is the preferred idea, by which providers reflect and gain open-ended appreciation for a patient’s culture [ 88 ].

Implications for Practice

Perhaps the most substantial takeaway is how embedded rugged individualism is within rural patient populations and how difficult that makes the delivery of care in rural health systems. We heard from participants that stoicism and perceptions of stigma within the system contribute to this, but other resulting factors may be influential at the provider- and organizational-levels. Stoicism and perceived stigma both appear to arise, in part, from an understandable knowledge gap regarding the care system. For instance, healthcare providers understand the relations between primary and secondary care, but many patients may perceive both concepts as elements of a single healthcare system [ 89 ]. Any issue experienced by a patient when tasked to see both a primary and secondary provider may result in a patient becoming confused [ 90 ]. This may also overlap with our third theme, as a disjointed means of communication between healthcare providers can exacerbate patients’ negative experiences. One consideration to improve this is to incorporate telehealth programs into an existing referral framework to reduce unnecessary interfacility transfers; telehealth programs have proven effective in rural and remote settings [ 91 ].

In fact, telehealth has been rolled out in a variety of virtual platforms throughout its evolution, its innovation matched with continued technological advancement. Simply put, telehealth allows health service delivery from a distance; it allows knowledge and practice of clinical care to be in a different space than a patient. Because of this, a primary benefit of telehealth is its impact on improving patient-centered outcomes among those living in rural areas. For instance, text messaging technology improves early infant diagnosis, adherence to recommended diagnostic testing, and participant engagement in lifestyle change interventions [ 92 , 93 , 94 ]. More sophisticated interventions have found their way into smartphone-based technology, some of which are accessible even without an internet connection [ 95 , 96 ]. Internet accessibility is important because a number of study participants noted internet connectivity as a barrier for patients who live in low resource communities. Videoconferencing is another function of telehealth that has delivered a variety of health services, including those which are mental health-specific [ 97 ], and mobile health clinics have been used in rural, hard-to-reach settings to show the delivery of quality healthcare is both feasible and acceptable [ 98 , 99 , 100 ]. While telehealth has potential to reduce a number of healthcare access barriers, it may not always address the most pressing healthcare needs [ 101 ]. However, telehealth does serve as a viable, cost-effective alternative for rural populations with limited physical access to specialized services [ 102 ]. With time and resource limitations acknowledged as a key theme in our study, an emphasis on expanding telehealth services is encouraged as it will likely have significant involvement on advancing healthcare in the future, especially as the COVID-19 pandemic persists [ 103 ].

Implications for Policy

One could argue that most of the areas of fragmentation in the US healthcare system can be linked to the very philosophy on which it is based: an emphasis on profits as highest priority. Americans are, therefore, forced to navigate a health service system that does not work solely in their best interests. It is not surprising to observe lower rates of healthcare usage in rural areas, which may be a result from rural persons’ negative views of the US healthcare system or a perception that the system does not exist to support wellness. These perceptions may interact with ‘rugged individualism’ to squelch rural residents’ engagement in healthcare. Many of the providers we interviewed for this study appeared to understand this and strived to improve their patients’ experiences and outcomes. Though these efforts are admirable, they may not characterize all providers who serve in rural areas of the US. From a policy standpoint, it is important to recognize these expansive efforts from providers. If incentives were offered to encourage maximum efforts be made, it may lessen burden due to physician burnout and fatigue. Of course, there is no easy fix to the persisting limit of time and resources for providers, problems that require workforce expansion. Ultimately, though, the current structure of the US healthcare system is failing rural America and doing little to help the practice of rural healthcare providers.

Implications for Future Research

It is important for future health systems research efforts to consider issues that arise from both individual- and system-level access barriers and where the two intersect. Oftentimes, challenges that appear linked to a patient or provider may actually stem from an overarching system failure. If failures are critically and properly addressed, we may refine our understanding of what we can do in our professional spaces to improve care as practitioners, workforce developers, researchers and advocates. This qualitative study was exploratory in nature. It represents a step forward in knowledge generation regarding challenges in access to healthcare for rural Americans. Although mental health did not come up by design in this study, future efforts exploring barriers to healthcare access in rural systems should focus on access to mental healthcare. In many rural areas, Montana included, rates of suicide, substance use and other mental health disorders are highly prevalent. These characteristics should be part of the overall discussion of access to healthcare in rural areas. Optimally, barriers to healthcare access should continue to be explored through qualitative and mixed study designs to honor its multi-dimensional stature.

Strengths and Limitations

It is important to note first that this study interviewed healthcare providers instead of patients, which served as both a strength and limitation. Healthcare providers were able to draw on numerous patient-provider experiences, enabling an account of the aggregate which would have been impossible for a patient population. However, accounts of healthcare providers’ perceptions of barriers to healthcare access for their patients may differ from patients’ specific views. Future research should examine acceptability- and appropriateness-related barriers to healthcare access in patient populations. Second, study participants were recruited through convenience sampling methods, so results may be biased towards healthcare providers who are more invested in addressing barriers to healthcare access. Particularly, the providers interviewed for this study represented a subset who go beyond expectations of their job descriptions by engaging with their communities and spending additional uncompensated time with their patients. It is likely that a provider who exhibits these behavioral traits is more likely to participate in research aimed at addressing barriers to healthcare access. Third, the inability to conduct face-to-face interviews for our qualitative study may have posed an additional limitation. It is possible, for example, that in-person interviews might have resulted in increased rapport with study participants. Notwithstanding this possibility, the remote interview format was necessary to accommodate health risks to the ongoing COVID-19 pandemic. Ultimately, given our qualitative approach, results from our study cannot be generalizable to all rural providers’ views or other rural health systems. In addition, no causality can be inferred regarding the influence of aspects of rurality on access. The purpose of this exploratory qualitative study was to probe research questions for future efforts. We also acknowledge the authors’ roles in the research, also known as reflexivity. The first author was the only author who administered interviews and had no prior relationships with all but one study participant. Assumptions and pre-dispositions to interview content by the first author were regularly addressed throughout data analysis to maintain study integrity. This was achieved by conducting analysis by unique interview question, rather than by unique participant, and recoding the numerical order of participants for each question. Our commitment to rigorous qualitative methods was a strength for the study for multiple reasons. Conducting member checks with participants ensured trustworthiness of findings. Continuing data collection to data saturation ensured dependability of findings, which was achieved after 10 interviews and confirmed after 2 additional interviews. We further recognize the heterogeneity in our sample of participants, which helped generate variability in responses. To remain consistent with appropriate means of presenting results in qualitative research however, we shared minimal demographic information about our study participants to ensure confidentiality.

The divide between urban and rural health stretches beyond a disproportionate allocation of resources. Rural health systems serve a more complicated and hard-to-reach patient population. They lack sufficient numbers of providers to meet population health needs. These disparities impact collaboration between patients and providers as well as the delivery of acceptable and appropriate healthcare. The marker of rurality complicates the already cumbersome challenge of administering acceptable and appropriate healthcare and impediments stemming from rurality require continued monitoring to improve patient experiences and outcomes. Our qualitative study explored rural healthcare providers’ views on some of the social, cultural, and programmatic factors that influence access to healthcare among their patient populations. We identified five key themes: 1) a friction exists between aspects of patients’ rural identities and healthcare systems; 2) facilitating access to healthcare requires application of and respect for cultural differences; 3) communication between healthcare providers is systematically fragmented; 4) time and resource constraints disproportionately harm rural health systems; and 5) profits are prioritized over addressing barriers to healthcare access in the US. This study provides implications that may shift the landscape of a healthcare provider’s approach to delivering healthcare. Further exploration is required to understand the effects these characteristics have on measurable patient-centered outcomes in rural areas.

Availability of data and materials

The datasets generated and/or analyzed during the current study are not publicly available due to individual privacy could be compromised but are available from the corresponding author on reasonable request.

Ethics approval and consent to participate.

All study procedures and methods were carried out in accordance with relevant guidelines and regulations from the World Medical Association Declaration of Helsinki. Ethics approval was given by exempt review from the Institutional Review Board (IRB) at the University of Montana (IRB Protocol No.: 186–20). Participants received oral and written information about the study prior to interview, which allowed them to provide informed consent for the interviews to be recorded and used for qualitative research purposes. No ethical concerns were experienced in this study pertaining to human subjects.

Consent for publication.

The participants consented to the publication of de-identified material from the interviews.

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Acknowledgements

This research was supported by the Center for Biomedical Research Excellence award (P20GM130418) from the National Institute of General Medical Sciences of the National Institute of Health. The first author was also supported by the University of Montana Burnham Population Health Fellowship. We would like to thank Dr. Christopher Dietrich, Dr. Jennifer Robohm and Dr. Eric Arzubi for their contributions on determining inclusion criteria for the healthcare provider population used for this study.

 This research did not receive any specific grant from funding agencies in the public, commercial, and not-for-profit sectors. 

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The authors confirm contribution to the paper as follows: study conception and design: NC and JC; data collection: NC; analysis and interpretation of results: NC and JC; draft manuscript preparation: NC, DC and JC; and manuscript editing: NC, DC and JC. All authors reviewed the results and approved the final version of the manuscript.

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Coombs, N.C., Campbell, D.G. & Caringi, J. A qualitative study of rural healthcare providers’ views of social, cultural, and programmatic barriers to healthcare access. BMC Health Serv Res 22 , 438 (2022). https://doi.org/10.1186/s12913-022-07829-2

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Social Problems in the US Research Paper

View sample sociology research paper on social problems in the US. Browse other research paper examples for more inspiration. If you need a thorough research paper written according to all the academic standards, you can always turn to our experienced writers for help. This is how your paper can get an A! Feel free to contact our custom writing service for professional assistance. We offer high-quality assignments for reasonable rates.

The study of social problems in the United States is no doubt one of the most difficult to summarize and analyze within sociology. In contrast to family sociology, criminology, social stratification, the sociology of sport, and so on, the study of social problems is always shifting in terms of what is included or excluded as the focus of study. But there is also the matter of shifting perspectives and theories within all the core issues within the field of social problems, such as racial discrimination, crime and delinquency, and sexual deviance, to name only a few of what have been among the core issues in the study of social problems in America.

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In what follows, we will briefly consider how social problems have been studied in early American history and then consider how social problems have been defined in sociology textbooks and look at the trends in these textbooks over the years. In the second half of this research paper, we will examine more critically how the particular pattern of American values have influenced our definitions of social problems, along with the impact of wealth and power on these definitions. With this examination of wealth and power, we will consider the impact of social movements on what comes to be defined as social problems. A complete understanding of the impact of social movements, however, also requires brief consideration of the causes of social movements. Finally, we will consider how solutions to social problems are also shaped by power, wealth, and American value orientations.

A Brief History of the Study of Social Problems in the United States

The first book in the United States with the title Social Problems was mostly likely that by Henry George, first published in 1883 (George 1939). But sociologists such as George Herbert Mead were already discussing the nature of social problems and the need for social reform in the late 1800s (see Mead 1899; Schwendinger and Schwendinger 1974:452–56). As industrialization took off dramatically in the final two decades of the nineteenth century, so did many conditions that came to be defined as social problems, such as urban poverty, unemployment, and crime. As the great historian Hofstader (1955) noted, it was soon after this that the United States entered one of its reoccurring cycles of reform movements (also see Garraty 1978). It was also a time when sociology was emerging as a major discipline of academic study in the United States (Gouldner 1970; Schwendinger and Schwendinger 1974). The timing of these two events is no doubt a reason why the study of social problems became one of the major subareas in American sociology. But it was also the unique set of utilitarian and individualistic values in the United States that affected the development of American sociology. A crusading spirit accompanied the emergence of American sociology, with many of the early American sociologists coming from Christian clergy backgrounds to a new secular orientation toward understanding the problems of the newly industrialized nation (Gouldner 1970).

It was also a liberal critique of the American society rooted in the early discipline of U.S. sociology, different from that found in European sociology. From the midnineteenth century, European sociology had developed with the full range of perspectives, from radical critiques of basic institutions provided by Marx to conservative support of the status quo from the likes of Herbert Spencer. American sociology through the first half of the twentieth century, in contrast, “came to dwell on those concrete institutional areas and social problems” (Gouldner 1970:93) accepted by the dominate society from a perspective of how to make them work better rather than suggesting basic change. “Indeed, nothing like Marxian sociology was even recognized by American sociology until well after World War II” (McLellan 1973). There were, of course, Marxian perspectives among European immigrants and the early labor movement in the United States, but little of this found its way into academic halls. It is telling that Talcott Parsons’s major book, designed to introduce Americans to European sociology in the early 1930s, had not one mention of Marx or Marxian theory (Parsons 1937). To this day, social problems are not considered a major subarea in European sociology or offered as a course in many European universities. The exception to this was sociology in the old Soviet Union, where the Soviet government found the social problem orientation of functional sociology a useful perspective for “fine-tuning” the Soviet society without criticism of the basic Soviet institutions (Gouldner 1970:447–52).

What is a Social Problem? Textbook Definitions

Standard “textbook” definitions of social problems are generally grouped into three categories, with the second two categories most often used by sociologists themselves. As we will consider in the following, however, there are many more underlying assumptions about the nature of society and humans that shape what sociologists as well as the general public come to define as social problems.

The public generally sees a social problem as any condition that is harmful to society; but the matter is not so simple, for the meanings of such everyday terms as harm and society are far from clear. Social conditions that some people see as a problem harm some segments of society but are beneficial to others. Take trade policy as an example. Shareholders and others affiliated with multinational corporate manufacturers typically argue that any kind of trade restriction is a problem because government regulation interferes with the free enterprise system and drives up costs to consumers. On the other hand, domestic workers and manufacturers argue that the government’s failure to exclude products produced in low-cost nations is a social problem because it costs jobs and hurts domestic business. As we will discuss in more detail later, one person’s social problem, in other words, is often another person’s solution. In fact, most people and organizations define something as a social problem only if it harms (or seems to harm) their own interests.

Sociologists have tried to take a less biased approach with mixed results. Most of the early sociological works on social problems held that a social problem exists when there is a sizable difference between the ideals of a society and its actual achievements. From this perspective, social problems are created by the failure to close the gap between the way people want things to be and the way things really are. Thus, racial discrimination is a social problem because although we believe that everyone should receive fair and equal treatment, some groups are still denied equal access to education, employment, and housing. Before this definition can be applied, however, someone must first examine the ideals and values of society and then decide whether these goals are being achieved. From this perspective, sociologists and other experts thus decide what is or is not a problem because they believe they are the ones with the skills necessary for measuring the desires and achievements of society (see Merton and Nisbet 1971).

Critics of this approach point out that no contemporary society has a single, unified set of values and ideals. When using this definition, sociologists must therefore decide which standards they will use for judging whether or not a certain condition is a social problem. Critics charge that those ideals and values used as standards are selected on the basis of the researcher’s personal opinions and prejudices, not objective analysis.

The “social constructivists,” who have become the dominant school in social problems research, take a different position, holding that a social problem exists when a significant number of people believe that a certain condition is in fact a problem. Here, the public (not a sociologist) decides what is or is not a social problem. The sociologist’s job is to determine which problems affect a substantial number of people. Thus, in this view, pollution did not become a social problem until environmental activists and news reports attracted the public’s attention to conditions that had actually existed for some time (see Blumer 1971; Spector and Kitsuse 1973).

The advantage of this definition is that it does not require a value judgment by sociologists who try to decide what is and is not a social problem: Such decisions are made by “the public.” However, a shortcoming of this approach is that the public is often uninformed or misguided and does not clearly understand its problems. If thousands of people were being poisoned by radiation leaking from a nuclear power plant but didn’t know it, wouldn’t that still be a social problem? A potentially more serious shortcoming of this approach is its hidden political bias. Obviously, in a mass society it is not simply the seriousness of the problem that wins it public attention but the way the corporate media present it. Furthermore, relatively powerless groups with little money or political organization are not able to get their problems recognized as social problems in the way that dominant groups can. Sociologists using the constructivist approach in the study of social problems creation have generally been very sensitive to the role power plays in this process, but researchers focusing more narrowly on individual social problems have often unreflectively accepted the definitions of problematic conditions provided by funding agencies or popular opinion (Galliher and McCartney 1973; Useem 1976a, 1976b; Kerbo 1981, 2006a:254–59).

But even these conflicting views of how social problems are to be defined miss important underlying assumptions that influence what people come to define as a social problem. These underlying assumptions account for how social problems are differently conceived across societies, through history, and across lines such as race, class, and religion within societies at one particular time. And it must be recognized that sociologists have also been influenced by these underlying and often hidden assumptions about humans and societies.

The Field Today: Trends in “Social Problems” Textbooks

The question of which problems are serious enough to warrant sociological attention has been a difficult and controversial one over the years. We will consider this issue from another perspective in the following. But for now, we can note that the pressure of social movements is one of four interwoven factors that determined which problems draw the most sociological attention. The public’s perception of its problems is a second important factor that, of course, is strongly influenced by the media of mass communication. Space does not permit an exploration of all the factors that influence the media’s decisions to turn its attention on one problem and not another, but certainly the corporate interests of the media conglomerates and the various political and financial pressures to which they are exposed are of prime importance (see, for example, Domhoff 2006, on the “policy formation process”). But in addition to the media, the public’s perception of social problems is also shaped by the actual experiences of everyday people. So a third factor is the social crises that have a wrenching impact on the public from time to time, as well as the ongoing contradictions of industrial capitalism. In January of 2001, for example, terrorism was not mentioned as a major problem in the Gallup Poll, but by the start of 2002, it was the number one problem identified by the respondents. With the start of the Iraq war the following year, warfare and international tension replaced terrorism on the list of national concerns. In 2001, less than 0.5 percent of the poll respondents mentioned warfare and international tensions as the nation’s most serious problem, but by 2003, 35 percent did so (Gallup 2004). A final factor involves the sociologists who are selecting the problems for consideration.

Since most practicing sociologists hold some kind of academic position, they function as semi-independent intellectuals in the arena of social problems creation. As such, they have considerably more independence (although less visibility and influence) than scientists and advocates working for the corporations or other special interest groups. But as noted in the foregoing, they are, nonetheless, still constrained by the need to obtain financial support for their research and the political climate of their universities. The paradigmatic shift that has occurred in sociology in the last 50 years as it moved away from the functionalist perspective to a more critical conflict orientation has certainly been an important influence both in the problems that are given attention and in the ways in which they are analyzed.

Since the focus of ociological research itself is determined as much by the priorities of the funding agencies as by the sociologists who carry it out, one of the best guides to the changes in sociological concerns is the content of the social problems textbooks. A comparison of contemporary texts with those from the earlier decades of the postwar era shows that although organizational styles and definitions vary, there is a significant group of problems that have maintained consistent sociological attention. If any social problems can be said to occupy the center of sociological concern, they are the ones related to crime and deviance. Certain types of crime and deviance were given more coverage in one era than another, but all the major texts have an extensive coverage of this topic. Other constants are the problems of the family, ethnic relations, population, and poverty or economic inequality. A second group of problems appears in some texts but not in others without any clear chronological pattern of increasing or decreasing attention. Surprisingly, given their importance in public opinion polls, economic problems other than poverty are not consistently covered. Other problems in this category include those of urbanization, sexuality, and education.

Finally, a third group of problems has shown an increase or decrease in sociological interest over the years. The first edition of the best-selling text by Horton and Leslie (1955) had chapters on two problems that are not seen in later texts: “Religious Problems and Conflicts” and “Civil Liberties and Subversion” (the focus of the latter being primarily on the dangers of communism). New social movements during this period also brought new problems to the foreground. By the time Joseph Julian’s text replaced Horton and Leslie as the top seller in the 1970s, several new problems had joined the core of sociological interest. In response to the rise of the environmental movement, Julian’s (1973) first edition contained a chapter on environmental problems—something that became a mainstay of social problems texts either on its own or with a presentation of population growth as a social problem. The feminist movement succeeded in adding another critical topic— gender inequity—to the mainstream texts. The extremely influential text, edited by Robert K. Merton and Robert Nisbet (1976), first added a chapter on gender in its fourth edition, and Julian (1977) added a similar chapter the following year. More recently, there has been growing attention to the problems faced by gays and lesbians, even though this topic has generally not been treated in an independent chapter of its own. Although chapters on the problems of aging are not quite as common, they also started showing up around the 1970s.

The main focus of most of these texts, like that of American sociology itself, has been on domestic issues, but there have been some important changes there as well. As the memories of World War II began to fade, there was some decline in interest in events beyond America’s borders. Horton and Leslie originally had two chapters with an international focus, “Population” and “Warfare and International Organization,” as did the Merton and Nisbet text in its early editions. In 1976, however, Merton and Nisbet replaced their chapter on “Warfare and Disarmament” with a chapter on “Violence,” which focused on criminal behavior, and Julian never had a chapter on warfare. However, as the process of globalization won increasing public attention in the 1990s, this trend was slowly reversed. Not only did many of the texts begin including more comparative material, but some added a chapter on global inequality as Coleman and Cressey (1993) did in their fifth edition.

Three overall trends are therefore evident in the sociological study of social problems in North America. As just indicated, one trend has been toward greater inclusivity. First African Americans, then other ethnic minorities, then women, and finally gays and lesbians have slowly won inclusion in what was originally an exclusively white male vision of the world. A second trend has been the slow expansion of sociological horizons to recognize the importance of environmental concerns as well as to take a more global perspective.

A third trend, not as easily recognizable from our previous analysis, has been an underlying paradigmatic shift. To the extent that they used any explicit theoretical approach, the earlier texts were based on functionalist assumptions. Following Horton and Leslie (1955:27–32), they tended to argue that there were three theoretical approaches to social problems: social disorganization, personal deviance, and value conflict. The value-conflict approach should not, however, be confused with contemporary conflict theory inspired by Marxian thought. Its basic assumptions were clearly functionalist: Society needed value consensus, and “value conflict” was therefore a cause of social conflict (Fuller and Myers 1941). As sociology slowly adopted a more critical perspective, a few books with an exclusively conflict orientation were published, and for most of the other textbooks, this tripartite approach was recast. The social disorganization approach was expanded and renamed to include all functionalist theory. The personal deviance approach expanded to become the interactionist approach, which had less of a functionalist cast and included other social psychological phenomena in addition to deviance. Finally, the issue of value conflict was subsumed under the much broader and more critical umbrella of a conflict approach (for example, see Coleman and Cressey 1980).

Of the new trends that seem to be developing for the twenty-first century, an increasing globalization perspective is most important. There is now greater recognition that for the United States, globalization is creating new social problems or making old ones such as poverty and unemployment worse. The movement of U.S. factories overseas and outsourcing of all kinds of work have helped reduce wages for the bottom half of the American labor force (see Kerbo 2006b:chaps. 2 and 3). In addition to this, the antiglobalization movements of recent years, as well as research on the negative impact of globalization for developing countries (Kerbo 2006b:chap. 4), have brought greater attention to the subjects of world poverty, environmental pollution, and global migration for most books on social problems. With global inequality expected to continue increasing for many years into the twenty-first century, the trend will likely become more pronounced.

Paradigm Assumptions and Defining Social Problems

In his classic work The Sociological Imagination, C. Wright Mills (1959) argued we should distinguish between “‘the personal troubles of milieu’ and ‘the public issues of social structure’” (p. 8). For him, of course, it was “the public issues of social structure” that should be the focus of sociology when defining the nature of a social problem. Mills offered this example:

In these terms, consider unemployment. When, in a city of 100,000, only one man is unemployed, that is his personal trouble, and for its relief we properly look to the character of the man . . . But when in a nation of 50 million employees, 15 million men are unemployed, that is an issue . . . Both the correct statement of the problem and the range of possible solutions require us to consider the economic and political institutions of the society, and not merely the personal situation and character of a scatter of individuals. (P. 9)

Mills, obviously, offers a definition of social problems that focuses on the breakdown of basic social institutions that must take care of individuals and assure the survival of the society and its social institutions. His plea for a focus on social institutions seems straightforward and obvious; but he made such a plea because of the particular aspects of American culture that create a bias against this focus.

It has long been recognized that power (generally defined) and values interact to determine what comes to be seen as social problems. Those with wealth and influence in government and/or the mass media in modern societies are the ones most able to shape what the society comes to view as a social problem. But there are many forms of influence held by those below the top ranks in the society, making the study of social problems overlap with the study of social movements. Several years ago, for example, one of the basic American social problems textbooks employed the title Social Problems as Social Movements (Mauss 1975). As we will consider in the following, however, assuming that social movements help define social problems is also problematic because of the complex set of forces that make the emergence of social movements possible. But in addition to this, the recognition that social movements help define social problems continues to neglect the question of cultural assumptions and values that make one country, in one historical epic, view conditions differently for people in other times and places, as well as neglect the ability of those with wealth and power to shape the perspective on the causes and solutions to social problems once they have been defined as such.

Sociological analyses of sociology itself, a form of “deconstructionism” popular among professional sociologists during the 1960s and 1970s, long before the current fad in humanities, has shown that “paradigm assumptions” or “metatheoretical assumptions” shape all sociological theories at least to some degree (Gouldner 1970; Strasser 1976; Ritzer 2005). And while all scientific disciplines are influenced by these political, religious, or cultural assumptions (Kuhn 1970), these assumptions shape some fields within the social sciences to a greater extent than others. Theories and research on politically sensitive subjects such as crime and poverty, along with most subjects within the general area of social problems, are most influenced by these paradigm assumptions (Galliher and McCartney 1973; Useem 1976a, 1976b; Kerbo 1981).

To understand theories and research on social problems in the American society, it is first important to examine some of the general American values that shape views on these subjects. Various international opinion polls show the following: Americans have the highest scores on (1) individualism (Hofstede 1991), (2) beliefs in the existence of equality of opportunity, (3) beliefs that government cannot and should not reduce inequality or poverty (Ladd and Bowman 1998), and (4) beliefs that high levels of poverty and inequality are acceptable (Verba et al. 1987; Ladd and Bowman 1998). For the study of social problems in general, this has meant that American values suggest that individuals themselves are responsible for their problems rather than some aspect of the society or basic institutions. In contrast to the early appeals of C. Wright Mills noted in the foregoing, content analyses of articles on social problems published in American sociology journals through the second half of the twentieth century confirm that the focus tends to be on the characteristics of individuals rather than problems of society (Galliher and McCartney 1973; Useem 1976a, 1976b; Kerbo 1981, 2006a:254–59).

This research also shows that it is not simply the views of sociologists themselves that set the trend toward blaming the characteristics of individuals for social problems as much as the assumptions of funding agencies; most social science research is funded by government agencies and private foundations that are more interested in controlling social problems rather than changing aspects of the society that are often at the root of social problems (Kerbo 1981). Interviews with social scientists indicate that they are most often conducting research on questions that they know will get funding rather than on what they think are the most important sociological questions or subjects in which they are most interested (Useem 1976a, 1976b). What this research suggests is that while the rich and powerful may not always define what is seen as a social problem, they do have extensive influence over what we think are the causes and solutions to social problems. They help set the research agendas, what gets research attention, and what gets talked about in government circles and the mass media through this influence on the social sciences through research funding (see Domhoff 2006:77–132).

This is not to say, however, that the assumptions and interests of the less affluent and politically powerless do not shape what we come to define as social problems. For example, an abundance of research has shown that the civil rights movements of the 1960s, and especially the violent demonstrations and riots of that period, shaped the American society’s definition of poverty as a social problem (Piven and Cloward 1971, 1977). Indeed, several studies have shown strong correlations between urban riots of the 1960s and the expansion of welfare benefits to the poor (Betz 1974; Kelly and Snyder 1980; Isaac and Kelly 1981).

The tie between social movements and what comes to be defined as social problems is especially critical in the United States. Compared with the rest of the industrialized world, of course, a much smaller percentage of Americans tend to vote during national elections. But an even bigger contrast to other industrialized nations is the class makeup of those who do vote in the United States: Toward the upper-income levels, some 70–80 percent of Americans who are eligible to vote do so, compared with 30 percent or less for people with a below-average income. This is not the case with other industrial societies, where the voter turnout is about the same at every income level (Piven and Cloward 1988, 2000; Kerbo and Gonzalez 2003). This is to say, therefore, that when the less affluent and less politically powerful in the United States have influenced definitions of social problems, it has been comparatively more often done in the streets than through the political process.

The Causes of Social Movements and Their Impact on Definitions of Social Problems

Recognizing that social movements are important in identifying what a society comes to view as a social problem forces us to ask how social movements themselves emerge. It is not our intent to review all the literature on the causes of social movements, but a brief summary of this literature is essential when considering how social problems have been defined in the United States.

For many years the study of social movements was dominated by theories based on some form of “deprivation” argument. In other words, social movements were seen to emerge and attract widespread membership because participants felt a sense of anger or outrage at their condition. Recognizing that long-standing deprivations do not always or even often spark widespread social movement activity (such as decades or centuries of discrimination and exploitation of a minority group by the majority), most deprivation theories of social movements attempted to explain how some type of change leads to a redefinition of the situation. The most popular of this type of theory has been called “relative deprivation theory” or “J-curve theory” (Davies 1962, 1969; Gurr 1970). During the early 1800s, Tocqueville (1955) recognized that, ironically, social movements and revolutions tend to emerge when conditions are actually improving. More recent refinements of “relative deprivation theory” distinguish between what is called “value expectations” and “value capabilities.” When value capabilities are low (such as high levels of poverty) and have been so for a long period of time, people come to accept their situation or assume improvements are unlikely or impossible. People in deprived situations are often, even likely, to be persuaded that they themselves are responsible for their condition and thus have no one else to blame (Piven and Cloward 1971; Gans 1972). This is to say that low-value capabilities are usually associated with lowvalue expectations over long periods of time. Thus, to understand the emergence of social movements, relative deprivation theories suggest the need to understand how value capabilities and value expectations move apart.

Obviously, the gap between the two can develop because value capabilities worsen (such as a big jump in unemployment of the working class), thus creating a gap between previous expectations and newly lowered capabilities. Faced with a sudden crisis, people seldom assume their situation is hopeless or that they deserve their worsening situation. However, as Tocqueville (1955) was first to recognize, social movements and revolutions actually seem to occur when long-standing conditions of deprivation are actually improving. Refinement of relative deprivation–type theories has come to suggest that improving conditions quickly raise levels of expectation, but improving conditions seldom occur without fluctuation, meaning that a sudden downturn in improving conditions creates the gap between value capabilities and value expectations. It is anger or fear that improvements finally achieved will be short lived that motivate more and more people to join a social movement.

While research has shown that some form of “relative deprivation” seems to have preceded many social movements, others have noted that this is not always the case— nor is anger or a sense of deprivation in and of itself usually sufficient to make a social movement. In recent years, what is generally referred to as “resource mobilization theory” has become much more popular among sociologists attempting to explain the development and spread of social movements (for original development of the perspective, see McCarthy and Zald 1977). In its basics, resource mobilization theory is a form of conflict theory focused on the balance of power between authorities (or the more powerful in a society) and those with possible grievances. Reduced power of authorities, increased power among those with a grievance, or both can lead to a strong social movement.

The concept of “resources” in resource mobilization theory refers to any value or condition that can be used to the advantage of a group. Obviously important are such things as money, publicity, arms, and the ability to interact with and organize larger numbers of people for the cause. In one of the first studies using resource mobilization theory, for example, Paige (1975) was able to show that certain kinds of crops and certain types of agricultural organization (such as wet rice agriculture with absentee landowners) are more likely associated with peasant revolts and revolutions because of the ability peasants have to interact freely, share common grievances, and be organized to oppose landowners. Likewise, the loss of legitimacy and the ability to punish opponents or hide information are conditions that reduce the power and resources of authorities. Ted Gurr (1970) has produced a long list of possible resources that includes things such as terrain (ability to hide or ability of authorities to uncover rebels), food supplies, and outside allies that can influence the power and size of social movements.

Perhaps more than any other social movement in recent American history, the new resource mobilization theory of social movements led to a reanalysis of the civil rights movement. Because of this extensive reanalysis of the causes of the civil rights movement, it is worth considering in more detail here how a particular social problem, racism and discrimination, came to be widely defined as a social problem in the second half of the twentieth century.

Civil Rights Movement

Considering the importance of the civil rights movement in the United States for defining racism, discrimination, and poverty as social problems, it is useful to consider how this social movement emerged and to consider the value of the social movement theories described in the foregoing.

Relative deprivation theory has some success in explaining why the more violent stage of the civil rights movement emerged in the mid-1960s. Sociologists using this perspective argue that the more violent stage of the civil rights movement was in response to a white “backlash” that resulted in some setbacks to the earlier achievements of the civil rights movement from the 1950s (Davies 1969). However, relative deprivation theory has difficulty in explaining why the civil rights movement suddenly appeared in the early 1950s, while so many other attempted social movements by black Americans failed in earlier American history. In recent years, research has shown resource mobilization theory to be a powerful tool in understanding why the civil rights movement became widespread and powerful when and where it did so (McAdam 1982).

In summary, the civil rights movement benefited from several changes that occurred in the American society after World War II. Among the most important changes was agricultural mechanization, which moved a majority of black Americans from rural areas and agricultural jobs into large cities all over the United States. Larger concentrations of black Americans in urban areas provided the ability to reach and organize far greater numbers of social movement participants than before. A key to organizational ability was also found in the huge churches dominated by black Americans in large cities in the southern United States. These black churches made possible organization within the denomination and across churches all over the South. At the same time, these large black churches provided support for social movement participants and their families when they were jailed or injured in social movement activities.

Among other new resources in the 1950s were more mass-media exposure to actions against black Americans and social movement activities that had remained relatively hidden in small cities and rural areas throughout the South in previous generations. But related to this was political change, as the Democratic Party lost its previously solid majority in the South. To counter this loss, the Democratic Party decided to “go for” new urban concentrations of potential black votes in the late 1950s. It was politicalization of black grievances in the presidential election of 1960 that gave black social movement activists more resources of many kinds and John F. Kennedy the presidency in one of the closest elections when newly organized black voters gave him overwhelming support.

Movements of Affluence

The foregoing analysis of social movements and their causes as instrumental in defining what comes to be seen as a social problem, however, should not be seen as reinforcing the common assumption that social movements are primarily by and for the poor and oppressed. We must recognize the distinction between what has been called “movements of crisis” and “movements of affluence” (Kerbo 1982). Most movements of crisis are made up of people who face critical problems such as poverty, discrimination, or some other deprivation. Most movements of affluence, on the other hand, involve people who are relatively comfortable, if not affluent, and have the luxury of devoting their attention and energy on “moral issues.” Current social movements in the United States that are usually pushed by people on the political right (such as the anti-abortion movement) as well as the political left (such as the environmental movement and antiglobalization) must be included among these movements of affluence, which focus on moral issues or issues that are not of immediate harm to individual social movement participants.

Solutions to Social Problems

We can conclude with an examination of what are considered “solutions” to social problems. While the possible solutions to social problems are seldom recognized, they are equally, if not more, shaped by power and influence in a society. Over the last four decades in the United States, the extent and seriousness of many, if not most, social problems have remained relatively unchanged. For example, while violent crime and property crime have dropped in recent years, violent crime especially remains at high levels compared with other industrial nations. Drug use has gone up and down within only a narrow range. Teenage pregnancy has dropped only slightly. Poverty rates have ranged between 11 and 15 percent of the American population in the last 40 years, among the highest in the industrialized world. These continuing high levels of social problems in the United States might suggest that relatively little has been learned about the subject in the last half century of sociological research. The reality, however, is quite different. Even more complex than definitions of social problems is finding solutions that do not adversely affect groups with more political and/or economic power or impinge on important values of the dominant group in the society. Consideration of possible solutions to poverty and inequality will be useful in demonstrating the point.

In most of the original European Union countries, poverty rates are substantially below the American rates. Using the purchasing power parity (PPP) method of estimating currency values, and using the poverty line established by the U.S. Census Bureau (roughly $11 per day per person), during the late 1990s (the most recent years we have data for several European countries) the U.S. poverty rate was over 13 percent, compared with about 7 percent in Germany and the Netherlands and around 4 percent in Scandinavian countries (Smeeding, Rainwater, and Burtless 2001:51). But while the American poverty rates are comparatively high, unemployment at around 4 to 5 percent in the same time period was low compared to over 10 percent unemployment in most original EU countries. There are two interacting explanations for this: First, in contrast to the United States, European labor unions are strong enough to force government action to keep poverty low even at the expense of higher unemployment rates (Esping-Anderson 1990; Thelen 1991; Goodin et al. 1999; Kerbo and Gonzalez 2003). Second, opinion polls indicate that Europeans are more concerned than are Americans about high inequality and poverty among their citizens and believe that governments have the responsibility to reduce poverty and inequality (Verba et al. 1987; Ladd and Bowman 1998). These two explanations are also behind the figures we see in Table 1. Without government action, poverty rates in Europe would be about the same or even higher than in the United States. But government interventions in Europe reduce poverty rates by 50 to 80 percent, compared with only a 28 percent reduction in the United States. Not surprisingly, the EU country with the weakest unions today and values closest to the United States, the United Kingdom, has the lowest rate of reducing poverty through government action in Europe and, using the PPP $11 per day poverty line, a poverty rate of 15.7 percent compared with 13.6 percent in the same time period in the United States (Smeeding et al. 2001:51).

The contrast between Germany and the United States is most clear. The influence of the American corporate elite, in the context of American values stressing individualism, has led the American public to generally accept the argument that the government should not be allowed to raise taxes, increase unemployment benefits, or raise minimum-wage laws to reduce poverty. Rather, the argument is that corporations and the rich should be left alone as much as possible to generate wealth that will then expand job opportunities that will reduce poverty among Americans. (For a broader discussion of this German vs. American contrast, see Kerbo and Strasser 2000, Kerbo 2006b:chap. 3.) In Germany, by contrast, the power of labor unions and labor laws already instituted with labor union pressure will not allow such government inaction as a presumed solution to the problem of poverty.

Another example can be briefly considered. Several studies indicate that high employment rates are instrumental in producing crime (Blau and Blau 1982; Williams 1984), which at least in part helps explain the lower crime rates in the United States from the early 1990s to the present. Thus, a guaranteed job after release from prison would significantly reduce the rate of recidivism. But since the 1930s, American politicians have not been willing to create employment through government programs in times of high unemployment or guarantee jobs to felons released from prison. The American corporate elite have been successful in blocking such government job guarantees or jobs created by government, even though it is clear this would be one viable solution to high rates of crime.

There are many other examples: Decriminalizing drugs would likely help reduce both property crime and drug addiction as it has in some European countries, and more sex education and freer access to condoms would help reduce teenage pregnancy rates, which are far higher in the United States than in Europe. But as with definitions of what is or is not a social problem, power and influence in combination with particular societal value orientations that can be exploited by those with power are also involved with what come to be viewed as accepted solutions to social problems.

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• COVID-19 and your mental health

Worries and anxiety about COVID-19 can be overwhelming. Learn ways to cope as COVID-19 spreads.

At the start of the COVID-19 pandemic, life for many people changed very quickly. Worry and concern were natural partners of all that change — getting used to new routines, loneliness and financial pressure, among other issues. Information overload, rumor and misinformation didn't help.

Worldwide surveys done in 2020 and 2021 found higher than typical levels of stress, insomnia, anxiety and depression. By 2022, levels had lowered but were still higher than before 2020.

Though feelings of distress about COVID-19 may come and go, they are still an issue for many people. You aren't alone if you feel distress due to COVID-19. And you're not alone if you've coped with the stress in less than healthy ways, such as substance use.

But healthier self-care choices can help you cope with COVID-19 or any other challenge you may face.

And knowing when to get help can be the most essential self-care action of all.

Recognize what's typical and what's not

Stress and worry are common during a crisis. But something like the COVID-19 pandemic can push people beyond their ability to cope.

In surveys, the most common symptoms reported were trouble sleeping and feeling anxiety or nervous. The number of people noting those symptoms went up and down in surveys given over time. Depression and loneliness were less common than nervousness or sleep problems, but more consistent across surveys given over time. Among adults, use of drugs, alcohol and other intoxicating substances has increased over time as well.

The first step is to notice how often you feel helpless, sad, angry, irritable, hopeless, anxious or afraid. Some people may feel numb.

Keep track of how often you have trouble focusing on daily tasks or doing routine chores. Are there things that you used to enjoy doing that you stopped doing because of how you feel? Note any big changes in appetite, any substance use, body aches and pains, and problems with sleep.

These feelings may come and go over time. But if these feelings don't go away or make it hard to do your daily tasks, it's time to ask for help.

Get help when you need it

If you're feeling suicidal or thinking of hurting yourself, seek help.

• Contact your healthcare professional or a mental health professional.
• Contact a suicide hotline. In the U.S., call or text 988 to reach the 988 Suicide & Crisis Lifeline , available 24 hours a day, seven days a week. Or use the Lifeline Chat . Services are free and confidential.

If you are worried about yourself or someone else, contact your healthcare professional or mental health professional. Some may be able to see you in person or talk over the phone or online.

You also can reach out to a friend or loved one. Someone in your faith community also could help.

And you may be able to get counseling or a mental health appointment through an employer's employee assistance program.

Another option is information and treatment options from groups such as:

• National Alliance on Mental Illness (NAMI).
• Substance Abuse and Mental Health Services Administration (SAMHSA).
• Anxiety and Depression Association of America.

Self-care tips

Some people may use unhealthy ways to cope with anxiety around COVID-19. These unhealthy choices may include things such as misuse of medicines or legal drugs and use of illegal drugs. Unhealthy coping choices also can be things such as sleeping too much or too little, or overeating. It also can include avoiding other people and focusing on only one soothing thing, such as work, television or gaming.

Unhealthy coping methods can worsen mental and physical health. And that is particularly true if you're trying to manage or recover from COVID-19.

Self-care actions can help you restore a healthy balance in your life. They can lessen everyday stress or significant anxiety linked to events such as the COVID-19 pandemic. Self-care actions give your body and mind a chance to heal from the problems long-term stress can cause.

Take care of your body

Healthy self-care tips start with the basics. Give your body what it needs and avoid what it doesn't need. Some tips are:

• Get the right amount of sleep for you. A regular sleep schedule, when you go to bed and get up at similar times each day, can help avoid sleep problems.
• Move your body. Regular physical activity and exercise can help reduce anxiety and improve mood. Any activity you can do regularly is a good choice. That may be a scheduled workout, a walk or even dancing to your favorite music.
• Choose healthy food and drinks. Foods that are high in nutrients, such as protein, vitamins and minerals are healthy choices. Avoid food or drink with added sugar, fat or salt.
• Avoid tobacco, alcohol and drugs. If you smoke tobacco or if you vape, you're already at higher risk of lung disease. Because COVID-19 affects the lungs, your risk increases even more. Using alcohol to manage how you feel can make matters worse and reduce your coping skills. Avoid taking illegal drugs or misusing prescriptions to manage your feelings.

Take care of your mind

Healthy coping actions for your brain start with deciding how much news and social media is right for you. Staying informed, especially during a pandemic, helps you make the best choices but do it carefully.

Set aside a specific amount of time to find information in the news or on social media, stay limited to that time, and choose reliable sources. For example, give yourself up to 20 or 30 minutes a day of news and social media. That amount keeps people informed but not overwhelmed.

For COVID-19, consider reliable health sources. Examples are the U.S. Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO).

Other healthy self-care tips are:

• Relax and recharge. Many people benefit from relaxation exercises such as mindfulness, deep breathing, meditation and yoga. Find an activity that helps you relax and try to do it every day at least for a short time. Fitting time in for hobbies or activities you enjoy can help manage feelings of stress too.
• Stick to your health routine. If you see a healthcare professional for mental health services, keep up with your appointments. And stay up to date with all your wellness tests and screenings.
• Stay in touch and connect with others. Family, friends and your community are part of a healthy mental outlook. Together, you form a healthy support network for concerns or challenges. Social interactions, over time, are linked to a healthier and longer life.

Avoid stigma and discrimination

Stigma can make people feel isolated and even abandoned. They may feel sad, hurt and angry when people in their community avoid them for fear of getting COVID-19. People who have experienced stigma related to COVID-19 include people of Asian descent, health care workers and people with COVID-19.

Treating people differently because of their medical condition, called medical discrimination, isn't new to the COVID-19 pandemic. Stigma has long been a problem for people with various conditions such as Hansen's disease (leprosy), HIV, diabetes and many mental illnesses.

People who experience stigma may be left out or shunned, treated differently, or denied job and school options. They also may be targets of verbal, emotional and physical abuse.

Communication can help end stigma or discrimination. You can address stigma when you:

• Get to know people as more than just an illness. Using respectful language can go a long way toward making people comfortable talking about a health issue.
• Get the facts about COVID-19 or other medical issues from reputable sources such as the CDC and WHO.
• Speak up if you hear or see myths about an illness or people with an illness.

COVID-19 and health

The virus that causes COVID-19 is still a concern for many people. By recognizing when to get help and taking time for your health, life challenges such as COVID-19 can be managed.

• Mental health during the COVID-19 pandemic. National Institutes of Health. https://covid19.nih.gov/covid-19-topics/mental-health. Accessed March 12, 2024.
• Mental Health and COVID-19: Early evidence of the pandemic's impact: Scientific brief, 2 March 2022. World Health Organization. https://www.who.int/publications/i/item/WHO-2019-nCoV-Sci_Brief-Mental_health-2022.1. Accessed March 12, 2024.
• Mental health and the pandemic: What U.S. surveys have found. Pew Research Center. https://www.pewresearch.org/short-reads/2023/03/02/mental-health-and-the-pandemic-what-u-s-surveys-have-found/. Accessed March 12, 2024.
• Taking care of your emotional health. Centers for Disease Control and Prevention. https://emergency.cdc.gov/coping/selfcare.asp. Accessed March 12, 2024.
• #HealthyAtHome—Mental health. World Health Organization. www.who.int/campaigns/connecting-the-world-to-combat-coronavirus/healthyathome/healthyathome---mental-health. Accessed March 12, 2024.
• Coping with stress. Centers for Disease Control and Prevention. www.cdc.gov/mentalhealth/stress-coping/cope-with-stress/. Accessed March 12, 2024.
• Manage stress. U.S. Department of Health and Human Services. https://health.gov/myhealthfinder/topics/health-conditions/heart-health/manage-stress. Accessed March 20, 2020.
• COVID-19 and substance abuse. National Institute on Drug Abuse. https://nida.nih.gov/research-topics/covid-19-substance-use#health-outcomes. Accessed March 12, 2024.
• COVID-19 resource and information guide. National Alliance on Mental Illness. https://www.nami.org/Support-Education/NAMI-HelpLine/COVID-19-Information-and-Resources/COVID-19-Resource-and-Information-Guide. Accessed March 15, 2024.
• Negative coping and PTSD. U.S. Department of Veterans Affairs. https://www.ptsd.va.gov/gethelp/negative_coping.asp. Accessed March 15, 2024.
• Health effects of cigarette smoking. Centers for Disease Control and Prevention. https://www.cdc.gov/tobacco/data_statistics/fact_sheets/health_effects/effects_cig_smoking/index.htm#respiratory. Accessed March 15, 2024.
• People with certain medical conditions. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html. Accessed March 15, 2024.
• Your healthiest self: Emotional wellness toolkit. National Institutes of Health. https://www.nih.gov/health-information/emotional-wellness-toolkit. Accessed March 15, 2024.
• World leprosy day: Bust the myths, learn the facts. Centers for Disease Control and Prevention. https://www.cdc.gov/leprosy/world-leprosy-day/. Accessed March 15, 2024.
• HIV stigma and discrimination. Centers for Disease Control and Prevention. https://www.cdc.gov/hiv/basics/hiv-stigma/. Accessed March 15, 2024.
• Diabetes stigma: Learn about it, recognize it, reduce it. Centers for Disease Control and Prevention. https://www.cdc.gov/diabetes/library/features/diabetes_stigma.html. Accessed March 15, 2024.
• Phelan SM, et al. Patient and health care professional perspectives on stigma in integrated behavioral health: Barriers and recommendations. Annals of Family Medicine. 2023; doi:10.1370/afm.2924.
• Stigma reduction. Centers for Disease Control and Prevention. https://www.cdc.gov/drugoverdose/od2a/case-studies/stigma-reduction.html. Accessed March 15, 2024.
• Nyblade L, et al. Stigma in health facilities: Why it matters and how we can change it. BMC Medicine. 2019; doi:10.1186/s12916-019-1256-2.
• Combating bias and stigma related to COVID-19. American Psychological Association. https://www.apa.org/topics/covid-19-bias. Accessed March 15, 2024.
• Yashadhana A, et al. Pandemic-related racial discrimination and its health impact among non-Indigenous racially minoritized peoples in high-income contexts: A systematic review. Health Promotion International. 2021; doi:10.1093/heapro/daab144.
• Sawchuk CN (expert opinion). Mayo Clinic. March 25, 2024.

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3. problems students are facing at public k-12 schools.

We asked teachers about how students are doing at their school. Overall, many teachers hold negative views about students’ academic performance and behavior.

• 48% say the academic performance of most students at their school is fair or poor; a third say it’s good and only 17% say it’s excellent or very good.
• 49% say students’ behavior at their school is fair or poor; 35% say it’s good and 13% rate it as excellent or very good.

Teachers in elementary, middle and high schools give similar answers when asked about students’ academic performance. But when it comes to students’ behavior, elementary and middle school teachers are more likely than high school teachers to say it’s fair or poor (51% and 54%, respectively, vs. 43%).

Teachers from high-poverty schools are more likely than those in medium- and low-poverty schools to say the academic performance and behavior of most students at their school are fair or poor.

The differences between high- and low-poverty schools are particularly striking. Most teachers from high-poverty schools say the academic performance (73%) and behavior (64%) of most students at their school are fair or poor. Much smaller shares of teachers from low-poverty schools say the same (27% for academic performance and 37% for behavior).

In turn, teachers from low-poverty schools are far more likely than those from high-poverty schools to say the academic performance and behavior of most students at their school are excellent or very good.

Lasting impact of the COVID-19 pandemic

Among those who have been teaching for at least a year, about eight-in-ten teachers say the lasting impact of the pandemic on students’ behavior, academic performance and emotional well-being has been very or somewhat negative. This includes about a third or more saying that the lasting impact has been very negative in each area.

Shares ranging from 11% to 15% of teachers say the pandemic has had no lasting impact on these aspects of students’ lives, or that the impact has been neither positive nor negative. Only about 5% say that the pandemic has had a positive lasting impact on these things.

A smaller majority of teachers (55%) say the pandemic has had a negative impact on the way parents interact with teachers, with 18% saying its lasting impact has been very negative.

These results are mostly consistent across teachers of different grade levels and school poverty levels.

Major problems at school

When we asked teachers about a range of problems that may affect students who attend their school, the following issues top the list:

• Poverty (53% say this is a major problem at their school)
• Chronic absenteeism – that is, students missing a substantial number of school days (49%)
• Anxiety and depression (48%)

One-in-five say bullying is a major problem among students at their school. Smaller shares of teachers point to drug use (14%), school fights (12%), alcohol use (4%) and gangs (3%).

Differences by school level

Similar shares of teachers across grade levels say poverty is a major problem at their school, but other problems are more common in middle or high schools:

• 61% of high school teachers say chronic absenteeism is a major problem at their school, compared with 43% of elementary school teachers and 46% of middle school teachers.
• 69% of high school teachers and 57% of middle school teachers say anxiety and depression are a major problem, compared with 29% of elementary school teachers.
• 34% of middle school teachers say bullying is a major problem, compared with 13% of elementary school teachers and 21% of high school teachers.

Not surprisingly, drug use, school fights, alcohol use and gangs are more likely to be viewed as major problems by secondary school teachers than by those teaching in elementary schools.

Differences by poverty level

Teachers’ views on problems students face at their school also vary by school poverty level.

Majorities of teachers in high- and medium-poverty schools say chronic absenteeism is a major problem where they teach (66% and 58%, respectively). A much smaller share of teachers in low-poverty schools say this (34%).

Bullying, school fights and gangs are viewed as major problems by larger shares of teachers in high-poverty schools than in medium- and low-poverty schools.

When it comes to anxiety and depression, a slightly larger share of teachers in low-poverty schools (51%) than in high-poverty schools (44%) say these are a major problem among students where they teach.  

Discipline practices

About two-thirds of teachers (66%) say that the current discipline practices at their school are very or somewhat mild – including 27% who say they’re very mild. Only 2% say the discipline practices at their school are very or somewhat harsh, while 31% say they are neither harsh nor mild.

We also asked teachers about the amount of influence different groups have when it comes to determining discipline practices at their school.

• 67% say teachers themselves don’t have enough influence. Very few (2%) say teachers have too much influence, and 29% say their influence is about right.

• 31% of teachers say school administrators don’t have enough influence, 22% say they have too much, and 45% say their influence is about right.
• On balance, teachers are more likely to say parents, their state government and the local school board have too much influence rather than not enough influence in determining discipline practices at their school. Still, substantial shares say these groups have about the right amount of influence.

Teachers from low- and medium-poverty schools (46% each) are more likely than those in high-poverty schools (36%) to say parents have too much influence over discipline practices.

In turn, teachers from high-poverty schools (34%) are more likely than those from low- and medium-poverty schools (17% and 18%, respectively) to say that parents don’t have enough influence.

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About Pew Research Center Pew Research Center is a nonpartisan fact tank that informs the public about the issues, attitudes and trends shaping the world. It conducts public opinion polling, demographic research, media content analysis and other empirical social science research. Pew Research Center does not take policy positions. It is a subsidiary of The Pew Charitable Trusts .