Just Medicine by
Offers an innovative plan to eliminate inequalities in the American health care and save the lives they endanger Over 84,000 black and brown lives are needlessly lost each year due to health disparities: the unfair, unjust, and avoidable differences between the quality and quantity of health care provided to Americans who are members of racial and ethnic minorities and care provided to whites. Health disparities have remained stubbornly entrenched in the American health care system--and in Just Medicine Dayna Bowen Matthew finds that they principally arise from unconscious racial and ethnic biases held by physicians, institutional providers, and their patients. Implicit bias is the single most important determinant of health and health care disparities. Because we have missed this fact, the money we spend on training providers to become culturally competent, expanding wellness education programs and community health centers, and even expanding access to health insurance will have only a modest effect on reducing health disparities. We will continue to utterly fail in the effort to eradicate health disparities unless we enact strong, evidence-based legal remedies that accurately address implicit and unintentional forms of discrimination, to replace the weak, tepid, and largely irrelevant legal remedies currently available. Our continued failure to fashion an effective response that purges the effects of implicit bias from American health care, Matthew argues, is unjust and morally untenable. In this book, she unites medical, neuroscience, psychology, and sociology research on implicit bias and health disparities with her own expertise in civil rights and constitutional law. In a time when the health of the entire nation is at risk, it is essential to confront the issues keeping the health care system from providing equal treatment to all.
Medicine and Social Justice by
Because medicine can preserve life, restore health and maintain the body's functions, it is widely acknowledged as a basic good that just societies should provide for their members. Yet, there is wide disagreement over the scope and content of what to provide, to whom, how, when, and why. Inthis unique and comprehensive volume, some of the best-known philosophers, physicians, legal scholars, political scientists, and economists writing on the subject discuss what social justice in medicine should be. Their contributions deepen our understanding of the theoretical and practical issuesthat run through the contemporary debate.The forty-two chapters in this reorganized second edition of Medicine and Social Justice update and expand upon the thirty-four chapters of the 2002 first edition. Eighteen chapters from the original volume are revised to address policy changes and challenging issues that have emerged in theintervening decade. Twenty-two of the chapters in this edition are entirely new. The treatment of foundational theory and conceptual issues related to access to health care and rationing medical resources have been expanded to provide a more comprehensive and nuanced discussion of the backgroundconcepts that underlie distributive justice debates, with global perspectives on health and well-being added. New additions to the section on health care justice for specific populations include chapters on health care for the chronically ill, soldiers, prisoners, the severely cognitivelydisabled, and the LGBT population. The section devoted to dilemmas and priorities addresses an array of topics that have recently become especially pressing because of new technologies or altered policies. New chapters address questions of justice related to genetics, medical malpractice, researchon human subjects, pandemic and disaster planning, newborn screening, and justice for the brain dead and those with profound neurological injury.
The Death Gap by
We hear plenty about the widening income gap between the rich and the poor in America and about the expanding distance separating the haves and the have-nots. But when detailing the many things that the poor have not, we often overlook the most critical--their health. The poor die sooner. Blacks die sooner. And poor urban blacks die sooner than almost all other Americans. In nearly four decades as a doctor at hospitals serving some of the poorest communities in Chicago, David A. Ansell, MD, has witnessed firsthand the lives behind these devastating statistics. In The Death Gap, he gives a grim survey of these realities, drawn from observations and stories of his patients. While the contrasts and disparities among Chicago's communities are particularly stark, the death gap is truly a nationwide epidemic--as Ansell shows, there is a thirty-five-year difference in life expectancy between the healthiest and wealthiest and the poorest and sickest American neighborhoods. If you are poor, where you live in America can dictate when you die. It doesn't need to be this way; such divisions are not inevitable. Ansell calls out the social and cultural arguments that have been raised as ways of explaining or excusing these gaps, and he lays bare the structural violence--the racism, economic exploitation, and discrimination--that is really to blame. Inequality is a disease, Ansell argues, and we need to treat and eradicate it as we would any major illness. To do so, he outlines a vision that will provide the foundation for a healthier nation--for all. Inequality is all around us, and often the distance between high and low life expectancy can be a matter of just a few blocks. But geography need not be destiny, urges Ansell. In The Death Gap he shows us how we can face this national health crisis head-on and take action against the circumstances that rob people of their dignity and their lives.
Impact of Demographics on Health and Healthcare by
This volume focuses on differences in health and health care as linked to important social factors. The first section reviews basic material on the topic. The second section on racial and ethnic factors in differences in health and health care is the largest section of the book, and includes six articles looking at racial disparities on a variety of topics such as: knowledge of hepatitis C Virus; health services received and patients' experiences in seeking health care; use of CAM (complementary and alternative medicine) services; and, the role of social capital in class and race health disparities in health information seeking behaviour. Further sections include articles focused on geographic and community factors, gender and age, gender and language, and lifecourse issues such as maternal depression and hospice care. "Research in the Sociology of Health Care, Volume 28" is essential reading for medical sociologists and people working in other social science disciplines studying health-related issues. It provides vital information for health services researchers, policy analysts and public health researchers.
Black and Blue: The Origins and Consequences of Medical Racism by
Black & Blue is the first systematic description of how American doctors think about racial differences and how this kind of thinking affects the treatment of their black patients. The standard studies of medical racism examine past medical abuses of black people and do not address the racially motivated thinking and behaviors of physicians practicing medicine today. Black & Blue penetrates the physician's private sphere where racial fantasies and misinformation distort diagnoses and treatments. Doctors have always absorbed the racial stereotypes and folkloric beliefs about racial differences that permeate the general population. Within the world of medicine this racial folklore has infiltrated all of the medical sub-disciplines, from cardiology to gynecology to psychiatry. Doctors have thus imposed white or black racial identities upon every organ system of the human body, along with racial interpretations of black children, the black elderly, the black athlete, black musicality, black pain thresholds, and other aspects of black minds and bodies. The American medical establishment does not readily absorb either historical or current information about medical racism. For this reason, racial enlightenment will not reach medical schools until the current race-aversive curricula include new historical and sociological perspectives.
Black Man in a White Coat by
One doctor's passionate and profound memoir of his experience grappling with race, bias, and the unique health problems of black Americans When Damon Tweedy begins medical school, he envisions a bright future where his segregated, working-class background will become largely irrelevant. Instead, he finds that he has joined a new world where race is front and center. The recipient of a scholarship designed to increase black student enrollment, Tweedy soon meets a professor who bluntly questions whether he belongs in medical school, a moment that crystallizes the challenges he will face throughout his career. Making matters worse,in lecture after lecture the common refrain for numerous diseases resounds, "More common in blacks than in whites." Black Man in a White Coat examines the complex ways in which both black doctors and patients must navigate the difficult and often contradictory terrain of race and medicine.
The Power to Heal by
In less than four months, beginning with a staff of five, an obscure office buried deep within the federal bureaucracy transformed the nation's hospitals from our most racially and economically segregated institutions into our most integrated. These powerful private institutions, which had for a half century selectively served people on the basis of race and wealth, began equally caring for all on the basis of need. The book draws the reader into the struggles of the unsung heroes of the transformation, black medical leaders whose stubborn courage helped shape the larger civil rights movement. They demanded an end to federal subsidization of discrimination in the form of Medicare payments to hospitals that embraced the "separate but equal" creed that shaped American life during the Jim Crow era. Faced with this pressure, the Kennedy and Johnson Administrations tried to play a cautious chess game, but that game led to perhaps the biggest gamble in the history of domestic policy. Leaders secretly recruited volunteer federal employees to serve as inspectors, and an invisible army of hospital workers and civil rights activists to work as agents, making it impossible for hospitals to get Medicare dollars with mere paper compliance. These triumphs did not come without casualties, yet the story offers lessons and hope for realizing this transformational dream. This book is the recipient of the Norman L. and Roselea J. Goldberg Prize from Vanderbilt University Press for the best book in the area of medicine.
Race, Ethnicity, and Health by
Race, Ethnicity and Health, Second Edition, is a new andcritical selection of hallmark articles that address healthdisparities in America. It effectively documents the need for equaltreatment and equal health status for minorities. Intended as aresource for faculty and students in public health as well as thesocial sciences, it will be also be valuable to public healthadministrators and frontline staff who serve diverse racial andethnic populations. The book brings together the bestpeer reviewed research literature from the leading scholars andfaculty in this growing field, providing a historical and politicalcontext for the study of health, race, and ethnicity, with keyfindings on disparities in access, use, and quality. This volumealso examines the role of health care providers in healthdisparities and discusses the issue of matching patients anddoctors by race. There has been considerable new research since the originalmanuscript?s preparation in 2001 and publication in 2002, andreflecting this, more than half the book is newcontent. New chapters cover: reflections on demographicchanges in the US based on the current census; metrics andnomenclature for disparities; theories of genetic basis fordisparities; the built environment; residential segregation;environmental health; occupational health; health disparities inintegrated communities; Latino health; Asian populations; stressand health; physician/patient relationships; hospital treatment ofminorities; the slavery hypertension hypothesis; geographicdisparities; and intervention design.
Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care by
Racial and ethnic disparities in health care are known to reflect access to care and other issues that arise from differing socioeconomic conditions. There is, however, increasing evidence that even after such differences are accounted for, race and ethnicity remain significant predictors of the quality of health care received. In Unequal Treatment, a panel of experts documents this evidence and explores how persons of color experience the health care environment. The book examines how disparities in treatment may arise in health care systems and looks at aspects of the clinical encounter that may contribute to such disparities. Patients (TM) and providers (TM) attitudes, expectations, and behavior are analyzed. How to intervene? Unequal Treatment offers recommendations for improvements in medical care financing, allocation of care, availability of language translation, community-based care, and other arenas. The committee highlights the potential of cross-cultural education to improve provider "patient communication and offers a detailed look at how to integrate cross-cultural learning within the health professions. The book concludes with recommendations for data collection and research initiatives. Unequal Treatment will be vitally important to health care policymakers, administrators, providers, educators, and students as well as advocates for people of color.