Health Care Divided

A vivid account of race and the organization of health services

The Health-Care Divide takes a close look at the history of health care in the United States while addressing topics such as the Affordable Care Act and the health-care poverty gap for the elderly, children, and minority groups. Features include a glossary, references, websites, source notes, and an index. Aligned to Common Core Standards and correlated to state standards. Essential Library is an imprint of Abdo Publishing, a division of ABDO.

In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.

"The Nation has lost sight of its public health goals and has allowed the system of public health to fall into 'disarray'," from The Future of Public Health. This startling book contains proposals for ensuring that public health service programs are efficient and effective enough to deal not only with the topics of today, but also with those of tomorrow. In addition, the authors make recommendations for core functions in public health assessment, policy development, and service assurances, and identify the level of government--federal, state, and local--at which these functions would best be handled.

The United States’ health care system stands out for its strict division of policies dealing with public health and individual medicine. Seeking to explain how this division came to be, what alternative paths might have been taken, and how this shapes the contemporary landscape, Daniel Sledge offers nothing less than a reinterpretation of the making of modern American health policy in Health Divided. Where previous scholars have focused on failed attempts to adopt national health insurance, Sledge demonstrates that the development of health policy cannot be properly understood without considering the connections between public health policy and policies dealing with individual medicine. His work shows how the distinct politics of the formative years of health policy—and the presence of debilitating diseases in the American South—led to outcomes that have fundamentally shaped modern policies and disputes. Until the end of the nineteenth century, health care in the United States was seen as a local issue, with the sole exception being the government’s role in providing care to seamen and immigrants. Then, as Health Divided reveals, the health problems that plagued the American South in the early twentieth century, from malaria to hookworm and pellagra, along with the political power of the southern Democrats during the New Deal, fueled the emergence of national intervention in public health work. At the same time, divisions among policymakers, as well as the resistance of the American Medical Association, led to federal inaction in the realm of individual medical services—setting the stage for the growth of employer-sponsored health insurance. The vision of those who built the institutions that became the Centers for Disease Control and Prevention was, we see here, far more expansive and innovative than has previously been realized—and it came surprisingly close to succeeding. Exploring the history behind its failure, and tracing the inextricable links between public health and national health policy, this book provides a valuable new perspective on the origins of America’s disjointed health care system.

Human remains have long been considered valuable material for use in medical science. Over time and in different places, they have been dissected, investigated, harvested for research purposes, collected to turn into museum specimens, and more. This book examines the history of such activities.

In a joint effort between the National Academy of Engineering and the Institute of Medicine, this books attempts to bridge the knowledge/awareness divide separating health care professionals from their potential partners in systems engineering and related disciplines. The goal of this partnership is to transform the U.S. health care sector from an underperforming conglomerate of independent entities (individual practitioners, small group practices, clinics, hospitals, pharmacies, community health centers et. al.) into a high performance "system" in which every participating unit recognizes its dependence and influence on every other unit. By providing both a framework and action plan for a systems approach to health care delivery based on a partnership between engineers and health care professionals, Building a Better Delivery System describes opportunities and challenges to harness the power of systems-engineering tools, information technologies and complementary knowledge in social sciences, cognitive sciences and business/management to advance the U.S. health care system.

A FINALIST FOR THE ORWELL PRIZE FOR POLITICAL WRITING 2023 A FINANCIAL TIMES BEST SUMMER BOOK OF 2023 'Important and ambitious' Observer, Book of the Day 'An illuminating and powerful intersectional analysis of health inequalities and racism' i-D Magazine 'Prepare to be blown away' Chikwe Ihekweazu, Assistant Director General at WHO In the wake of the Covid-19 pandemic, we are all too aware of the urgent health inequalities that plague our world. But these inequalities have always been urgent: modern medicine has a colonial and racist history. Here, in an essential and searing account, Annabel Sowemimo unravels the colonial roots of modern medicine. Tackling systemic racism, hidden histories and healthcare myths, Sowemimo recounts her own experiences as a doctor, patient and activist. Divided exposes the racial biases of medicine that affect our everyday lives and provides an illuminating - and incredibly necessary - insight into how our world works, and who it works for. This book will reshape how we see health and medicine - forever. 'A vital call to action' Leah Hazard, author of Womb 'Urgent examination of how modern medicine is intertwined with colonial histories and racist ideas ... compelling story-telling' Joanna Wolfarth, author of Milk 'Outstanding ... beautifully written and erudite, yet highly accessible ... should be mandatory reading for all medical practitioners' Jacqueline Roy, author of The Fat Lady Sings 'Necessary. In the right hands, this book will save lives' Nova Reid, author of The Good Ally

A profound and insightful investigation into how the American Civil War transformed modern medicine. At the start of the Civil War, the medical field in America was rudimentary, unsanitary, and woefully underprepared to address what would become the bloodiest conflict on U.S. soil. However, in this historic moment of pivotal social and political change, medicine was also fast evolving to meet the needs of the time. Unprecedented strides were made in the science of medicine, and as women and African Americans were admitted into the field for the first time. The Civil War marked a revolution in healthcare as a whole, laying the foundations for the system we know today. In Healing a Divided Nation, Carole Adrienne will track this remarkable and bloody transformation in its cultural and historical context, illustrating how the advancements made in these four years reverberated throughout the western world for years to come. Analyzing the changes in education, society, humanitarianism, and technology in addition to the scientific strides of the period lends Healing a Divided Nation a uniquely wide lens to the topic, expanding the legacy of the developments made. The echoes of Civil War medicine are in every ambulance, every vaccination, every woman who holds a paying job, and in every Black university graduate. Those echoes are in every response of the International and American Red Cross and they are in the recommended international protocol for the treatment of prisoners of war and wounded soldiers. Beginning with the state of medicine at the outset of the war, when doctors did not even know about sterilizing their tools, Adrienne illuminates the transformation in American healthcare through primary source texts that document the lives and achievements of the individuals who pioneered these changes in medicine and society. The story that ensues is one of American innovation and resilience in the face of unparalleled violence, adding a new dimension to the legacy of the Civil War.

This unique and engaging open access title provides a compelling and ground-breaking account of the patient safety movement in the United States, told from the perspective of one of its most prominent leaders, and arguably the movement’s founder, Lucian L. Leape, MD. Covering the growth of the field from the late 1980s to 2015, Dr. Leape details the developments, actors, organizations, research, and policy-making activities that marked the evolution and major advances of patient safety in this time span. In addition, and perhaps most importantly, this book not only comprehensively details how and why human and systems errors too often occur in the process of providing health care, it also promotes an in-depth understanding of the principles and practices of patient safety, including how they were influenced by today’s modern safety sciences and systems theory and design. Indeed, the book emphasizes how the growing awareness of systems-design thinking and the self-education and commitment to improving patient safety, by not only Dr. Leape but a wide range of other clinicians and health executives from both the private and public sectors, all converged to drive forward the patient safety movement in the US. Making Healthcare Safe is divided into four parts: I. In the Beginning describes the research and theory that defined patient safety and the early initiatives to enhance it. II. Institutional Responses tells the stories of the efforts of the major organizations that began to apply the new concepts and make patient safety a reality. Most of these stories have not been previously told, so this account becomes their histories as well. III. Getting to Work provides in-depth analyses of four key issues that cut across disciplinary lines impacting patient safety which required special attention. IV. Creating a Culture of Safety looks to the future, marshalling the best thinking about what it will take to achieve the safe care we all deserve. Captivatingly written with an “insider’s” tone and a major contribution to the clinical literature, this title will be of immense value to health care professionals, to students in a range of academic disciplines, to medical trainees, to health administrators, to policymakers and even to lay readers with an interest in patient safety and in the critical quest to create safe care.