A review of the original edition of The Burdens of Disease that appeared in ISIS stated, "Hays has written a remarkable book. He too has a message: That epidemics are primarily dependent on poverty and that the West has consistently refused to accept this." This revised edition confirms the book's timely value and provides a sweeping approach to the history of disease.

In this updated volume, with revisions and additions to the original content, including the evolution of drug-resistant diseases and expanded coverage of HIV/AIDS, along with recent data on mortality figures and other relevant statistics, J. N. Hays chronicles perceptions and responses to plague and pestilence over two thousand years of western history. Disease is framed as a multidimensional construct, situated at the intersection of history, politics, culture, and medicine, and rooted in mentalities and social relations as much as in biological conditions of pathology. This revised edition of The Burdens of Disease also studies the victims of epidemics, paying close attention to the relationships among poverty, power, and disease.

In this sweeping approach to the history of disease, historian J. N. Hays chronicles perceptions and responses to plague and pestilence over two thousand years of western history. Hays frames disease as a multi-dimensional construct, situated at the intersection of history, politics, culture, and medicine, and rooted in mentalities and social relations as much as in biological conditions of pathology.  He shows how diseases affect social and political change, reveal social tensions, and are mediated both within and outside the realm of scientific medicine.

Beginning with the legacy of Greek, Roman, and early Christian ideas about disease, the book then discusses many of the dramatic epidemics from the fourteenth through the twentieth centuries, moving from leprosy and bubonic plague through syphilis, smallpox, cholera, tuberculosis, influenza, and poliomyelitis to AIDS. Hays examines the devastating exchange of diseases between cultures and continents that ensued during the age of exploration. He also describes disease through the lenses of medical theory, public health, folk traditions, and government response. The history of epidemics is also the history of their victims.  Hays pays close attention to the relationships between poverty and power and disease, using contemporary case studies to support his argument that diseases concentrate their pathological effects on the poor, while elites associate the cause of disease with the culture and habits of the poor.

Unevenly distributed resources and rising costs have become enduring problems in the American health care system. Health care is more expensive in the United States than in other wealthy nations, and access varies significantly across space and social classes. James A. Schafer Jr. shows that these problems are not inevitable features of modern medicine, but instead reflect the informal organization of health care in a free market system in which profit and demand, rather than social welfare and public health needs, direct the distribution and cost of crucial resources.

The Business of Private Medical Practice is a case study of how market forces influenced the office locations and career paths of doctors in one early twentieth-century city, Philadelphia, the birthplace of American medicine. Without financial incentives to locate in poor neighborhoods, Philadelphia doctors instead clustered in central business districts and wealthy suburbs. In order to differentiate their services in a competitive marketplace, they also began to limit their practices to particular specialties, thereby further restricting access to primary care. Such trends worsened with ongoing urbanization.

Illustrated with numerous maps of the Philadelphia neighborhoods he studies, Schafer’s work helps underscore the role of economic self-interest in shaping the geography of private medical practice and the growth of medical specialization in the United States.