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.

As the COVID-19 mortality rates in underserved communities proved, inequality is all around us, and often the distance between high and low life expectancy can be a matter of just a few blocks. Updated with a new foreword by Chicago mayor Lori Lightfoot and an afterword by Ansell, The Death Gap speaks to the urgency to face this national health crisis head-on.

A Telegraph Book of the Year
A Washington Post Notable Work
A Times Book of the Year
A Hughes Award Finalist

“An indisputable masterpiece…comprehensive, fascinating, and persuasive.”
—Wall Street Journal

“Brimming with wisdom and brio, this masterful work spans the history of psychiatry. Exceedingly well-researched, wide-ranging, provocative in its conclusions, and magically compact, it is riveting from start to finish. Mark my words, Desperate Remedies will soon be a classic.”
—Susannah Cahalan, author of Brain on Fire

“Compulsively readable…Scull has joined his wide-ranging reporting and research with a humane perspective on matters that many of us continue to look away from.”
—Daphne Merkin, The Atlantic

"Scull's fascinating and enraging book is the story of the quacks and opportunists who have claimed to offer cures for mental illness...Madness remains the most fascinating—arguably the defining—aspect of Homo sapiens."
—Sebastian Faulks, Sunday Times

“I would recommend this fascinating, alarming, and alerting book to anybody. For anyone referred to a psychiatrist it is surely essential.”
—The Spectator

For more than two hundred years disturbances of the mind have been studied and treated by the medical profession. Mental illness, some insist, is a disease like any other, from which one can be cured. But is this true?

From the birth of the asylum to the latest drug trials, Desperate Remedies brings together a galaxy of mind doctors working in and out of institutional settings: psychologists and psychoanalysts, neuroscientists and cognitive behavioral therapists, as well as patients and their families desperate for relief. Surprising, disturbing, and compelling, this passionate account of America’s long battle with mental illness challenges us to revisit some of our deepest assumptions and to confront the epidemic of mental illness so visible all around us.

While many doctors claim that Lyme disease—a tick-borne bacterial infection—is easily diagnosed and treated, other doctors and the patients they care for argue that it can persist beyond standard antibiotic treatment in the form of chronic Lyme disease. In Divided Bodies, Abigail A. Dumes offers an ethnographic exploration of the Lyme disease controversy that sheds light on the relationship between contested illness and evidence-based medicine in the United States. Drawing on fieldwork among Lyme patients, doctors, and scientists, Dumes formulates the notion of divided bodies: she argues that contested illnesses are disorders characterized by the division of bodies of thought in which the patient's experience is often in conflict with how it is perceived. Dumes also shows how evidence-based medicine has paradoxically amplified differences in practice and opinion by providing a platform of legitimacy on which interested parties—patients, doctors, scientists, politicians—can make claims to medical truth.

From the late nineteenth century until the 1920s, authorities required San Francisco's Pesthouse to segregate the diseased from the rest of the city. Although the Pesthouse stood out of sight and largely out of mind, it existed at a vital nexus of civic life where issues of medicine, race, class, environment, morality, and citizenship entwined and played out. Guenter B. Risse places this forgotten institution within an emotional climate dominated by widespread public dread and disgust. In Driven by Fear, he analyzes the unique form of stigma generated by San Franciscans. Emotional states like xenophobia and racism played a part. Yet the phenomenon also included competing medical paradigms and unique economic needs that encouraged authorities to protect the city's reputation as a haven of health restoration. As Risse argues, public health history requires an understanding of irrational as well as rational motives. To that end he delves into the spectrum of emotions that drove extreme measures like segregation and isolation and fed psychological, ideological, and pragmatic urges to scapegoat and stereotype victims--particularly Chinese victims--of smallpox, leprosy, plague, and syphilis.

Filling a significant gap in contemporary scholarship, Driven by Fear looks at the past to offer critical lessons for our age of bioterror threats and emerging infectious diseases.