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Mama Might Be Better Off Dead
The Failure of Health Care in Urban America
Laurie Kaye Abraham
University of Chicago Press, 1994
North Lawndale, a neighborhood that lies in the shadows of Chicago’s Loop, is surrounded by some of the city’s finest medical facilities, Yet, it is one of the sickest, most medically underserved communities in the country.

Mama Might Be Better Off Dead immerses readers in the lives of four generations of a poor, African-American family in the neighborhood, who are beset with the devastating illnesses that are all too common in America’s inner-cities. Headed by Jackie Banes, who oversees the care of a diabetic grandmother, a husband on kidney dialysis, an ailing father, and three children, the Banes family contends with countless medical crises. From visits to emergency rooms and dialysis units, to trials with home care, to struggles for Medicaid eligibility, Laurie Kaye Abraham chronicles their access—or more often, lack thereof—to medical care. Told sympathetically but without sentimentality, their story reveals an inadequate health care system that is further undermined by the direct and indirect effects of poverty.

Both disturbing and illuminating, Mama Might Be Better Off Dead is an unsettling, profound look at the human face of health care in America. Published to great acclaim in 1993, the book in this new edition includes an incisive foreword by David Ansell, a physician who worked at Mt. Sinai Hospital, where much of the Banes family’s narrative unfolds.

 
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Mama Might Be Better Off Dead
The Failure of Health Care in Urban America
Laurie Kaye Abraham
University of Chicago Press, 1993
Mama Might Be Better Off Dead is an unsettling, profound look at the human face of health care. Both disturbing and illuminating, it immerses readers in the lives of four generations of a poor, African-American family beset with the devastating illnesses that are all too common in America's inner-cities.

The story takes place in North Lawndale, a neighborhood that lies in the shadows of Chicago's Loop. Although surrounded by some of the city's finest medical facilities, North Lawndale is one of the sickest, most medically underserved communities in the country. Headed by Jackie Banes, who oversees the care of a diabetic grandmother, a husband on kidney dialysis, an ailing father, and three children, the Banes family contends with countless medical crises. From visits to emergency rooms and dialysis units, to trials with home care, to struggles for Medicaid eligibility, Abraham chronicles their access (or lack of access) to medical care.

Told sympathetically but without sentimentality, their story reveals an inadequate health care system that is further undermined by the direct and indirect effects of poverty. When people are poor, they become sick easily. When people are sick, their families quickly become poorer.

Embedded in the family narrative is a lucid analysis of the gaps, inconsistencies, and inequalities the poor face when they seek health care. This book reveals what health care policies crafted in Washington, D. C. or state capitals look like when they hit the street. It shows how Medicaid and Medicare work and don't work, the Catch-22s of hospital financing in the inner city, the racial politics of organ transplants, the failure of childhood immunization programs, the vexed issues of individual responsibility and institutional paternalism. One observer puts it this way: "Show me the poor woman who finds a way to get everything she's entitled to in the system, and I'll show you a woman who could run General Motors."

Abraham deftly weaves these themes together to make a persuasive case for health care reform while unflinchingly presenting the complexities that will make true reform as difficult as it is necessary. Mama Might Be Better Off Dead is a book with the power to change the way health care is understood in America. For those seeking to learn what our current system of health care promises and what it delivers, it offers a place for the debate to begin.


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Managed Care and Monopoly Power
The Antitrust Challenge
Deborah Haas-Wilson
Harvard University Press, 2003

As millions of Americans are aware, health care costs continue to increase rapidly. Much of this increase is due to the development of new life-sustaining drugs and procedures, but part of it is due to the increased monopoly power of physicians, insurance companies, and hospitals, as the health care sector undergoes reorganization and consolidation. There are two tools to limit the growth of monopoly power: government regulation and antitrust policy. In this timely book, Deborah Haas-Wilson argues that enforcement of the antitrust laws is the tool of choice in most cases.

The antitrust laws, when wisely enforced, permit markets to work competitively and therefore efficiently. Competitive markets foster low prices and high quality. Applying antitrust tools wisely, however, is a tricky business, and Haas-Wilson carefully explains how it can be done. Focusing on the economic concepts necessary to the enforcement of the antitrust laws in health care markets, Haas-Wilson provides a useful roadmap for guiding the future of these markets.

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Manitoba Medicine
A Brief History
Ian Carr
University of Manitoba Press, 1999
For many Canadians, the state of our health care and medical system is at the top of the public agenda. By following the growth and development of modern medicine in one Canadian province, Manitoba Medicine provides an insight into where our present medical system came from and how it developed .Beginning with a description of some early Aboriginal healing practices and of the physicians of the Red River Settlement, Manitoba Medicine follows the struggles in the 1870s to establish what would become the first medical college and the first major hospitals in Western Canada. It chronicles the fight for public health in the 1920s, the development of health insurance and medicare after WWII, and medicine's role in fighting the 1950 Winnipeg Flood and the polio epidemic of the late 1950s. Manitoba Medicine also provides vivid accounts of many of the individuals who built Manitoba's medical system, including early educators like Swale Vincent, pioneering women physicians such as Charlotte Ross, important researchers like Bruce Chown, and colourful private practitioners such as Murrough O'Brien.
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Meaning in Suffering
Caring Practices in the Health Professions
Edited by Nancy Johnston and Alwilda Scholler-Jaquish
University of Wisconsin Press, 2007
     Compelling, timely, and essential reading for healthcare providers, Meaning in Suffering addresses the multiplicity of meanings suffering brings to all it touches: patients, families, health workers, and human science professionals. Examining suffering in writing that is both methodologically rigorous and accessible, the contributors preserve first-hand experiences using narrative ethnography, existential hermeneutics, hermeneutic phenomenology, and traditional ethnography. They offer nuanced insights into suffering as a human condition experienced by persons deserving of dignity, empathy, and understanding. Collectively, these essays demonstrate that understanding the suffering of the "other" reveals something vital about the moral courage required to heal—and stay humane—in the face of suffering.
 
 
Winner, Nursing Research Category, American Journal of Nursing
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Measuring and Modeling Health Care Costs
Edited by Ana Aizcorbe, Colin Baker, Ernst R. Berndt, and David M. Cutler
University of Chicago Press, 2018
Health care costs represent a nearly 18% of U.S. gross domestic product and 20% of government spending. While there is detailed information on where these health care dollars are spent, there is much less evidence on how this spending affects health. 
           
The research in Measuring and Modeling Health Care Costs seeks to connect our knowledge of expenditures with what we are able to measure of results, probing questions of methodology, changes in the pharmaceutical industry, and the shifting landscape of physician practice. The research in this volume investigates, for example, obesity’s effect on health care spending, the effect of generic pharmaceutical releases on the market, and the disparity between disease-based and population-based spending measures. This vast and varied volume applies a range of economic tools to the analysis of health care and health outcomes.

Practical and descriptive, this new volume in the Studies in Income and Wealth series is full of insights relevant to health policy students and specialists alike.
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Measuring Functioning and Well-Being
The Medical Outcomes Study Approach
Anita L. Stewart and John E. Ware Jr., eds.
Duke University Press, 1992
Measuring Functioning and Well-Being is a comprehensive account a broad range of self-reported functioning and well-being measures developed for the Medical Outcomes Study, a large-sale study of how patients fare with health care in the United States. This book provides a set of ready-to-use generic measures that are applicable to all adults, including those well and chronically ill, as well as a methodological guide to collecting health data and constructing health measures. As demand increases for more practical methods to monitor the outcomes of health care, this volume offers a timely and valuable contribution to the field.
The contributors address conceptual and methodological issues involved in measuring such important health status concepts as: physical, social, and role functioning; psychological distress and well-being; general health perceptions; energy and fatigue; sleep; and pain. The authors present psychometric results and explain how to administer, score, and interpret the measures.
Comprising the work of a number of highly respected scholars in the field of health assessment, Measuring Functioning and Well-Being will be of great interest and value to the growing number of researchers, policymakers, and clinicians concerned with the management and evaluation of health care.
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Measuring the Quality of Care for Psychological Health Conditions in the Military Health System
Candidate Quality Measures for Posttraumatic Stress Disorder and Major Depressive Disorder
Kimberly A. Hepner
RAND Corporation, 2015
To inform improvements to the quality of care delivered by the military health system for posttraumatic stress disorder and major depressive disorder, researchers developed a framework and identified, developed, and described a candidate set of measures for monitoring, assessing, and improving the quality of care. This document describes their research approach and the measure sets that they identified.
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Medical Care at the End of Life
A Catholic Perspective
David F. Kelly
Georgetown University Press, 2006

For over thirty years, David F. Kelly has worked with medical practitioners, students, families, and the sick and dying to confront the difficult and often painful issues that concern medical treatment at the end of life. In this short and practical book, Kelly shares his vast experience, providing a rich resource for thinking about life's most painful decisions.

Kelly outlines eight major issues regarding end-of-life care as seen through the lens of the Catholic medical ethics tradition. He looks at the distinction between ordinary and extraordinary means; the difference between killing and allowing to die; criteria of patient competence; what to do in the case of incompetent patients; the meaning and use of advance directives; the morality of hydration and nutrition; physician-assisted suicide and euthanasia; and medical futility. Kelly's analysis is sprinkled with significant legal decisions and, throughout, elaborations on how the Catholic medical ethics tradition—as well as teachings of bishops and popes—understands each issue. He provides a helpful glossary to supplement his introduction to the terminology used by philosophical health care ethics. Included in Kelly's discussion is his lucid description of why the Catholic tradition supports the discontinuation of medical care in the Terry Schiavo case. He also explores John Paul II's controversial papal allocution concerning hydration and nutrition for unconscious patients, arguing that the Catholic tradition does not require feeding the permanently unconscious.

Medical Care at the End of Life addresses the major issues that inform this last stage of caregiving. It offers a critical guide to understanding the medical ethics and relevant legal cases needed for clear thinking when individuals are faced with those crucial decisions.

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Medical Care Output and Productivity
Edited by David M. Cutler and Ernst R. Berndt
University of Chicago Press, 2001
With the United States and other developed nations spending as much as 14 percent of their GDP on medical care, economists and policy analysts are asking what these countries are getting in return. Yet it remains frustrating and difficult to measure the productivity of the medical care service industries.

This volume takes aim at that problem, while taking stock of where we are in our attempts to solve it. Much of this analysis focuses on the capacity to measure the value of technological change and other health care innovations. A key finding suggests that growth in health care spending has coincided with an increase in products and services that together reduce mortality rates and promote additional health gains. Concerns over the apparent increase in unit prices of medical care may thus understate positive impacts on consumer welfare. When appropriately adjusted for such quality improvements, health care prices may actually have fallen. Provocative and compelling, this volume not only clarifies one of the more nebulous issues in health care analysis, but in so doing addresses an area of pressing public policy concern.
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The Medical Triangle
Physicians, Politicians, and the Public
Eli Ginzberg
Harvard University Press, 1990

Runaway medical costs, long-term care, market competition, for-profit medicine, nursing shortages—these are but a few of the issues that swirl around in the late twentieth century’s volatile health care scene. How much of the system do we want to change, and how much do we want to keep? Health policy expert Eli Ginzberg examines such crucial questions in his characteristically broad-gauged perspective. Framing the issues in their historical, political, and professional contexts, the author analyzes how we have arrived at the current crisis.

The book focuses on the three sides of the medical triangle that have separate and sometimes conflicting goals: the physicians want to provide the most health care for the most money; the government, which furnishes 40 percent of the system's funding, wants to limit the money it pays out for health care; and the public, with over a billion annual visits to doctors, wants the most health care for the least money.

Ginzberg explains how the core components of our health care system—the community hospital and physicians who have long practiced in a fee-for-service mode—are under attack, and he indicates the factors that make it uncertain whether the destabilization will slow down or accelerate. Moreover, can key health care centers maintain their leadership in a time when new dollars for health are scarce? How will the floundering state of foundations affect medical care in local communities?

In his final chapters the author zeroes in on the special concerns of the public: high-need patients (including those suffering from cancer, catastrophic illness, and the infirmities of old age, or those who are mentally ill or chronically poor), nursing shortages, unsuccessful cost containment, and lack of consensus within the medical triangle about the major issues on our nation's health agenda.

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Medicating Race
Heart Disease and Durable Preoccupations with Difference
Anne Pollock
Duke University Press, 2012
In Medicating Race, Anne Pollock traces the intersecting discourses of race, pharmaceuticals, and heart disease in the United States over the past century, from the founding of cardiology through the FDA's approval of BiDil, the first drug sanctioned for use in a specific race. She examines wide-ranging aspects of the dynamic interplay of race and heart disease: articulations, among the founders of American cardiology, of heart disease as a modern, and therefore white, illness; constructions of "normal" populations in epidemiological research, including the influential Framingham Heart Study; debates about the distinctiveness African American hypertension, which turn on disparate yet intersecting arguments about genetic legacies of slavery and the comparative efficacy of generic drugs; and physician advocacy for the urgent needs of black patients on professional, scientific, and social justice grounds. Ultimately, Pollock insists that those grappling with the meaning of racialized medical technologies must consider not only the troubled history of race and biomedicine but also its fraught yet vital present. Medical treatment should be seen as a site of, rather than an alternative to, political and social contestation. The aim of scholarly analysis should not be to settle matters of race and genetics, but to hold medicine more broadly accountable to truth and justice.
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Medicine in the Meantime
The Work of Care in Mozambique
Ramah McKay
Duke University Press, 2018
In Mozambique, where more than half of the national health care budget comes from foreign donors, NGOs and global health research projects have facilitated a dramatic expansion of medical services. At once temporary and unfolding over decades, these projects also enact deeply divergent understandings of what care means and who does it. In Medicine in the Meantime, Ramah McKay follows two medical projects in Mozambique through the day-to-day lives of patients and health care providers, showing how transnational medical resources and infrastructures give rise to diverse possibilities for work and care amid constraint. Paying careful attention to the specific postcolonial and postsocialist context of Mozambique, McKay considers how the presence of NGOs and the governing logics of the global health economy have transformed the relations—between and within bodies, medical technologies, friends, kin, and organizations—that care requires and how such transformations pose new challenges for ethnographic analysis and critique.
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Mending Broken Soldiers
The Union and Confederate Programs to Supply Artificial Limbs
Guy R. Hasegawa
Southern Illinois University Press, 2012

The four years of the Civil War saw bloodshed on a scale unprecedented in the history of the United States. Thousands of soldiers and sailors from both sides who survived the horrors of the war faced hardship for the rest of their lives as amputees. Now Guy R. Hasegawa presents the first volume to explore the wartime provisions made for amputees in need of artificial limbs—programs that, while they revealed stark differences between the resources and capabilities of the North and the South, were the forebears of modern government efforts to assist in the rehabilitation of wounded service members.

Hasegawa draws upon numerous sources of archival information to offer a comprehensive look at the artificial limb industry as a whole, including accounts of the ingenious designs employed by manufacturers and the rapid advancement of medical technology during the Civil War; illustrations and photographs of period prosthetics; and in-depth examinations of the companies that manufactured limbs for soldiers and bid for contracts, including at least one still in existence today. An intriguing account of innovation, determination, humanitarianism, and the devastating toll of battle, Mending Broken Soldiers shares the never-before-told story of the artificial-limb industry of the Civil War and provides a fascinating glimpse into groundbreaking military health programs during the most tumultuous years in American history.

Univeristy Press Books for Public and Secondary Schools 2013 edition

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Mexican Americans and Health
¡Sana! ¡Sana!
Adela de la Torre and Antonio Estrada
University of Arizona Press, 2015

Given recent developments in health care and policy and a steadily increasing population of people of Mexican origin in the United States, a comprehensive look at Mexican American health has never been more necessary. Adela de la Torre and Antonio Estrada first accomplished such an overview with Mexican Americans and Health in 2001, and they have since continued to revise and expand their initial work. With a multitude of additions and renovations, Mexican Americans and Health, 2nd Edition provides a timely and accessible description of current topics in Latino health.

De la Torre and Estrada once again present a broad and nuanced understanding of recent issues involving Mexican American health and well-being, this time with the addition of discussions on:

* the new U.S. Human Development Index to contextualize the health, education, and income status of Mexican Americans relative to other population groups,
* emerging diseases, such as diabetes and obesity,
* recent health-care reforms under the Obama administration,
* substance abuse, sexual risk, and psychological distress among HIV-positive individuals in the gay/bisexual community,
* and predictions of future trends for the next decade.
 
This new volume has been updated throughout to reflect the many developments in health care since its first edition. Mexican Americans and Health, 2nd Edition continues to present data on a large number of health issues that are important and relevant to the Mexican American population, while describing the social contexts in which they are occurring. Its comprehensive and interdisciplinary approach brings originality and focus to a dynamic literature.

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Mexican Americans and Health
¡Sana! ¡Sana!
Adela de la Torre and Antonia Estrada
University of Arizona Press, 2001
By the middle of the twenty-first century, one out of every six Americans will be of Mexican descent; and as health care becomes of increasing concern to all Americans, the particular needs of Mexican Americans will have to be more thoroughly addressed. Mexican Americans and Health explains how the health of Mexican-origin people is often related to sociodemographic conditions and genetic factors, while historical and political factors influence how Mexican Americans enter the health care system and how they are treated once they access it. It considers such issues as occupational hazards for Mexican-origin agricultural workers—including pesticide poisoning, heat-related conditions, and musculoskeletal disorders—and women's health concerns, such as prenatal care, preventable cancers, and domestic violence. The authors clearly discuss the health status of Mexican Americans relative to the rest of the U.S. population, interweaving voices of everyday people to explain how today's most pressing health issues have special relevance to the Mexican American community:
- how values such as machismo, familismo, and marianismo influence care-seeking decisions and treatment of illness;
- how factors such as cultural values, socioeconomic status, peer pressure, and family concerns can contribute to substance abuse;
- how cultural attitudes toward sex can heighten the risk of AIDS—and how approaches to AIDS prevention and education need to reflect core cultural values such as familismo, respeto, and confianza. The book also addresses concerns of Mexican Americans regarding the health care system. These include not only access to care and to health insurance but also the shortage of bilingual and bicultural health care professionals. This coverage stresses not only the importance of linguistic competency but also the need to understand folklore illnesses, herbal remedies, and spiritual practices that can delay the treatment of illness and either complement or compromise treatment. Of all the issues that face the contemporary Mexican American community, none is as important to its very survival as health and health care. This timely book gives readers a broad understanding of these complex issues and points the way toward a healthier future for all people of Mexican origin. Mexican Americans and Health and
Chicano Popular Culture are the first volumes in the series The Mexican American Experience, a cluster of modular texts designed to provide greater flexibility in undergraduate education. Each book deals with a single topic concerning the Mexican American population. Instructors can create a semester-length course from any combination of volumes, or may choose to use one or two volumes to complement other texts.
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Migration and Health
Edited by Sandro Galea, Catherine K. Ettman, and Muhammad H. Zaman
University of Chicago Press, 2022
A new introduction to a timeless dynamic: how the movement of humans affects health everywhere.

International migrants compose more than three percent of the world’s population, and internal migrants—those migrating within countries—are more than triple that number. Population migration has long been, and remains today, one of the central demographic shifts shaping the world around us. The world’s history—and its health—is shaped and colored by stories of migration patterns, the policies and political events that drive these movements, and narratives of individual migrants. 

Migration and Health offers the most expansive framework to date for understanding and reckoning with human migration’s implications for public health and its determinants. It interrogates this complex relationship by considering not only the welfare of migrants, but also that of the source, destination, and ensuing-generation populations. The result is an elevated, interdisciplinary resource for understanding what is known—and the considerable territory of what is not known—at an intersection that promises to grow in importance and influence as the century unfolds.
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My Mother's Hip
Lessons From The World Of Eldercare
Luisa Margolies
Temple University Press, 2004
Some 400,000 hip fractures occur every year, the vast majority among the elderly; all too often these fractures are associated with death or severe disability. After her mother's double hip fracture, Luisa Margolies immersed herself in identifying and coordinating the services and professionals needed to provide critical care for an elderly person. She soon realized that the American medical system is ill prepared to deal with the long-term care needs of our graying society. The heart of My Mother's Hip is taken up with the author's day-to-day observations as her mother's condition worsened, then improved only to worsen again, while her father became increasingly anxious and disoriented. As both a devoted daughter and a skilled anthropologist, Margolies vividly renders her interactions with physicians, nurses, hospital workers, nursing home administrators, the Medicare bureaucracy, home care providers, and her parents. In the Lessons chapter that follows each episode, she discusses in a broader context the weighty decisions that adult children must make on their parents' behalf and the emotional toll their responsibility takes. Here she addresses the complex practical issues that commonly arise in such situations: understanding the consequences of hip fracture and its treatment, preparing health care proxies and advanced directives, enabling elders to remain at home, and the heartbreaking dilemma of prolonging life. Like many adult children, Margolies learned her lessons about eldercare in the midst of crises. This book is intended to ease the information-gathering and decision-making processes for others involved in eldercare.
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