front cover of Africanizing Oncology
Africanizing Oncology
Creativity, Crisis, and Cancer in Uganda
Marissa Mika
Ohio University Press, 2021
An innovative contemporary history that blends insights from a variety of disciplines to highlight how a storied African cancer institute has shaped lives and identities in postcolonial Uganda. Over the past decade, an increasingly visible crisis of cancer in Uganda has made local and international headlines. Based on transcontinental research and public engagement with the Uganda Cancer Institute that began in 2010, Africanizing Oncology frames the cancer hospital as a microcosm of the Ugandan state, as a space where one can trace the lived experiences of Ugandans in the twentieth century. Ongoing ethnographic fieldwork, patient records, oral histories, private papers from US oncologists, American National Cancer Institute records, British colonial office reports, and even the architecture of the institute itself show how Ugandans understood and continue to shape ideas about national identity, political violence, epidemics, and economic life. Africanizing Oncology describes the political, social, technological, and biomedical dimensions of how Ugandans created, sustained, and transformed this institute over the past half century. With insights from science and technology studies and contemporary African history, Marissa Mika’s work joins a new wave of contemporary histories of the political, technological, moral, and intellectual aspirations and actions of Africans after independence. It contributes to a growing body of work on chronic disease and situates the contemporary urgency of the mounting cancer crisis on the continent in a longer history of global cancer research and care. With its creative integration of African studies, science and technology studies, and medical anthropology, Africanizing Oncology speaks to multiple scholarly communities.
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Bending Science
How Special Interests Corrupt Public Health Research
Thomas O. McGarity and Wendy E. Wagner
Harvard University Press, 2008

What do we know about the possible poisons that industrial technologies leave in our air and water? How reliable is the science that federal regulators and legislators use to protect the public from dangerous products? As this disturbing book shows, ideological or economic attacks on research are part of an extensive pattern of abuse.

Thomas O. McGarity and Wendy E. Wagner reveal the range of sophisticated legal and financial tactics political and corporate advocates use to discredit or suppress research on potential human health hazards. Scientists can find their research blocked, or find themselves threatened with financial ruin. Corporations, plaintiff attorneys, think tanks, even government agencies have been caught suppressing or distorting research on the safety of chemical products.

With alarming stories drawn from the public record, McGarity and Wagner describe how advocates attempt to bend science or “spin” findings. They reveal an immense range of tools available to shrewd partisans determined to manipulate research.

Bending Science exposes an astonishing pattern of corruption and makes a compelling case for reforms to safeguard both the integrity of science and the public health.

[more]

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Body, Society, and Nation
The Creation of Public Health and Urban Culture in Shanghai
Chieko Nakajima
Harvard University Press, 2018

Body, Society, and Nation tells the story of China’s unfolding modernity by exploring the changing ideas, practices, and systems related to health and body in late nineteenth- and twentieth-century Shanghai. The pursuit of good health loomed large in Chinese political, social, and economic life. Yet, “good health” had a range of associations beyond individual well-being. It was also an integral part of Chinese nation-building, a goal of charitable activities, a notable outcome of Western medical science, a marker of modern civilization, and a commercial catchphrase. With the advent of Western powers, Chinese notions about personal hygiene and the body gradually expanded. This transformation was complicated by indigenous medical ideas, preexisting institutions and social groups, and local cultures and customs.

This study explores the many ways that members of the various strata of Shanghai society experienced and understood multiple meanings of health and body within their everyday lives. Chieko Nakajima traces the institutions they established, the regulations they implemented, and the practices they brought to the city as part of efforts to promote health. In doing so, she explains how local practices and customs fashioned and constrained public health and, in turn, how hygienic modernity helped shape and develop local cultures and influenced people’s behavior.

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Catastrophic Diseases
Who Decides What?
Jay Katz
Russell Sage Foundation, 1975
People do not choose to suffer from catastrophic illnesses, but considerable human choice is involved in the ways in which the participants in the process treat and conduct research on these diseases. Catastrophic Diseases draws a powerful and humane portrait of the patients who suffer from these illnesses as well as of the physician-investigators who treat them, and describes the major pressures, conflicts, and decisions which confront all of them. By integrating a discussion of "facts" and "values," the authors highlight the forces which affect new developments in medicine—such as kidney and heart transplants—and the controversial issues they generate. Katz and Capron explore these issues through the use of dual conceptual perspectives. Their study first examines and evaluates the authority which should be vested in each of the chief participants in the catastrophic disease process—the physician-investigator, the patient-subject and his relatives, the professionals, and the state. Challenging questions are raised concerning medical education, informed consent, and professional responsibility. The authors next explore how the roles and capacities of the participants vary not only according to the basic issues they face but also according to the point in decision-making at which these issues arise. The process of investigating and treating catastrophic diseases, the authors believe, can thus usefully be divided into three decision-making stages—the formulation of policy, the administration of research and therapy, and the review of the decisions and their consequences. In conclusion, Katz and Capron demonstrate the need for a variety of individuals and groups with diverse values to be involved in decision-making in a manner which will not unnecessarily impede the scientific investigation of these diseases.
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The Colonial Politics of Global Health
France and the United Nations in Postwar Africa
Jessica Lynne Pearson
Harvard University Press, 2018

In The Colonial Politics of Global Health, Jessica Lynne Pearson explores the collision between imperial and international visions of health and development in French Africa as decolonization movements gained strength.

After World War II, French officials viewed health improvements as a way to forge a more equitable union between France and its overseas territories. Through new hospitals, better medicines, and improved public health, French subjects could reimagine themselves as French citizens. The politics of health also proved vital to the United Nations, however, and conflicts arose when French officials perceived international development programs sponsored by the UN as a threat to their colonial authority. French diplomats also feared that anticolonial delegations to the United Nations would use shortcomings in health, education, and social development to expose the broader structures of colonial inequality. In the face of mounting criticism, they did what they could to keep UN agencies and international health personnel out of Africa, limiting the access Africans had to global health programs. French personnel marginalized their African colleagues as they mapped out the continent’s sanitary future and negotiated the new rights and responsibilities of French citizenship. The health disparities that resulted offered compelling evidence that the imperial system of governance should come to an end.

Pearson’s work links health and medicine to postwar debates over sovereignty, empire, and human rights in the developing world. The consequences of putting politics above public health continue to play out in constraints placed on international health organizations half a century later.

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Combating Teen Smoking
Research and Policy Strategies
Peter D. Jacobson, Paula M. Lantz, Kenneth E. Warner, Jeffrey Wasserman, Harold A. Pollack, and Alexis K. Ahlstrom
University of Michigan Press, 2001
Every year, more than 400,000 Americans die prematurely because of tobacco use. Most began smoking during their teen years. Adolescent tobacco use remains our nation's most preventable threat to life and health. This public health crisis has generated widespread debate over how best to prevent young people from initiating smoking or using other tobacco products. Combating Teen Smoking is an invaluable guide for policymakers and communities on the front lines of this prevention effort.
Synthesizing recent research regarding the prevention and control of adolescent smoking, this book offers the reader a convenient compendium of what is known about adolescents and tobacco use; it also highlights areas where additional research is needed. Based on their assessment of the considerable amount of information presented, the authors recommend various ways to help slow--or even reverse--the recent rise in teenage smoking. A comprehensive antitobacco program might include, for example, antismoking media campaigns based on social marketing strategies, clean indoor air laws, and the increase of cigarette prices.
Combating Teen Smoking will appeal to a broad spectrum of readers concerned about the problem of adolescent tobacco use, including policymakers who are actively seeking ways to help reduce teen smoking.
Peter D. Jacobson is Associate Professor, University of Michigan School of Public Health. Paula Lantz is Assistant Professor, University of Michigan School of Public Health. Kenneth Warner is Richard D. Remington Collegiate Professor of Public Health and Director, University of Michigan Tobacco Research Network. Jeffrey Wasserman is Consultant, the RAND Corporation and Senior Project Director, The MEDSTAT Group. Harold Pollack is Assistant Professor, University of Michigan School of Public Health. Alexis Ahlstrom is Research Associate, University of Michigan School of Public Health.
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Conjuring the State
Public Health Encounters in Highland Ecuador, 1908-1945
A. Kim Clark
University of Pittsburgh Press, 2023
The First English-Language Book on the History of Public Health in Ecuador during the Early and Mid-Twentieth Century 

The Ecuadorian Public Health Service was founded in 1908 in response to the arrival of bubonic plague to the country. A. Kim Clark uses this as a point of departure to explore questions of social history and public health by tracing how the service extended the reach of its broader programs across the national landscape and into domestic spaces. Delving into health conditions in the country—especially in the highlands—and efforts to combat disease, she shows how citizens’ encounters with public health officials helped make abstract ideas of state government tangible. By using public health as a window to understand social relations in a country deeply divided by region, class, and ethnicity, Conjuring the State examines the cultural, social, and political effects of the everyday practices of public health officials. 
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Critical Issues in Healthcare Policy and Politics in the Gulf Cooperation Council States
Ravinder Mamtani
Georgetown University Press

This is the first book to examine challenges in the healthcare sector in the six Gulf Cooperation Council (GCC) countries (Saudi Arabia, Oman, the United Arab Emirates, Qatar, Kuwait, and Bahrain). These countries experienced remarkably swift transformations from small fishing and pearling communities at the beginning of the twentieth century to wealthy petro-states today. Their healthcare systems, however, are only now beginning to catch up.

Rapid changes to the population and lifestyles of the GCC states have completely changed—and challenged—the region’s health profile and infrastructure. While major successes in combatting infectious diseases and improving standards of primary healthcare are reflected in key health indicators, new trends have developed; increasingly “lifestyle” or “wealthy country” diseases, such as diabetes, heart disease, and cancer, have replaced the old maladies. To meet these emerging healthcare needs, GCC states require highly trained and skilled healthcare workers, an environment that supports local training, state-of-the-art diagnostic laboratories and hospitals, research production and dissemination, and knowledge acquisition. They face shortages in most if not all of these areas. This book provides a comprehensive study of the rapidly changing health profile of the region, the existing conditions of healthcare systems, and the challenges posed to healthcare management across the six states of the GCC.

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The Death Gap
How Inequality Kills
David A. Ansell, MD
University of Chicago Press, 2021
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.
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The Death Gap
How Inequality Kills
David A. Ansell, MD
University of Chicago Press, 2017
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.
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DES Daughters, Embodied Knowledge, and the Transformation of Women's Health Politics in the Late Twentieth Century
Susan E. Bell
Temple University Press, 2009
From the 1940s to the 1970s, millions of women were exposed prenatally to the synthetic estrogen DES, a “wonder drug” intended to prevent miscarriages. However, DES actually had damaging consequences for the women born from DES mothers. The “DES daughters” as they are known, were found to have a rare form of vaginal cancer or were infertile. They were also at risk for miscarriages, stillbirths, and ectopic pregnancies.

In DES Daughters, Susan Bell recounts the experiences of this generation of “victims.” In moving, heartfelt narratives, she presents the voices of those women who developed cancer, those who were cancer-free but have concerns about becoming pregnant, and those who suffered other medical and/or reproductive difficulties.

Bell examines the hierarchy of knowledge and power of scientists, doctors, and daughters, tracing the emergence of a feminist health movement. The “embodied knowledge” of these DES daughters prompted them to become advocates and form a social movement that challenged reproductive medical knowledge specifically, but also the politics of women’s health in general. Bell’s important book chronicles the history and future of these grassroots activists born out of illness, suffering, and uncertainty.
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The Dilemma of Federal Mental Health Policy
Radical Reform or Incremental Change?
Grob, Gerald N
Rutgers University Press, 2006
Severe and persistent mental illnesses are among the most pressing health and social problems in contemporary America. Recent estimates suggest that more than three million people in the U.S. have disabling mental disorders. The direct and indirect costs of their care exceed 180 billion dollars nationwide each year. Effective treatments and services exist, but many such individuals do not have access to these services because of limitations in mental health and social policies.

For nearly two centuries Americans have grappled with the question of how to serve individuals with severe disorders. During the second half of the twentieth century, mental health policy advocates reacted against institutional care, claiming that community care and treatment would improve the lives of people with mental disorders. Once the exclusive province of state governments, the federal government moved into this policy arena after World War II. Policies ranged from those focused on mental disorders, to those that focused more broadly on health and social welfare.

In this book, Gerald N. Grob and Howard H. Goldman trace how an ever-changing coalition of mental health experts, patients' rights activists, and politicians envisioned this community-based system of psychiatric services. The authors show how policies shifted emphasis from radical reform to incremental change. Many have benefited from this shift, but many are left without the care they require.

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Disease Prevention as Social Change
The State, Society, and Public Health in the United States, France, Great Britain, and Canada
Constance A. Nathanson
Russell Sage Foundation, 2007
From mad-cow disease and E. coli-tainted spinach in the food supply to anthrax scares and fears of a bird flu pandemic, national health threats are a perennial fact of American life. Yet not all crises receive the level of attention they seem to merit. The marked contrast between the U.S. government's rapid response to the anthrax outbreak of 2001 and years of federal inaction on the spread of AIDS among gay men and intravenous drug users underscores the influence of politics and public attitudes in shaping the nation's response to health threats. In Disease Prevention as Social Change, sociologist Constance Nathanson argues that public health is inherently political, and explores the social struggles behind public health interventions by the governments of four industrialized democracies. Nathanson shows how public health policies emerge out of battles over power and ideology, in which social reformers clash with powerful interests, from dairy farmers to tobacco lobbyists to the Catholic Church. Comparing the history of four public health dilemmas—tuberculosis and infant mortality at the turn of the last century, and more recently smoking and AIDS—in the United States, France, Britain, and Canada, Nathanson examines the cultural and institutional factors that shaped reform movements and led each government to respond differently to the same health challenges. She finds that concentrated political power is no guarantee of government intervention in the public health domain. France, an archetypical strong state, has consistently been decades behind other industrialized countries in implementing public health measures, in part because political centralization has afforded little opportunity for the development of grassroots health reform movements. In contrast, less government centralization in America has led to unusually active citizen-based social movements that campaigned effectively to reduce infant mortality and restrict smoking. Public perceptions of health risks are also shaped by politics, not just science. Infant mortality crusades took off in the late nineteenth century not because of any sudden rise in infant mortality rates, but because of elite anxieties about the quantity and quality of working-class populations. Disease Prevention as Social Change also documents how culture and hierarchies of race, class, and gender have affected governmental action—and inaction—against particular diseases. Informed by extensive historical research and contemporary fieldwork, Disease Prevention as Social Change weaves compelling narratives of the political and social movements behind modern public health policies. By comparing the vastly different outcomes of these movements in different historical and cultural contexts, this path-breaking book advances our knowledge of the conditions in which social activists can succeed in battles over public health.
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Doctors and the State
The Politics of Health Care in France and the United States
David Wilsford
Duke University Press, 1991
All advanced health care systems face severe difficulties in financing the delivery of today’s sophisticated medical care. In this study David Wilsford compares the health systems in France and the United States to demonstrate that some political systems are considerably more effective at controlling the cost of care than others. He argues that two variables—the autonomy of the state and the strength and cohesiveness of organized medicine—explain this variance.
In France, Wilsford shows, the state is strong in the health policy domain, while organized medicine is weak and divided. Consequently, physicians exercise little influence over health care policymaking. By contrast, in the United States the state is weak, the employers and insurers who pay for health care are fragmented, and organized medicine is strong and well financed. As a result, medical professionals are able to exert a greater influence on policymaking, thus making cost control more difficult.
Wilsford extends his comparison to health care systems in the United Kingdom, West Germany, Italy, Canada, and Japan. Whether the private or public sector finances health care, he discovers, there is now an important trend in all of the advanced industrial countries toward controlling escalating costs by curbing both the medical profession’s clinical autonomy and physicians’ incomes.
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Dying to Count
Post-Abortion Care and Global Reproductive Health Politics in Senegal
Siri Suh
Rutgers University Press, 2021
During the early 1990s, global health experts developed a new model of emergency obstetric care: post-abortion care or PAC. In developing countries with restrictive abortion laws and where NGOs relied on US family planning aid, PAC offered an apolitical approach to addressing the consequences of unsafe abortion. In Dying to Count, Siri Suh traces how national and global population politics collide in Senegal as health workers, health officials, and NGO workers strive to demonstrate PAC’s effectiveness in the absence of rigorous statistical evidence that the intervention reduces maternal mortality. Suh argues that pragmatically assembled PAC data convey commitments to maternal mortality reduction goals while obscuring the frequency of unsafe abortion and the inadequate care women with complications are likely to receive if they manage to reach a hospital. At a moment when African women face the highest risk worldwide of death from complications related to pregnancy, birth, or abortion, Suh’s ethnography of PAC in Senegal makes a critical contribution to studies of global health, population and development, African studies, and reproductive justice.
 
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Engaging the Intersection of Housing and Health
Volume Three
Edited by Mina Silberberg
University of Cincinnati Press, 2021

Researchers often hope that their work will inform social change. The questions that motivate them to pursue research careers in the first place often stem from observations about gaps between the world as we wish it to be and the world as it is, accompanied by a deep curiosity about how it might be made different. Researchers view their profession as providing important information about what is, what could be, and how to get there. However, if research is to inform social change, we must first change the way in which research is done.

Engaging the Intersection of Housing and Health offers case studies of research that is interdisciplinary, stakeholder-engaged and intentionally designed for “translation” into practice. There are numerous ways in which housing and health are intertwined. This intertwining—which is the focus of this volume—is lived daily by the children whose asthma is exacerbated by mold in their homes, the adults whose mental illness increases their risk for homelessness and whose homelessness worsens their mental and physical health, the seniors whose home environment enhances their risk of falls, and the families who must choose between paying for housing and paying for healthcare.

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Epidemic City
The Politics of Public Health in New York
James Colgrove
Russell Sage Foundation, 2011
An insightful chronicle of the changing public health demands in New York City. The first permanent Board of Health in the United States was created in response to a cholera outbreak in New York City in 1866. By the mid-twentieth century, thanks to landmark achievements in vaccinations, medical data collection, and community health, the NYC Department of Health had become the nation's gold standard for public health. However, as the city's population grew in number and diversity, the department struggled to balance its efforts between the treatment of diseases—such as AIDS, tuberculosis, and West Nile Virus—and the prevention of illness-causing factors like lead paint, heroin addiction, homelessness, smoking, and unhealthy foods. In Epidemic City, historian of public health James Colgrove chronicles the challenges faced by the health department since New York City's mid-twentieth-century "peak" in public health provision. This insightful volume draws on archival research and oral histories to examine how the provision of public health has adapted to the competing demands of diverse public needs, public perceptions, and political pressure. Epidemic City analyzes the perspectives and efforts of the people responsible for the city's public health from the 1960s to the present—a time that brought new challenges, such as budget and staffing shortages, and new threats like bioterrorism. Faced with controversies such as needle exchange programs and AIDS reporting, the health department struggled to maintain a delicate balance between its primary focus on illness prevention and the need to ensure public and political support for its activities. In the past decade, after the 9/11 attacks and bioterrorism scares partially diverted public health efforts from illness prevention to threat response, Mayor Michael Bloomberg and Health Commissioner Thomas Frieden were still able to pass New York's Clean Indoor Air Act restricting smoking and significant regulations on trans-fats used by restaurants. This legislation—preventative in nature much like the department's original sanitary code—reflects a return to the nineteenth century roots of public health, when public health measures were often overtly paternalistic. The assertive laws conceived by Frieden and executed by Bloomberg demonstrate how far the mandate of public health can extend when backed by committed government officials. Epidemic City provides a compelling historical analysis of the individuals and groups tasked with negotiating the fine line between public health and political considerations. By examining the department's successes and failures during the ambitious social programs of the 1960s, the fiscal crisis of the 1970s, the struggles with poverty and homelessness in the 1980s and 1990s, and in the post-9/11 era, Epidemic City shows how the NYC Department of Health has defined the role and scope of public health services for the entire nation.
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Epidemic Invasions
Yellow Fever and the Limits of Cuban Independence, 1878-1930
Mariola Espinosa
University of Chicago Press, 2009

In the early fall of 1897, yellow fever shuttered businesses, paralyzed trade, and caused tens of thousand of people living in the southern United States to abandon their homes and flee for their lives. Originating in Cuba, the deadly plague inspired disease-control measures that not only protected U.S. trade interests but also justified the political and economic domination of the island nation from which the pestilence came. By focusing on yellow fever, Epidemic Invasions uncovers for the first time how the devastating power of this virus profoundly shaped the relationship between the two countries.

Yellow fever in Cuba, Mariola Espinosa demonstrates, motivated the United States to declare war against Spain in 1898, and, after the war was won and the disease eradicated, the United States demanded that Cuba pledge in its new constitution to maintain the sanitation standards established during the occupation. By situating the history of the fight against yellow fever within its political, military, and economic context, Espinosa reveals that the U.S. program of sanitation and disease control in Cuba was not a charitable endeavor. Instead, she shows that it was an exercise in colonial public health that served to eliminate threats to the continued expansion of U.S. influence in the world.

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Flatlined
Resuscitating American Medicine
Clifton, Guy L
Rutgers University Press, 2008

Flatlined lifts the veil of secrecy on twenty-first century health care and delves into the realities of good people caught in a bad medical system. Dr. Guy L. Clifton, a practitioner as well as a policy advocate, reveals first-hand accounts of needless tragedy, such as the young man who died after a car wreck for lack of a bed in a qualified hospital and the surgeon who was dejected by the scarcity of resources needed to enable him to perform heart surgery on an uninsured man.

Arguing that a lack of coordinated care and quality medical practice benchmarks result in high levels of redundancy and ineffectiveness, Clifton proposes that the key to reducing health care costs, improving quality, and financially protecting the uninsured, is to reduce wastefulness, and offers a solution for achieving success.

Flatlined sounds the warning call: By 2018 Medicare and Medicaid will consume about one-third of the federal budget. American businesses now pay three times as much of their payroll for health care as global competitors, expected to worsen as health care grows at twice the rate of the U.S. economy. Based on his years of experience in policy and medicine, Clifton offers an attainable solution through the development of an American Medical Quality System.

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Global Health Challenges for Human Security
Lincoln C. Chen
Harvard University Press, 2003

The goals of health and human security are fundamentally valued in all societies, yet the breadth of their interconnections are not properly understood. This volume explores the evolving relationship between health and security in today's interdependent world, and offers policy guidelines for global health action.

This volume underscores three basic principles. First, recent developments in the changing security landscape present enormous challenges for human security and global health. Second, although the connections between health and security are long-standing, the current context of new conflicts, pervasive poverty, and accelerating global flows has brought the fields closer together. Finally, a human security approach dependent upon individual and collective action can identify new strategies for meeting the goals of global health and security.

The distinguished contributions to this volume were commissioned by Harvard University's Global Equity Initiative, a research unit supporting the work of the International Commission on Human Security.

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Global Health in Africa
Historical Perspectives on Disease Control
Tamara Giles-Vernick
Ohio University Press, 2013

Global Health in Africa is a first exploration of selected histories of global health initiatives in Africa. The collection addresses some of the most important interventions in disease control, including mass vaccination, large-scale treatment and/or prophylaxis campaigns, harm reduction efforts, and nutritional and virological research.The chapters in this collection are organized in three sections that evaluate linkages between past, present, and emergent. Part I, “Looking Back,” contains four chapters that analyze colonial-era interventions and reflect upon their implications for contemporary interventions. Part II, “The Past in the Present,” contains essays exploring the historical dimensions and unexamined assumptions of contemporary disease control programs. Part III, “The Past in the Future,” examines two fields of public health intervention in which efforts to reduce disease transmission and future harm are premised on an understanding of the past.

This much-needed volume brings together international experts from the disciplines of demography, anthropology, and historical epidemiology. Covering health initiatives from smallpox vaccinations to malaria control to HIV campaigns, Global Health in Africa offers a first comprehensive look at some of global health’s most important challenges.

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Glyphosate and the Swirl
An Agroindustrial Chemical on the Move
Vincanne Adams
Duke University Press, 2022
In Glyphosate and the Swirl Vincanne Adams explores the chemical glyphosate—the active ingredient in Roundup and a pervasive agricultural herbicide—as a predicament of contested science and chemically saturated life. Adams traces the history of glyphosate’s invention and its multiple uses as activists, regulators, scientists, clinicians, consumers, and sick people try to determine its safety and harm. Scientific and political debates over glyphosate’s toxicity are agitated into a swirl—a condition in which certainty is continually contested, divided, and multiplied. This movement replicates the chemical’s movement in soils, foods, bodies, archives, labs, and legislative bodies, settling in some places here and in other places there, its potencies changing and altering what it touches with different scales and kinds of impact. The swirl is both an artifact of academic capitalism, activist tactics, and contested scientific facts and a way to capture the complexity of contemporary life with chemicals.
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Healing the Body Politic
El Salvador's Popular Struggle for Health Rights from Civil War to Neoliberal Peace
Smith-Nonini, Sandy
Rutgers University Press, 2010
Incorporating investigative journalism and drawing on interviews with participants and leaders, Sandy Smith-Nonini examines the contested place of health and development in El Salvador over the last two decades. Healing the Body Politic recounts the dramatic story of radical health activism from its origins in liberation theology and guerrilla medicine during the third-world country's twelve-year civil war, through development of a remarkable "popular health system," administered by lay providers in a former war zone controlled by leftist rebels. This ethnography casts light on the conflicts between the conservative Ministry of Health and primary health advocates during the 1990s peace process--a time when the government sought to dismantle the effective peasant-run rural system. It offers a rare analysis of the White Marches of 2002û2003, when radicalized physicians rose to national leadership in a successful campaign against privatization of the social security health system. Healing the Body Politic contributes to the productive integration of medical and political anthropology by bringing the semiotics of health and the body to bear on cultural understandings of warfare, the state, and globalization.
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Health and Social Change in International Perspective
Lincoln C. Chen
Harvard University Press, 1994

Health and Social Change in International Perspective brings together an unprecedented interdisciplinary series of approaches to understanding the social dimensions of health change around the world. The seventeen contributors—demographers, epidemiologists, economists, anthropologists, public health scientists—are among the intellectual leaders of efforts to respond to the world’s health challenges.

Moving beyond the limits of established theories about demographic and epidemiologic transition, this book offers broad explorations of the social causes and consequences of health change. Consensus is reached on some matters, but critical debate and controversy predominate in others. The authors address several critical questions: What are the forms and structures of health transitions? Do these changes assume universally consistent patterns, or are health transitions particularistic, reflecting space, time, and community? What are the methodological issues in definition and measurement? And how can understanding improve health policy, interventions, and the research agenda?

Exploring new frontiers of a vital topic, Health and Social Change in International Perspective is an invaluable resource for social and health scientists working to understand world health change.

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The Health Care Mess
How We Got Into It and What It Will Take To Get Out
Julius B. Richmond and Rashi Fein, Ph.D.
Harvard University Press, 2005

If we can decode the human genome and fashion working machines out of atoms, why can't we navigate the quagmire that is our health care system? In this important new book, Julius Richmond and Rashi Fein recount the fraught history of health care in America since the 1960s. After the advent of Medicare and Medicaid and with the progressive goal to make advances in medical care available to all, medical costs began their upward spiral. Cost control measures failed and led to the HMO revolution, turning patients into consumers and doctors into providers. The swelling ranks of Americans without any insurance at all dragged the United States to the bottom of the list of industrialized nations.

Over the last century medical education was also profoundly transformed into today's powerful triumvirate of academic medical centers, schools of medicine and public health, and research programs, all of which have shaped medical practice and medical care. The authors show how the promises of medical advances have not been matched either by financing or by delivery of care.

As a new crisis looms, and the existing patchwork of insurance is poised to unravel, American leaders must again take up the question of health care. This book brings the voice of reason and the promise of compromise to that debate.

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Health Policy and the Disadvantaged
Lawrence D. Brown, ed.
Duke University Press, 1991
This important collection of essays, originating in a 1989 conference on the disadvantaged in American health care, provides incisive commentary on U.S. health care policy and politics. Examining public responses to health crises and analyzing the political logic of the American community, this volume charts the immobility of U.S. health policy in recent years and points to its disastrous consequences for the 1990s.
Focusing on the particular needs of disadvantaged groups—the elderly, children, people with AIDS, the mentally ill, the chemically dependent, the homeless, the hungry, the medically uninsured—these essays develop strong policy statements. The authors describe the growth in U.S. health care programs, from Kerr-Mills to Medicare, Medicaid, and subsequent revisions, and stress the serious omissions resulting from incremental policy expansion, both in identifying disadvantaged groups and in implementing programs. They report the weakness of the U.S. health care system compared to systems of other technologically developed countries.

Contributors. Deborah A. Stone and Theodore R. Marmor, Judith Feder, Alice Sardell, Bruce C. Vladeck, Michael Lipsky and Marc A. Thibodeau, Daniel M. Fox, William E. McAuliffe, M. Gregg Bloche and Francine Cournos, Lawrence D. Brown, James A. Morrone

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Health Sector Reform in Developing Countries
Making Health Development Sustainable
Peter Berman
Harvard University Press, 1995

In Mexico City or Nairobi or Manila, a young girl in one part of the city is near death with measles, while, not far away, an elderly man awaits transplantation of a new kidney. How is one denied a cheap, simple, and effective remedy while another can command the most advanced technology medicine can offer? Can countries like Mexico, Kenya, or the Philippines, with limited funds and medical resources, find an affordable, effective, and fair way to balance competing health needs and demands?

Such dilemmas are the focus of this insightful book in which leading international researchers bring together the latest thinking on how developing countries can reform health care. The choices these poorer countries make today will determine the pace of health improvement for vast numbers of people now and in the future. Exploring new ideas and concepts, as well as the practical experiences of nations in all parts of the world, this volume provides valuable insights and information to both generalists and specialists interested in how health care will look in the world of the twenty-first century.

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Health Services Privatization in Industrial Societies
Scarpaci, Joseph L
Rutgers University Press, 1989
As governments in industrialized nations around the world face fiscal crises, they are increasingly turning over the functions of the welfare state to the private sector. Health care systems are particularly tempting targets for privatization. The costs of health care have risen faster than many other services. Health care systems fail to reward efficiency, and liberal welfare policies have enlarged the number of people who benefit from public health care services, and have done so in ways that often seem inequitable. The particular forms that privatized health care take are closely intertwined with local and political and economic circumstances, but the popularity of the idea in all kinds of governments, in all parts of the world, is very striking. This book looks at the theory and practice of privatization of health services internationally. The contributors argue that the restructuring of health care systems affects local communities in markedly uneven ways. Ultimately, they conclude, conflicts arising from economic and geographic inequities implicit in privatization will limit the degree to which any government can dismantle its health care services.
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History and Health Policy in the United States
Putting the Past Back In
Stevens, Rosemary A
Rutgers University Press, 2006
In our rapidly advancing scientific and technological world, many take great pride and comfort in believing that we are on the threshold of new ways of thinking, living, and understanding ourselves. But despite dramatic discoveries that appear in every way to herald the future, legacies still carry great weight. Even in swiftly developing fields such as health and medicine, most systems and policies embody a sequence of earlier ideas and preexisting patterns.

In History and Health Policy in the United States, seventeen leading scholars of history, the history of medicine, bioethics, law, health policy, sociology, and organizational theory make the case for the usefulness of history in evaluating and formulating health policy today. In looking at issues as varied as the consumer economy, risk, and the plight of the uninsured, the contributors uncover the often unstated assumptions that shape the way we think about technology, the role of government, and contemporary medicine. They show how historical perspectives can help policymakers avoid the pitfalls of partisan, outdated, or merely fashionable approaches, as well as how knowledge of previous systems can offer alternatives when policy directions seem unclear.

Together, the essays argue that it is only by knowing where we have been that we can begin to understand health services today or speculate on policies for tomorrow.

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How Many Doctors Do We Need?
Duncan Yaggy and Patricia Hodgson, eds.
Duke University Press, 1986
This volume addresses the public and private policies affecting physician supply in the United States, focusing on the physician surplus, market forces, and geographic distribution of physicians, life-style choices and evolving practice patterns, market influences of foreign medical graduates, the university's role in establishing priorities for medical education, and other pertinent topics.
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Human Insecurity in a Global World
Lincoln C. Chen
Harvard University Press, 2003

The decade of the 1990s witnessed enormous changes in the international environment. The Cold War conclusively ended. Biotechnology and communications technology made rapid advances. Barriers to international trade and investment declined. Taken together, these developments created many opportunities for peace and prosperity.

At the same time, with the end of superpower domination, ethnically based intranational conflicts brought on widespread suffering. And while globalization expanded opportunity, growth, and incomes, it increased inequality of incomes and decreased human security. Moreover, as countries have become more closely linked, insecurity in one country has affected security in other countries.

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In the Public Interest
Medical Licensing and the Disciplinary Process
Horowitz, Ruth
Rutgers University Press, 2012

Winner of the American Sociological Association Sociology of Law Section 2013 Outstanding Book Award

How do we know when physicians practice medicine safely? Can we trust doctors to discipline their own? What is a proper role of experts in a democracy? In the Public Interest raises these provocative questions, using medical licensing and discipline to advocate for a needed overhaul of how we decide public good in a society dominated by private interest groups. Throughout the twentieth century, American physicians built a powerful profession, but their drive toward professional autonomy has made outside observers increasingly concerned about physicians’ ability to separate their own interests from those of the general public.

Ruth Horowitz traces the history of medical licensure and the mechanisms that democratic societies have developed to certify doctors to deliver critical services. Combining her skills as a public member of medical licensing boards and as an ethnographer, Horowitz illuminates the workings of the crucial public institutions charged with maintaining public safety. She demonstrates the complex agendas different actors bring to board deliberations, the variations in the board authority across the country, the unevenly distributed institutional resources available to board members, and the difficulties non-physician members face as they struggle to balance interests of the parties involved.

In the Public Interest suggests new procedures, resource allocation, and educational initiatives to increase physician oversight. Horowitz makes the case for regulations modeled after deliberative democracy that promise to open debates to the general public and allow public members to take a more active part in the decision-making process that affects vital community interests.

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Litigating Health Rights
Can Courts Bring More Justice to Health?
Alicia Ely Yamin
Harvard University Press, 2011

The last fifteen years have seen a tremendous growth in the number of health rights cases focusing on issues such as access to health services and essential medications. This volume examines the potential of litigation as a strategy to advance the right to health by holding governments accountable for these obligations. It includes case studies from Costa Rica, South Africa, India, Brazil, Argentina and Colombia, as well as chapters that address cross-cutting themes.

The authors analyze what types of services and interventions have been the subject of successful litigation and what remedies have been ordered by courts. Different chapters address the systemic impact of health litigation efforts, taking into account who benefits both directly and indirectly—and what the overall impacts on health equity are.

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Making Americans Healthier
Social and Economic Policy as Health Policy
Robert F. Schoeni
Russell Sage Foundation, 2008
The United States spends billions of dollars annually on social and economic policies aimed at improving the lives of its citizens, but the health consequences associated with these policies are rarely considered. In Making Americans Healthier, a group of multidisciplinary experts shows how social and economic policies seemingly unrelated to medical well-being have dramatic consequences for the health of the American people. Most previous research concerning problems with health and healthcare in the United States has focused narrowly on issues of medical care and insurance coverage, but Making Americans Healthier demonstrates the important health consequences that policymakers overlook in traditional cost-benefit evaluations of social policy. The contributors examine six critical policy areas: civil rights, education, income support, employment, welfare, and neighborhood and housing. Among the important findings in this book, David Cutler and Adriana Lleras-Muney document the robust relationship between educational attainment and health, and estimate that the health benefits of education may exceed even the well-documented financial returns of education. Pamela Herd, James House, and Robert Schoeni discover notable health benefits associated with the Supplemental Security Income Program, which provides financial support for elderly and disabled Americans. George Kaplan, Nalini Ranjit, and Sarah Burgard document a large and unanticipated improvement in the health of African-American women following the enactment of civil rights legislation in the 1960s. Making Americans Healthier presents ground-breaking evidence that the health impact of many social policies is substantial. The important findings in this book pave the way for promising new avenues for intervention and convincingly demonstrate that ultimately social and economic policy is health policy. A Volume in the National Poverty Center Series on Poverty and Public Policy
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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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Markets and Medicine
The Politics of Health Care Reform in Britain, Germany, and the United States
Susan Giaimo
University of Michigan Press, 2002
Are advanced industrialized countries converging on a market response to reform their systems of social protection? By comparing the health care reform experiences of Britain, Germany, and the United States in the 1990s, Susan Giaimo explores how countries pursue diverse policy responses and how such variations reflect distinctive institutions, actors, and reform politics in each country.
In Britain, the Thatcher government's plan to inject a market into the state-administered national health service resulted in a circumscribed experiment orchestrated from above. In Germany, the Kohl government sought to repair defects in the corporatist arrangement with doctors and insurers, thus limiting the market experiment and designing it to enhance the solidarity of the national health insurance system. In the United States, private market actors foiled Clinton's bid to expand the federal government's role in the private health care system through managed competition and national insurance. But market reform continued, albeit led by private employers and with government officials playing a reactive role. Actors and institutions surrounding the existing health care settlement in each country created particular reform politics that either militated against or fostered the deployment of competition.
The finding that major transformations are occurring in private as well as public systems of social protection suggests that studies of social policy change expand their focus beyond statutory welfare state programs. The book will interest political scientists and policymakers concerned with welfare state reform in advanced industrial societies; social scientists interested in the changing balance among state, market, and societal interests in governance; and health policy researchers, health policymakers, and health care professionals.
Susan Giaimo is an independent scholar. She completed her Ph.D. in Political Science at the University of Wisconsin-Madison. She also earned an MSc in Politics from the London School of Economics and Political Science, with the Politics and Government of Western Europe as the branch of study. After completing her doctorate, she was a postdoctoral fellow in the Robert Wood Johnson Foundation Scholars in Health Policy Research Program, University of California at Berkeley, and the Robert Bosch Foundation Scholars Program in Comparative Public Policy and Comparative Institutions, American Institute for Contemporary German Studies, Johns Hopkins University. She taught in the Political Science Department at Massachusetts Institute of Technology for five years. During that period she won the Society for the Advancement of Socio-Economics Founder's Prize for "Adapting the Welfare State: The Case of Health Care Reform in Britain, Germany, and the United States," a paper she coauthored with Philip Manow. She has also worked for health maintenance organizations (HMOs) and medical practices in the United States.
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The Medical Delivery Business
Health Reform, Childbirth, and the Economic Order
Perkins, Barbara Bridgman
Rutgers University Press, 2004

 

Americans at the end of the twentieth century worried that managed care had fundamentally transformed the character of medicine. In The Medical Delivery Business, Barbara Bridgman Perkins uses examples drawn from maternal and infant care to argue that the business approach in medicine is not a new development. Health care reformers throughout the century looked to industrial, corporate, and commercial enterprises as models for the institutions, specialties, and technological strategies that defined modern medicine.

In the case of perinatal care, the business model emphasized specialized over primary care, encouraged the use of surgical and technological procedures, and unnecessarily turned childbirth into an intensive care situation. Active management techniques, for example, encouraged obstetricians to accelerate labor with oxytocin to augment their productivity. Despite the achievements of the childbirth and women’s health movement in the 1970s, aggressive medical intervention has remained the birth experience for millions of American women (and their babies) every year.

The Medical Delivery Business challenges the conventional view that a dose of the market is good for medicine. While Perkins is sympathetic to the goals of progressive and feminist reformers, she questions whether their strategies will succeed in making medicine more equitable and effective. She argues that the medical care system itself needs to be fundamentally "re-formed," and the reforms must be based on democracy, caring, and social justice as well as economics.

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Medical Professionalism in the New Information Age
Edited and with an Introduction by David J. Rothman and David Blumenthal
Rutgers University Press, 2011
With computerized health information receiving unprecedented government support, a group of health policy scholars analyze the intricate legal, social, and professional implications of the new technology. These essays explore how Health Information Technology (HIT) may alter relationships between physicians and patients, physicians and other providers, and physicians and their home institutions. Patient use of web-based information may undermine the traditional information monopoly that physicians have long enjoyed. New IT systems may increase physicians' legal liability and heighten expectations about transparency. Case studies on kidney transplants and maternity practices reveal the unanticipated effects, positive and negative, of patient uses of the new technology. An independent HIT profession may emerge, bringing another organized interest into the medical arena. Taken together, these investigations cast new light on the challenges and opportunities presented by HIT.
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Medicine and Health in Africa
Multidisciplinary Perspectives
Paula Viterbo
Michigan State University Press, 2011
Over the last two decades, the implosion of economies under the burden of debt, the negative repercussions of structural adjustment programs, the crisis of legitimacy, civil wars, and the collapse of some states have resulted in serious health issues across the African continent. Newly emerging diseases, such as Ebola virus and HIV/AIDS have killed and disabled millions. Some “old diseases,” such as yellow fever, tuberculosis, and polio have reappeared. Malaria, cholera, and meningitis continue to kill thousands. In many countries, the medical infrastructure has collapsed, while an increasing number of physicians and nurses have migrated to more hospitable places. Stigmatization of the affected people has exacerbated social and racial discrimination and has affected the implementation of national and international public health programs. The complexity of the situation requires an interdisciplinary approach. This collection, including contributions by historians, sociologists, anthropologists, and biologists, emphasizes the social and cultural contexts of African health, paying particular attention to the history of the colonial public health system and its legacy.
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More than Medicine
The Broken Promise of American Health
Robert M. Kaplan
Harvard University Press, 2019

Stanford’s pioneering behavioral scientist draws on a lifetime of research and experience guiding the NIH to make the case that America needs to radically rethink its approach to health care if it wants to stop overspending and overprescribing and improve people’s lives.

American science produces the best—and most expensive—medical treatments in the world. Yet U.S. citizens lag behind their global peers in life expectancy and quality of life. Robert Kaplan brings together extensive data to make the case that health care priorities in the United States are sorely misplaced. America’s medical system is invested in attacking disease, but not in addressing the social, behavioral, and environmental problems that engender disease in the first place. Medicine is important, but many Americans act as though it were all important.

The United States stakes much of its health funding on the promise of high-tech diagnostics and miracle treatments, while ignoring strong evidence that many of the most significant pathways to health are nonmedical. Americans spend millions on drugs for high cholesterol, which increase life expectancy by only six to eight months on average. But they underfund education, which might extend life expectancy by as much as twelve years. Wars on infectious disease have paid off, but clinical trials for chronic conditions—costing billions—rarely confirm that new treatments extend life. Meanwhile, the National Institutes of Health spends just 3 percent of its budget on research on the social and behavioral determinants of health, even though these factors account for 50 percent of premature deaths.

America’s failure to take prevention seriously costs lives. More than Medicine argues that we need a shakeup in how we invest resources, and it offers a bold new vision for longer, healthier living.

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National Health Insurance and Health Resources
The European Experience
Jan Blanpain
Harvard University Press, 1978

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Organizational State
Social Choice: In National Policy Domains
Edward O. Laumann
University of Wisconsin Press, 1987
The Federal Government in the United States is a government “of the people, by the people, and for the people.” Presidents are elected by popular vote in the nation (filtered through the electoral college), Senators are elected by popular vote in their states, and Representatives are elected by popular vote in their Congressional districts. Cabinet members and agency heads are appointed by the elected president, as are members of the Supreme Court.

But this says nothing about politics. Professor Lauman and Knoke have asked, in this book, how policies were made, in the period 1977-1980, in the areas of energy and health. The question is a very different one from the question of how the positions of president and Congress are filled.

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Para-States and Medical Science
Making African Global Health
P. Wenzel Geissler, editor
Duke University Press, 2015
In Para-States and Medical Science, P. Wenzel Geissler and the contributors examine how medicine and public health in Africa have been transformed as a result of economic and political liberalization and globalization, intertwined with epidemiological and technological changes. The resulting fragmented medical science landscape is shaped and sustained by transnational flows of expertise and resources. NGOs, universities, pharmaceutical companies and other nonstate actors now play a significant role in medical research and treatment. But as the contributors to this volume argue, these groups have not supplanted the primacy of the nation-state in Africa. Although not necessarily stable or responsive, national governments remain crucial in medical care, both as employers of health care professionals and as sources of regulation, access, and – albeit sometimes counterintuitively - trust for their people. “The state” has morphed into the “para-state” — not a monolithic and predictable source of sovereignty and governance, but a shifting, and at times ephemeral, figure.  Tracing the emergence of the “global health” paradigm in Africa in the treatment of HIV, malaria, and leprosy, this book challenges familiar notions of African statehood as weak or illegitimate by elaborating complex new frameworks of governmentality that can be simultaneously functioning and dysfunctional.

Contributors. Uli Beisel, Didier Fassin, P. Wenzel Geissler, Rene Gerrets, Ann Kelly, Guillaume Lachenal, John Manton, Lotte Meinert, Vinh-Kim Nguyen, Branwyn Poleykett, Susan Reynolds Whyte
 
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Patients as Policy Actors
Hoffman, Beatrix
Rutgers University Press, 2011
Patients as Policy Actors offers groundbreaking accounts of one of the health field's most important developments of the last fifty years--the rise of more consciously patient-centered care and policymaking. The authors in this volume illustrate, from multiple disciplinary perspectives, the unexpected ways that patients can matter as both agents and objects of health care policy yet nonetheless too often remain silent, silenced, misrepresented, or ignored. The volume concludes with a unique epilogue outlining principles for more effectively integrating patient perspectives into a pluralistic conception of policy-making. With the recent enactment of the Patient Protection and Affordable Care Act, patients' and consumers' roles in American health care require more than ever the careful analysis and attention exemplified by this innovative volume.
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Peripheral Nerve
Health and Medicine in Cold War Latin America
Anne-Emanuelle Birn and Raúl Necochea López
Duke University Press, 2020
Buenos Aires psychoanalysts resisting imperialism. Brazilian parasitologists embracing communism as an antidote to rural misery. Nicaraguan revolutionaries welcoming Cuban health cooperation. Chilean public health reformers gauging domestic approaches against their Soviet and Western counterparts. As explored in Peripheral Nerve, these and accompanying accounts problematize existing understandings of how the Cold War unfolded in Latin America generally and in the health and medical realms more specifically. Bringing together scholars from across the Americas, this volume chronicles the experiences of Latin American physicians, nurses, medical scientists, and reformers who interacted with dominant U.S. and European players and sought alternative channels of health and medical solidarity with the Soviet Union and via South-South cooperation. Throughout, Peripheral Nerve highlights how Latin American health professionals accepted, rejected, and adapted foreign involvement; manipulated the rivalry between the United States and the USSR; and forged local variants that they projected internationally. In so doing, this collection reveals the multivalent nature of Latin American health politics, offering a significant contribution to Cold War history.

Contributors. Cheasty Anderson, Anne-Emanuelle Birn, Katherine E. Bliss, Gilberto Hochman, Jennifer L. Lambe, Nicole Pacino, Carlos Henrique Assunção Paiva, Jadwiga E. Pieper Mooney, Raúl Necochea López, Marco A. Ramos, Gabriela Soto Laveaga
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Poisoned for Pennies
The Economics of Toxics and Precaution
Frank Ackerman
Island Press, 2008
“Cost-benefit analysis” is a term that is used so frequently we rarely stop to think about it. But relying on it can lead to some dubious conclusions, as Frank Ackerman points out in this eye-opening book. For example, some economists have argued that states should encourage—and even subsidize—cigarette smoking by citizens because smoking will shorten life spans and therefore reduce the need and expense of caring for the elderly. How did the economists reach that conclusion? The answer is cost-benefit analysis, Ackerman explains.
 
Then in clear, understandable language, he describes an alternative, precautionary approach to making decisions under uncertainty. Once a mere theory, the precautionary principle has now been applied in practice through the European Union’s REACH protocol. Citing major studies, many of which he has directed, he shows that the precautionary approach has not only worked, but has been relatively cheap.
 
Poisoned for Pennies shows how the misuse of cost-benefit analysis is impeding efforts to clean up and protect our environment, especially in the case of toxic chemicals. According to Ackerman, conservatives—in elected office, in state and federal regulatory agencies, and in businesses of every size—have been able to successfully argue that environmental clean-up and protection are simply too expensive. But he proves, that is untrue in case after case.
 
Ackerman is already well known for his carefully reasoned attacks on the conventional wisdom about the costs of environmental regulation. This new book, which finds Ackerman ranging from psychological research to risk analysis to the benefits of aggressive pesticide regulation, and from mad cow disease to lead paint, will further his reputation as a thought leader in environmental protection. We can’t afford not to listen to him.
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Policy Challenges in Modern Health Care
Edited by David Mechanic, Lynn B. Rogut, David Colby, and James R. Knickman
Rutgers University Press, 2005

Health care delivery in the United States is an enormously complex enterprise, and its $1.6 trillion annual expenditures involve a host of competing interests. While arguably the nation offers among the most technologically advanced medical care in the world, the American system consistently under performs relative to its resources. Gaps in financing and service delivery pose major barriers to improving health, reducing disparities, achieving universal insurance coverage, enhancing quality, controlling costs, and meeting the needs of patients and families.

Bringing together twenty-five of the nation’s leading experts in health care policy and public health, this book provides a much-needed perspective on how our health care system evolved, why we face the challenges that we do, and why reform is so difficult to achieve. The essays tackle tough issues including: socioeconomic disadvantage, tobacco, obesity, gun violence, insurance gaps, the rationing of services, the power of special interests, medical errors, and the nursing shortage.

Linking the nation’s health problems to larger political, cultural, and philosophical contexts, Policy Challenges in Modern Health Care offers a compelling look at where we stand and where we need to be headed.

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The Politics of Health Care Reform
Lessons from the Past, Prospects for the Future
James A. Morone and Gary S. Belkin, eds.
Duke University Press, 1994
This distinguished collection stands out from the recent flurry of books on health reform by its sustained and sophisticated analysis of the political dimension. In The Politics of Health Care Reform, some of America’s best-known political scientists, historians, and legal scholars make sense of our most turbulent policy issue. They dig below the jargon and minutiae to explore the enduring questions of American politics, government reform, and health care.
The Politics of Health Care Reform explains how successful reforms occur in the United States and shows what is unique about health care issues. Theoretically informed, politically astute, historically nuanced, this volume takes an inventory of our health policy infrastructure. Here is an account of the institutions, ideas, and interests that shape health policy in the 1990s: Congress, the federal courts, interest groups, state governments, the public bureaucracy, business (large and small), the insurance industry, the medical profession. The volume offers a fresh look at such critical matters as public opinion, the politics of race and gender, and the lessons we can draw from other nations.
The Politics of Health Care Reform is the definitive collection of political science essays about health care. Expanded from two special issues of the Journal of Health Politics, Policy and Law, the most prominent scholarly journal in the field it helped create, this collection will enliven the present debate over health reform and instruct everyone who is concerned about the future of American health care.

Contributors. Lawrence Brown, Robert Evans, William Glaser, Colleen Grogan, Robert Hackey, Lawrence Jacobs, Nancy Jecker, Taeku Lee, Joan Lehman, David McBride, Ted Marmor, Cathie Jo Martin, James A. Morone, Mark Peterson, David Rochefort, Rand Rosenblatt, David Rothman, Joan Ruttenberg, Mark Schlesinger, Theda Skocpol, Michael Sparer, Deborah Stone, Kenneth Thorpe

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The Politics of Herding Cats
When Congressional Leaders Fail
John Lovett
University of Michigan Press, 2021
In The Politics of Herding Cats, John Lovett looks at the relationship between media, Congress, and public policy, showing that leaders in Congress under normal circumstances control public policy on issue areas due to their status both within Congress and in the media by and large. When issue coverage on topics increases in media, however, other members seize on the opportunities to engage in the issue and shift public policy away from leader desires. As more members engage and more groups become involved, leaders lose the ability to control the process and are more likely to have problems actually getting public policy enacted. Lovett look at this phenomenon using newspaper coverage in the Washington Post over a 40-year period, both in terms of general analysis as well as individual case studies exploring agricultural subsidies (a low coverage topic), immigration (a changing coverage topic), and health care (a high coverage topic). As coverage increases, the amount leaders can control in the process decreases. Only under extreme circumstances, as seen in the Affordable Care Act, can leaders get anything done at all. The Politics of Herding Cats would be useful for those who wish to better understand the relationship between the media and Congress. It will also be useful to those who want to understand the relationship between actors in government and how the media has influenced American politics, as well as how individual members of Congress can go against party leaders on major issues.
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The Politics of Potential
Global Health and Gendered Futures in South Africa
Michelle Pentecost
Rutgers University Press, 2024
The first one thousand days of human life, or the period between conception and age two, is one of the most pivotal periods of human development. Optimizing nutrition during this time not only prevents childhood malnutrition but also determines future health and potential. The Politics of Potential examines early life interventions in the first one thousand days of life in South Africa, drawing on fieldwork from international conferences, government offices, health-care facilities, and the everyday lives of fifteen women and their families in Cape Town. Michelle Pentecost explores various aspects of a politics of potential, a term that underlines the first one thousand days concept and its effects on clinical care and the lives of childbearing women in South Africa. Why was the First One Thousand Days project so readily adopted by South Africa and many other countries? Pentecost not only explores this question but also discusses the science of intergenerational transmissions of health, disease, and human capital and how this constitutes new forms of intergenerational responsibility. The women who are the target of first one thousdand days interventions are cast as both vulnerable and responsible for the health of future generations, such that, despite its history, intergenerational responsibility in South Africa remains entrenched in powerfully gendered and racialized ways.
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Politics, Science, and Dread Disease
A Short History of United States Medical Research Policy
Stephen P. Strickland
Harvard University Press, 1972

In 1927 the first bill to secure government support in the search for a cure for cancer was introduced to Congress. In 1971 Congress passed the Conquest of Cancer Act, which initiated a new and enlarged effort in the fight against cancer, including possible annual expenditures of up to one billion dollars. The forty-four years between these two dates have witnessed the evolution of medical research from a limited, private endeavor to a major national enterprise commanding substantial support from the federal government.

In this first historical analysis of national policy in biomedical research, Stephen Strickland examines the rise of the National Institutes for Health, tells of the recurrent struggle between elected public officials and science administrators over the pace and direction of cancer and heart disease research; analyzes the roles that key members of Congress have played in the development of medical research; and discusses the medical research lobby and its founder, Mrs. Albert D. Lasker. What emerges is a clear picture of how government officials actually formulate national policy, not only in medical research but in other areas as well.

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Private Guns, Public Health
David Hemenway
University of Michigan Press, 2004
"In this small book David Hemenway has produced a masterwork. He has dissected the various aspects of the gun violence epidemic in the United States into its component parts and considered them separately. He has produced a scientifically based analysis of the data and indeed the microdata of the over 30,000 deaths and 75,000 injuries which occur each year. Consideration and adoption of the policy lessons he recommends would strengthen the Constitutional protections that all of our citizens have to life, liberty, and the pursuit of happiness."
-Richard F. Corlin, Past President, American Medical Association

"This lucid and penetrating study is essential reading for anyone who wishes to understand the tragedy of gun violence in America and-even more important-what we can do to stop it. David Hemenway cuts through the cant and rhetoric in a way that no fair-minded person can dismiss, and no sane society can afford to ignore."
-Richard North Patterson, novelist

"The rate of gun-related homicide, suicide, and accidental injury has reached epidemic proportions in American society. Diagnosing and treating the gun violence epidemic demands the development of public health solutions in conjunction with legislative and law enforcement strategies."
-Kweisi Mfume, President and CEO of NAACP

"In scholarly, sober analytic assessments, including rigorous critiques of NRA-popularized pseudoscience, David Hemenway constructs a convincing case that firearm availability is a critical and proximal cause of unparalleled carnage. By formulating such violence as a public health issue, he proposes workable policies analogous to ones that reduced injuries from tobacco, alcohol, and automobiles."
-Jerome P. Kassirer, Editor-in-Chief Emeritus, New England Journal of Medicine, and Distinguished Professor, Tufts University School of Medicine

"As a former District Attorney and Attorney General, I know the urgency of providing safe homes, schools and neighborhoods for all. This remarkable tour-de-force is a powerful study of one promising solution: a data-rich, eminently readable demonstration of why we should treat gun violence as an American epidemic."
-Scott Harshbarger, Former Attorney General of Massachusetts, President and CEO of Common Cause


On an average day in the United States, guns are used to kill almost eighty people, and to wound nearly three hundred more. If any other consumer product had this sort of disastrous effect, the public outcry would be deafening; yet when it comes to guns such facts are accepted as a natural consequence of supposedly high American rates of violence.

Private Guns, Public Health explodes that myth and many more, revealing the advantages of treating gun violence as a consumer safety and public health problem. David Hemenway fair-mindedly and authoritatively demonstrates how a public-health approach-which emphasizes prevention over punishment, and which has been so successful in reducing the rates of injury and death from infectious disease, car accidents, and tobacco consumption-can be applied to gun violence.

Hemenway uncovers the complex connections between guns and self-defense, gun violence and schools, gun prevalence and homicide, and more. Finally, he outlines a policy course that would significantly reduce gun-related injury and death.

With its bold new public-health approach to guns, Private Guns, Public Health marks a shift in our understanding of guns that will-finally-point us toward a solution.


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Private Guns, Public Health, New Ed.
David Hemenway
University of Michigan Press, 2017
On an average day in the United States, guns are used to kill over ninety people and wound about three hundred more; yet such facts are accepted as a natural consequence of supposedly high American rates of violence. Private Guns, Public Health reveals the advantages of treating gun violence as a consumer safety and public health problem—an approach that emphasizes prevention over punishment and that has successfully reduced the rates of injury and death from infectious disease, car accidents, and tobacco consumption.

Hemenway fair-mindedly and authoritatively outlines a policy course that would significantly reduce gun-related injury and death, pointing us toward a solution.



 
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Privatizing Health Services in Africa
Turshen, Meredeth
Rutgers University Press, 1998

Privatizing Health Services in Africa analyzes the disappearance of public health in the form of state services in Africa, and the growth of a private market in health care that will serve primarily an urban elite. Meredeth Turshen considers the implications of introducing private insurance in countries with growing unemployment, a shrinking formal job sector, and a lack of social security programs or other safety nets. She debates the pros and cons of shifting the delivery of health services to the nongovernmental sector in the context of new concepts of the role of the state. Many of the schemes to privatize the purchase and sale of pharmaceuticals reverse decades of United Nations work challenging the power of the multinational drug industry.  Turshen weighs these policy changes in light of the World Bank’s eclipse of the World Health Organization as the premier UN health policy agency.  Until now, no book has disputed the World Bank’s plans to privatize health care in Africa.  This is the first book-length analysis of policy changes in light of monetarism and globalization.

Throughout the book, Turshen examines the implications of privatization for gender equity.  She also provides a case study of Zimbabwe and comparative material from Malawi, Mozambique, and Zambia. Her study makes a contribution to current debates on the impact of structural adjustment policies on health and the design of health services in the Third World.

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Protecting American Health Care Consumers
Eleanor DeArman Kinney
Duke University Press, 2002
Despite the attention to the problem of protecting the health care interests of Americans, there is little consensus on what should be done politically or otherwise to address this problem. In Protecting American Health Care Consumers Eleanor DeArman Kinney, a nationally regarded expert on health policy and law, tackles the serious and ongoing debate among state and federal policymakers, health care providers, third-party payers, and consumers about how to provide procedural justice to patients in the present health care climate.
To promote and ensure consumer protection in an increasingly adversarial and complicated health-care culture, Kinney first analyzes the procedures by which consumer concerns are presently discerned and resolved and then explains why these systems are unsatisfactory. She also discusses problematic procedures for making coverage policy and quality standards and proposes reforms in a variety of processes that would enable all consumers, including the uninsured, to influence key policies and standards and also to raise concerns and obtain appropriate remedies.
As the first comprehensive treatment of administrative procedures in American health plans and other such institutions, Protecting American Health Care Consumers will be welcomed by state and federal policymakers, managed care executives, and lawyers charged with designing and implementing protections for consumers in public and private health plans.
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Readings In American Health Care
Current Issues In Socio-Historical Perspective
William G. Rothstein
University of Wisconsin Press, 1995
Readings in American Health Care is an introduction to the historical development and current status of a wide variety of health care topics. The readings, written by historians, sociologists, economists, physicians, nurses, and public health researchers, are organized in sections:
•    Basic Concepts: mortality trends, concepts of disease, changes in medical therapy
•    Public Health: AIDS, cigarette smoking, preventive medicine, fluoridation
•    Health Care Professions: cardiology, pathology, women in medicine, nursing, podiatry, midwives
•    Health Care Organizations: hospitals, HMOs
•    Mental Illness
•    Financing Health Care
•    Medical Education
•    Issues: abortion, ethical issues, cancer control, prenatal care, home care, the pharmaceutical industry
•    Background Readings: American medicine from 1920 to midcentury.

    The readings were chosen especially for course use in history, sociology, public health, and related fields, but can also provide useful background reading for anyone interested or involved in American health care. Each selection includes an introduction, questions for the reader, and a bibliography. Scholars and students alike will find the book an invaluable resource.
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Revolutionary Medicine
Health and the Body in Post-Soviet Cuba
P. Sean Brotherton
Duke University Press, 2012
Revolutionary Medicine is a richly textured examination of the ways that Cuba's public health care system has changed during the past two decades and of the meaning of those changes for ordinary Cubans. Until the Soviet bloc collapsed in 1989, socialist Cuba encouraged citizens to view access to health care as a human right and the state's responsibility to provide it as a moral imperative. Since the loss of Soviet subsidies and the tightening of the U.S. economic embargo, Cuba's government has found it hard to provide the high-quality universal medical care that was so central to the revolutionary socialist project. In Revolutionary Medicine, P. Sean Brotherton deftly integrates theory and history with ethnographic research in Havana, including interviews with family physicians, public health officials, research scientists, and citizens seeking medical care. He describes how the deterioration of health and social welfare programs has led Cubans to seek health care through informal arrangements, as well as state-sponsored programs. Their creative, resourceful pursuit of health and well-being provides insight into how they navigate, adapt to, and pragmatically cope with the rapid social, economic, and political changes in post-Soviet Cuba.
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The Sanitation of Brazil
Nation, State, and Public Health, 1889-1930
Gilberto Hochman
University of Illinois Press, 2016
Celebrated as a major work since its original publication, The Sanitation of Brazil traces how rural health and sanitation policies influenced the formation of Brazil's national public health system. Gilberto Hochman's pioneering study examines the ideological, social and political forces that approached questions of health and government action. The era from 1910 to 1930 offered unique opportunities for public health reform, and Hochman examines its successes and failures. He looks at how health became a state concern, tying the emergence of public health policies to a nationalistic movement and to a convergence of the elites' social consciousness with their political and material interests. Politicians weighed the costs and benefits of state-run public health versus the burdens imposed by disease. Physicians and intellectuals, meanwhile, swayed them with warnings that endemic disease and official neglect might affect everyone--rich and poor, rural and urban, interior and coastal--if left unchecked. The book shows how disease and health were and are associated with nation-state building in Brazil.
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Science and Medicine in Twentieth-Century China
Research and Education
John Z. Bowers, J. William Hess, and Nathan Sivin, Editors
University of Michigan Press, 1988
The first part of this volume is devoted is devoted to synoptical and analytical examinations by historians of attempts to root modern science in China during the Republican period. The second contains reports by scientists who have been involved in China’s recent efforts to modernize. Topics include genetic research, taxonomy, contraception, food policy, and schistosomiasis. With an introduction by Nathan Sivin.
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Social Experimentation
Edited by Jerry A. Hausman and David A. Wise
University of Chicago Press, 1985
Since 1970 the United States government has spent over half a billion dollars on social experiments intended to assess the effect of potential tax policies, health insurance plans, housing subsidies, and other programs. Was it worth it? Was anything learned from these experiments that could not have been learned by other, and cheaper, means? Could the experiments have been better designed or analyzed? These are some of the questions addressed by the contributors to this volume, the result of a conference on social experimentation sponsored in 1981 by the National Bureau of Economic Research.

The first section of the book looks at four types of experiments and what each accomplished. Frank P. Stafford examines the negative income tax experiments, Dennis J. Aigner considers the experiments with electricity pricing based on time of use, Harvey S. Rosen evaluates housing allowance experiments, and Jeffrey E. Harris reports on health experiments. In the second section, addressing experimental design and analysis, Jerry A. Hausman and David A. Wise highlight the absence of random selection of participants in social experiments, Frederick Mosteller and Milton C. Weinstein look specifically at the design of medical experiments, and Ernst W. Stromsdorfer examines the effects of experiments on policy. Each chapter is followed by the commentary of one or more distinguished economists.
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The Spectacular Generic
Pharmaceuticals and the Simipolitical in Mexico
Cori Hayden
Duke University Press, 2023
In The Spectacular Generic, Cori Hayden examines how generic drugs have transformed public health politics and everyday experiences of pharmaceutical consumption in Latin America. Focusing on the Mexican pharmacy chain Farmacias Similares and its proprietor, Víctor González Torres, Hayden shows how generics have become potent commodities in a postpatent world. In the early 2000s, González Torres, a.k.a. “Dr. Simi,” capitalized on the creation of new markets for generic medicines, selling cheaper copies of leading-brand drugs across Latin America. But Dr. Simi has not simply competed with the transnationals; his enterprise has also come to compete with the Mexican state, reorganizing the provision of medicine and basic health care for millions of people. Hayden juxtaposes this story with Dr. Simi’s less successful efforts in Argentina, where he confronted a radically different configuration of pharmaceutical politics. Building from these diverging trajectories, Hayden illuminates the politics of generic substitution as a question that goes beyond substituting one drug for another. Generic politics can radically reshape the relations among consumers, states, and pharmaceutical markets, even as they have yet to resolve the problems of cost and access.
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State Healthcare and Yanomami Transformations
A Symmetrical Ethnography
José Antonio Kelly
University of Arizona Press, 2011
Amazonian indigenous peoples have preserved many aspects of their culture and cosmology while also developing complex relationships with dominant non-indigenous society. Until now, anthropological writing on Amazonian peoples has been divided between “traditional” topics like kinship, cosmology, ritual, and myth, on the one hand, and the analysis of their struggles with the nation-state on the other. What has been lacking is work that bridges these two approaches and takes into consideration the meaning of relationships with the state from an indigenous perspective.

That long-standing dichotomy is challenged in this new ethnography by anthropologist José Kelly. Kelly places the study of culture and cosmology squarely within the context of the modern nation-state and its institutions. He explores Indian-white relations as seen through the operation of a state-run health system among the indigenous Yanomami of southern Venezuela.

With theoretical foundations in the fields of medical and Amazonian anthropology, Kelly sheds light on how Amerindian cosmology shapes concepts of the state at the community level. The result is a symmetrical anthropology that treats white and Amerindian perceptions of each other within a single theoretical framework, thus expanding our understanding of each group and its influences on the other. This book will be valuable to those studying Amazonian peoples, medical anthropology, development studies, and Latin America. Its new takes on theory and methodology make it ideal for classroom use.
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Superbugs
An Arms Race against Bacteria
William Hall, Anthony McDonnell, and Jim O'Neill
Harvard University Press, 2018

Antibiotics are powerful drugs that can prevent and treat infections, but they are becoming less effective as a result of drug resistance. Resistance develops because the bacteria that antibiotics target can evolve ways to defend themselves against these drugs. When antibiotics fail, there is very little else to prevent an infection from spreading.

Unnecessary use of antibiotics in both humans and animals accelerates the evolution of drug-resistant bacteria, with potentially catastrophic personal and global consequences. Our best defenses against infectious disease could cease to work, surgical procedures would become deadly, and we might return to a world where even small cuts are life-threatening. The problem of drug resistance already kills over one million people across the world every year and has huge economic costs. Without action, this problem will become significantly worse.

Following from their work on the Review on Antimicrobial Resistance, William Hall, Anthony McDonnell, and Jim O’Neill outline the major systematic failures that have led to this growing crisis. They also provide a set of solutions to tackle these global issues that governments, industry, and public health specialists can adopt. In addition to personal behavioral modifications, such as better handwashing regimens, Superbugs argues for mounting an offense against this threat through agricultural policy changes, an industrial research stimulus, and other broad-scale economic and social incentives.

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Taking Aim
Target Populations and the Wars on AIDS and Drugs
Mark C. Donovan
Georgetown University Press, 2001

As elected lawmakers confront complex social problems, they inevitably make choices to single out certain populations for government-sanctioned benefits or burdens. Why some groups and not others are targeted is the central question explored in this analysis of the congressional response to two related public health crises.

Weaving case studies from the wars against AIDS and drugs with an empirical analysis of fifteen years of congressional action on these issues, Mark Donovan shows how members of Congress balance problem solving with re-election concerns, paying particular attention to their need to craft compelling rationales for their actions. His analysis shows that, counterintuitive as it may seem, most target populations with negative public images are selected to receive benefits rather than burdens.

Demonstrating that it is possible to analyze simultaneously both policy rhetoric and policy outputs, this book shows how problem frames and policy decisions evolve through the dynamic interplay of conflict participants.

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Technology in American Health Care
Policy Directions for Effective Evaluation and Management
Alan B. Cohen and Ruth S. Hanft, with William E. Encinosa, Stephanie M. Spernak, Shirley A. Stewart, and Catherine C. White
University of Michigan Press, 2004
"The definitive overview of health technology assessment in the U.S. and Europe, the biotech industry, adoption and use of medtech in health care."
---The World Future Society, Best Books and Reports

"This excellent book provides a broad overview of the development, impact, and evaluation of health technology in the United States. . . .The authors take a well-organized and thorough approach to address these topics, combining reviews of each with case examples of particular technologies. . . .Given the broad scope of the book, it could serve as a text for students, an introduction to the field for healthcare professionals, or a tool for academics and policymakers wishing to fill knowledge gaps outside their disciplines. . . .The book makes a compelling case for the logic and potential benefits of medical technology evaluation as a tool for improving health care."
---Journal of the American Medical Association

"By being comprehensive in their review, the authors chart a clear path to understanding the future of health care technology in America. They clarify the technical methods for evaluation and provide insight into the sociopolitical aspects of development and diffusion. Case studies are informative. Excellent reading for students and health professionals either as a textbook or as an off-the-shelf guide to methods for deciding among alternative technologies."
---Norman W. Weissman, University of Alabama

"Technology today dominates every aspect of health care. This useful book offers a diverse range of perspectives for students, professors, and medical practitioners who wish to understand how to evaluate medical technology."
---Joel Howell, University of Michigan Medical School

Technology in American Health Care is a comprehensive, multidisciplinary guide to understanding how medical advances-new drugs, biological devices, and surgical procedures-are developed, brought to market, evaluated, and adopted into health care.

Cost-effective delivery of evidence-based health care is the sine qua non of American medicine in the twenty-first century. Health care decision makers, providers, payers, policymakers, and consumers all need vital information about the risks, benefits, and costs of new technologies in order to make informed decisions about which ones to adopt and how to use them. Alan B. Cohen and Ruth S. Hanft explore the evolving field of medical technology evaluation (MTE), as well as the current controversies surrounding the evaluation and diffusion of medical technologies, including the methods employed in their assessment and the policies that govern their adoption and use.

The book opens with an introduction that provides basic definitions and the history of technological change in American medicine, and a second chapter that explores critical questions regarding medical technology in health care. Part I discusses biomedical innovation, the development and diffusion of medical technology, and the adoption and use of technology by hospitals, physicians, and other health care organizations and professions under changing health care market conditions. Part II examines the methods of MTE-including randomized controlled trials, meta-analyses, economic evaluation methods (such as cost-benefit, cost-effectiveness, and cost-utility analyses), and clinical decision analysis. Part III focuses on key public policy issues and concerns that affect the organization, financing, and delivery of health care and that relate importantly to medical technology, including safety, efficacy, quality, cost, access, equity, social, ethical, legal, and evaluation concerns. All three parts of the book provide a historical perspective on the relevant issues, methods, and policy concerns and contain examples of technologies whose development, adoption, evaluation, and use have contributed to our understanding of the field.

This book will be invaluable in making MTE more accessible to individuals who are directly involved in the evaluation process and those who are touched by it in their professional lives-policymakers, clinicians, managers, and researchers.

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To Live and Die in America
Class, Power, Health and Healthcare
Robert Chernomas and Ian Hudson
Pluto Press, 2013

To Live and Die in America details how the United States has among the worst indicators of health in the industrialised world and at the same time spends significantly more on its health care system than any other industrial nation.

Robert Chernomas and Ian Hudson explain this contradictory phenomenon as the product of the unique brand of capitalism that has developed in the US. It is this particular form of capitalism that created both the social and economic conditions that largely influence health outcomes and the inefficient, unpopular and inaccessible health care system that is incapable of dealing with them.

The authors argue that improving health in America requires a change in the conditions in which people live and work as well as a restructured health care system.

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Total Cure
The Antidote to the Health Care Crisis
Harold S. Luft
Harvard University Press, 2008

Proposals to reform the health care system typically focus on either increasing private insurance or expanding government-sponsored plans. Guaranteeing that everyone is insured, however, does not create a system with the quality of care patients want, the flexibility clinicians need, and the internal dynamics to continually improve the value of health care.

In Total Cure, Hal Luft presents a comprehensive new proposal, SecureChoice, which does all that while providing affordable health insurance for every American. SecureChoice is a plan that restructures payment for medical care, harnessing the flexibility and responsiveness of the market by aligning the incentives of clinicians, hospitals, and insurers with those of the patient. It uses the accountability of government to ensure transparency, competition, and equity.

SecureChoice has two major components. A universal pool covers the major risks of hospitalization and chronic illness, which account for almost two-thirds of all costs. Everyone would be in the pool, irrespective of employment, income, or health status. The second component emphasizes choice, flexibility, and responsibility. People will be able to choose any physician to serve as their “medical home,” to keep track of their health records, provide much of their care, and suggest referrals. Clinicians will have the information and incentives to continually enhance quality. SecureChoice also facilitates improvements in areas ranging from malpractice to pharmaceuticals and establishes new roles for key stakeholders such as health insurers.

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The Truth About Health Care
Why Reform is Not Working in America
Mechanic, David
Rutgers University Press, 2006
The United States spends greatly more per person on health care than any other country but the evidence shows that care is often poor and inappropriate. Despite expenditures of 1.7 trillion dollars in 2003, and growing substantially each year, services remain fragmented and poorly coordinated, and more than 46 million people are uninsured. Why can't America, with its vast array of resources, sophisticated technologies, superior medical research and educational institutions, and talented health care professionals, produce higher quality care and better outcomes?

In The Truth about Health Care, David Mechanic explains how health care in America has evolved in ways that favor a myriad of economic, professional, and political interests over those of patients. While money has always had a place in medical care, "big money" and the quest for profits has become dominant, making meaningful reforms difficult to achieve. Mechanic acknowledges that railing against these influences, which are here to stay, can achieve only so much. Instead, he asks whether it is possible to convert what is best about health care in America into a well functioning system that better serves the entire population.

Bringing decades of experience as an active health policy participant, researcher, teacher, and consultant to the public and private sectors, Mechanic examines the strengths and weaknesses of our system and how it has evolved. He pays special attention to areas often neglected in policy discussions, such as the loss of public trust in medicine, the tragic state of long-term care, and the relationship of mental health to health care.

For anyone who has been frustrated by uncoordinated health networks, insurance denials, and other obstacles to obtaining appropriate care, this book will provide a refreshing and frank look at the system's current and future dilemmas. Mechanic's thoughtful roadmap describes how health plans, healthcare professionals, policymakers, and consumer groups can work together to improve access, quality, fairness, and health outcomes in America.
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Unaffordable
American Healthcare from Johnson to Trump
Jonathan Engel
University of Wisconsin Press, 2018
Written for nonexperts, this is a brisk, engaging history of American healthcare from the advent of Medicare and Medicaid in the 1960s to the impact of the Affordable Care Act in the 2010s. Step by step, Jonathan Engel shows how we arrived at our present convoluted situation, where generic drugs prices can jump 1,000 percent in a day and primary care physicians can lose 20 percent of their income at the stroke of a Congressional pen.

Unaffordable covers, in a conversational style punctuated by apt examples, topics ranging from health insurance, pharmaceutical pricing, and physician training to health maintenance organizations and hospital networks. Along the way, Engel introduces approaches that other nations have taken in organizing and paying for healthcare and offers insights on ethical quandaries around end-of-life decisions, neonatal care, life-sustaining treatments, and the limits of our ability to define death. While describing the political origins of many of the federal and state laws that govern our healthcare system today, he never loses sight of the impact that healthcare delivery has on our wallets and on the balance sheets of hospitals, doctors' offices, government agencies, and private companies.
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The U.S. Experiment in Social Medicine
The Community Health Center Program, 1965-1986
Alice Sardell
University of Pittsburgh Press, 1989
This book represents the first political history of the federal government's only experiment in social medicine. Alice Sardell examines the Neighborhood, or Community Health Center Program (NHC/CHC) from its origins in 1965 as part of Lyndon Johnson's War on Poverty campaign up until 1986. The program embodied concepts of social medicine, community development, and consumer involvement in health policy decision-making. Sardell views the NHC experiment in the context of a series of political struggles, beginning in the 1890s, over the boundaries of public and private medicine, and demonstrates that these health centers so challenged mainstream medicine that they could only be funded as a program limited to the poor.
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Your Pocket Is What Cures You
The Politics of Health in Senegal
Foley, Ellen E
Rutgers University Press, 2009
In the wake of structural adjustment programs in the 1980s and health reforms in the 1990s, the majority of sub-Saharan African governments spend less than ten dollars per capita on health annually, and many Africans have limited access to basic medical care. Using a community-level approach, anthropologist Ellen E. Foley analyzes the implementation of global health policies and how they become intertwined with existing social and political inequalities in Senegal. Your Pocket Is What Cures You examines qualitative shifts in health and healing spurred by these reforms, and analyzes the dilemmas they create for health professionals and patients alike. It also explores how cultural frameworks, particularly those stemming from Islam and Wolof ethnomedicine, are central to understanding how people manage vulnerability to ill health.

While offering a critique of neoliberal health policies, Your Pocket Is What Cures You remains grounded in ethnography to highlight the struggles of men and women who are precariously balanced on twin precipices of crumbling health systems and economic decline. Their stories demonstrate what happens when market-based health reforms collide with material, political, and social realities in African societies.

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