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.

 

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

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

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

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

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

What happens when the market tries to help the poor? In many parts of the world today, neoliberal development programs are offering ordinary people the tools of free enterprise as the means to well-being and empowerment. Schemes to transform the poor into small-scale entrepreneurs promise them the benefits of the market and access to the rewards of globalization. Markets of Dispossession is a theoretically sophisticated and sobering account of the consequences of these initiatives.

Julia Elyachar studied the efforts of bankers, social scientists, ngo members, development workers, and state officials to turn the craftsmen and unemployed youth of Cairo into the vanguard of a new market society based on microenterprise. She considers these efforts in relation to the alternative notions of economic success held by craftsmen in Cairo, in which short-term financial profit is not always highly valued. Through her careful ethnography of workshop life, Elyachar explains how the traditional market practices of craftsmen are among the most vibrant modes of market life in Egypt. Long condemned as backward, these existing market practices have been seized on by social scientists and development institutions as the raw materials for experiments in “free market” expansion. Elyachar argues that the new economic value accorded to the cultural resources and social networks of the poor has fueled a broader process leading to their economic, social, and cultural dispossession.

Probing the similarities and differences in the ways Americans, Australians, and Britons understood and responded to poverty, Mark Peel draws a picture of social work that is based in the sometimes fraught encounters between the poor and their interpreters. He uses dramatization to bring these encounters to life—joining Miss Cutler and that resurrected horse are Miss Lindstrom and the fried potatoes and Mr. O’Neil and the seductive client—and to give these people a voice. Adding new dimensions to the study of charity and social work, this book is essential to understanding and tackling poverty in the twenty-first century.