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.

The Devil's Fruit describes the facets of the strawberry industry as a harm industry, and explores author Dvera Saxton’s activist ethnographic work with farmworkers in response to health and environmental injustices. She argues that dealing with devilish—as in deadly, depressing, disabling, and toxic—problems requires intersecting ecosocial, emotional, ethnographic, and activist labors. Through her work as an activist medical anthropologist, she found the caring labors of engaged ethnography take on many forms that go in many different directions. Through chapters that examine farmworkers’ embodiment of toxic pesticides and social and workplace relationships, Saxton critically and reflexively describes and analyzes the ways that engaged and activist ethnographic methods, frameworks, and ethics aligned and conflicted, and in various ways helped support still ongoing struggles for farmworker health and environmental justice in California. These are problems shared by other agricultural communities in the U.S. and throughout the world.
 

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.

Only a few decades ago, we were ready to declare victory over infectious diseases. Today, infectious diseases are responsible for significant morbidity and mortality throughout the world. This book examines the epidemiology and social impact of past and present infectious disease epidemics in the developing and developed world. In the introduction, the authors define global health as a discipline, justify its critical importance in the modern era, and introduce the Millennium Development Goals, which have become critical targets for most of the developing world. The first half of the volume provides an epidemiological overview, exploring early and contemporary perspectives on disease and disease control. An analysis of nutrition, water, and sanitation anchors the discussion of basic human needs. Specific diseases representing both “loud” and “silent” emergencies are investigated within broader structures of ecological and biological health such as economics, education, state infrastructure, culture, and personal liberty. The authors also examine antibiotic resistance, AIDS, malaria, tuberculosis, and pandemic influenza, and offer an epilogue on diseases of affluence, which now threaten citizens of countries both rich and poor. A readable guide to specific diseases, richly contextualized in environment and geography, this book will be used by health professionals in all disciplines interested in global health and its history and as a textbook in university courses on global health.