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Evidence from the United States suggests that technological change is a key factor in understanding both medical expenditure growth and recent dramatic improvements in the health of people with serious illnesses. Yet little international research has examined how the causes and consequences of technological change in health care differ worldwide. Seeking to illuminate these issues, this volume documents how use of high-technology treatments for heart attack changed in fifteen developed countries over the 1980s and 1990s. Drawn from the collaborative effort of seventeen research teams in fifteen countries, it provides a cross-country analysis of microdata that illuminates the relationships between public policies toward health care, technology, costs, and health outcomes.
The comparisons presented here confirm that the use of medical technology in treatment for heart attack is strongly related to incentives, and that technological change is an important cause of medical expenditure growth in all developed countries. Each participating research team reviewed the economic and regulatory incentives provided by their country's health system, and major changes in those incentives over the 1980s and 1990s, according to a commonly used framework. Such incentives include: the magnitude of out-of-pocket costs to patients, the generosity of reimbursement to physicians and hospitals, regulation of the use of new technologies or the supply of physicians, regulation of competition, and the structure of hospital ownership. Each team also reviewed how care for heart attacks has changed in their country over the past decade.
The book will be of enormous importance to health economists, medical researchers and epidemiologists, and policymakers.
Mark McClellan is Associate Professor of Economics and of Medicine and, by courtesy, of Health Research and Policy, Stanford University. He is a National Fellow, the Hoover Institution. Daniel P. Kessler is Associate Professor of Economics, Law, and Policy in the Graduate School of Business, Stanford University, and a Research Fellow, the Hoover Institution.

"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.

Within forty-eight hours after birth, the heel of every baby in the United States has been pricked and the blood sent for compulsory screening to detect or rule out a large number of disorders. Newborn screening is expanding rapidly, fueled by the prospect of saving lives. Yet many lives are also changed by it in ways not yet recognized.

Testing Baby is the first book to draw on parents’ experiences with newborn screening in order to examine its far-reaching sociological consequences. Rachel Grob’s cautionary tale also explores the powerful ways that parents’ narratives have shaped this emotionally charged policy arena. Newborn screening occurs almost always without parents’ consent and often without their knowledge or understanding, yet it has the power to alter such things as family dynamics at the household level, the context of parenting, the way we manage disease identity, and how parents’ interests are understood and solicited in policy debates.

Beginning with the colonial era, Western biomedicine has radically transformed African medical beliefs and practices. Conversely, in using Western biomedicine, Africans have also transformed it. The African Transformation of Western Medicine and the Dynamics of Global Cultural Exchange contends that contemporary African medical systems—no less “biomedical” than Western medicine—in fact greatly enrich and expand the notion of biomedicine, reframing it as a global cultural form deployed across global networks of cultural exchange.

The book analyzes biomedicine as a complex and dynamic sociocultural form, the conceptual premises of which make it necessarily subject to ongoing change and development as it travels the globe. David Baronov captures the complexities of this cultural exchange by using world-systems analysis in a way that places global cultural processes on equal footing with political and economic processes. In doing so, he both allows the story of Africa’s transformation of “Western” biomedicine to be told and offers new insights into the capitalist world system.

In 1918 the People's Commissariat of Public Health began a quest to protect the health of all Soviet citizens, but health became more than a political platform or a tactical decision. The Soviets defined and categorized the world by interpreting political orthodoxy and citizenship in terms of hygiene. The assumed political, social, and cultural benefits of a regulated, healthy lifestyle informed the construction of Soviet institutions and identity. Cleanliness developed into a political statement that extended from domestic maintenance to leisure choices and revealed gender, ethnic, and class prejudices. Dirt denoted the past and poor politics; health and cleanliness signified mental acuity, political orthodoxy, and modernity.

Health, though essential to the revolutionary vision and crucial to Soviet plans for utopia, has been neglected by traditional histories caught up in Cold War debates. The Body Soviet recovers this significant aspect of Soviet thought by providing a cross-disciplinary, comparative history of Soviet health programs that draws upon rich sources of health care propaganda, including posters, plays, museum displays, films, and mock trials. The analysis of propaganda makes The Body Soviet more than an institutional history; it is also an insightful critique of the ideologies of the body fabricated by health organizations.

"A masterpiece that will thoroughly fascinate and delight readers. Starks's understanding of propaganda and hygiene in the early Soviet state is second to none. She tells the stories of Soviet efforts in this field with tremendous insight and ingenuity, providing a rich picture of Soviet life as it was actually lived."— Elizabeth Wood, author of From Baba to Comrade: Gender and Politics in Revolutionary Russia

Representatives of industry, government, caregivers, and consumers join scholars and policy analysts in comparing market forces to regulation as potential means for righting what is wrong with managed care. The contributors that John E. Billi and Gail B. Agrawal have gathered here quickly move the healthcare debate beyond the classroom, think tank, and statehouse to the boardroom and examining room.

Some argue strongly that the solution is to be found in the democratic process and government intervention, while others maintain that only market forces in a competitive environment can respond quickly to the needs of consumers and purchasers alike. The contributors' diverse opinions about the oversight of managed care reflect an enduring divide, one that will affect how society ultimately resolves questions about the inevitable tradeoffs among health-care quality, cost, and access in an environment of limited resources.

The Challenge of Regulating Managed Care will appeal to policymakers, those in the medical field, and all readers interested in the American experience with managed care.

John E. Billi is Associate Professor of Internal Medicine and Medical Education; Associate Dean for Clinical Affairs, University of Michigan Medical School; and Associate Vice President for Medical Affairs, University of Michigan.

Gail B. Agrawal is Associate Professor of Law, University of North Carolina, Chapel Hill.

In recent years, the hospital industry has been undergoing massive change and reorganization with technological innovations and the spread of managed care. As a result, the total number of hospitals countrywide has been declining, and a growing number of not-for-profit hospitals have converted to for-profit status. These changes raise two fundamental questions: What determines a hospital's choice of for-profit or not-for-profit organizational form? And how does that form affect patients and society?

This timely volume provides a factual basis for discussing for-profit versus not-for-profit ownership of hospitals and gives a first look at the evidence about new and important issues in the hospital industry. The Changing Hospital Industry: Comparing Not-for-Profit and For-Profit Institutions will have significant implications for public-policy reforms in this vital industry and will be of great interest to scholars in the fields of health economics, public finance, hospital organization, and management; and to health services researchers.

The Experiment Must Continue is a beautifully articulated ethnographic history of medical experimentation in East Africa from 1940 through 2014. In it, Melissa Graboyes combines her training in public health and in history to treat her subject with the dual sensitivities of a medical ethicist and a fine historian. She breathes life into the fascinating histories of research on human subjects, elucidating the hopes of the interventionists and the experiences of the putative beneficiaries.

Historical case studies highlight failed attempts to eliminate tropical diseases, while modern examples delve into ongoing malaria and HIV/AIDS research. Collectively, these show how East Africans have perceived research differently than researchers do and that the active participation of subjects led to the creation of a hybrid ethical form.

By writing an ethnography of the past and a history of the present, Graboyes casts medical experimentation in a new light, and makes the resounding case that we must readjust our dominant ideas of consent, participation, and exploitation. With global implications, this lively book is as relevant for scholars as it is for anyone invested in the place of medicine in society.

'A brilliant exposé' - Danny Dorling

Covid-19 has exposed the limits of a neoliberal public health orthodoxy. But instead of imagining radical change, the left is stuck in a rearguard action focused on defending the NHS from the wrecking ball of privatization.

Public health expert Christopher Thomas argues that we must emerge from Covid-19 on the offensive - with a bold, new vision for our health and care. He maps out five new frontiers for public health and imagines how we can move beyond safeguarding what we have to a radical expansion of the principles put forward by Aneurin Bevan, the founder of the NHS, over 70 years ago.

Beyond recalibrating our approach to healthcare services, his blueprint includes a fundamental redesign of our economy through Public Health Net Zero; a bold new universal public health service fit to address the real causes of ill health; and a major recalibration in the efforts against the epidemiological reality of an era of pandemics.

The Health Care Safety Net in a Post-Reform World examines how national health care reform will impact safety net programs that serve low-income and uninsured patients. The “safety net” refers to the collection of hospitals, clinics, and doctors who treat disadvantaged people, including those without insurance, regardless of their ability to pay. Despite comprehensive national health care reform, over twenty million people will remain uninsured. And many of those who obtain insurance from reform will continue to face shortages of providers in their communities willing or able to serve them. As the demand for care grows with expanded insurance, so will the pressure on an overstretched safety net.

This book, with contributions from leading health care scholars, is the first comprehensive assessment of the safety net in over a decade. Rather than view health insurance and the health care safety net as alternatives to each other, it examines their potential to be complementary aspects of a broader effort to achieve equity and quality in health care access. It also considers whether the safety net can be improved and strengthened to a level that can provide truly universal access, both through expanded insurance and the creation of a well-integrated and reasonably supported network of direct health care access for the uninsured.

Seeing safety net institutions as key components of post-health care reform in the United States—as opposed to stop-gap measures or as part of the problem—is a bold idea. And as presented in this volume, it is an idea whose time has come.

Malaria is an infectious disease like no other: it is a dynamic force of nature and Africa’s most deadly and debilitating malady. James C. McCann tells the story of malaria in human, narrative terms and explains the history and ecology of the disease through the science of landscape change. All malaria is local. Instead of examining the disease at global or continental scale, McCann investigates malaria’s adaptation and persistence in a single region, Ethiopia, over time and at several contrasting sites.

Malaria has evolved along with humankind and has adapted to even modern-day technological efforts to eradicate it or to control its movement. Insecticides, such as DDT, drug prophylaxis, development of experimental vaccines, and even molecular-level genetic manipulation have proven to be only temporary fixes. The failure of each stand-alone solution suggests the necessity of a comprehensive ecological understanding of malaria, its transmission, and its persistence, one that accepts its complexity and its local dynamism as fundamental features.

The story of this disease in Ethiopia includes heroes, heroines, witches, spirits—and a very clever insect—as well as the efforts of scientists in entomology, agroecology, parasitology, and epidemiology. Ethiopia is an ideal case for studying the historical human culture of illness, the dynamism of nature’s disease ecology, and its complexity within malaria.

This first extensive study of the practice of blood transfusion in Africa traces the history of one of the most important therapies in modern medicine from the period of colonial rule to independence and the AIDS epidemic. The introduction of transfusion held great promise for improving health, but like most new medical practices, transfusion needed to be adapted to the needs of sub-Saharan Africa, for which there was no analogous treatment in traditional African medicine.

This otherwise beneficent medical procedure also created a “royal road” for microorganisms, and thus played a central part in the emergence of human immune viruses in epidemic form. As with more developed health care systems, blood transfusion practices in sub-Saharan Africa were incapable of detecting the emergence of HIV. As a result, given the wide use of transfusion, it became an important pathway for the initial spread of AIDS. Yet African health officials were not without means to understand and respond to the new danger, thanks to forty years of experience and a framework of appreciating long-standing health risks. The response to this risk, detailed in this book, yields important insight into the history of epidemics and HIV/AIDS.

Drawing on research from colonial-era governments, European Red Cross societies, independent African governments, and directly from health officers themselves, this book is the only historical study of the practice of blood transfusion in Africa.

This book examines the major phases in the history of health services in Africa and treats health as an integral aspect of the deepening crisis in Africa’s underdevelopment. One important thesis is that Western delivery systems have made health care less accessible for most people. Contributors direct attention to problems engendered by food shortages, acute cases of infection, the market in fake drugs as well as the inequality of access to facilities, the violation of human rights, and the recent danger of the dumping of toxic wastes in several African countries. One major implication of this volume is that there can be no solution to the health crisis in Africa until the linkage between health and poverty is recognized. The authors consider questions that add to the contemporary discussion of the place that traditional African medicine and philosophy should take alongside modern Western medicine in Africa today.

In recent years, bitter partisan disputes have erupted over Medicare reform. Democrats and Republicans have fiercely contested issues such as prescription drug coverage and how to finance Medicare to absorb the baby boomers. As Jonathan Oberlander demonstrates in The Political Life of Medicare, these developments herald the reopening of a historic debate over Medicare's fundamental purpose and structure. Revealing how Medicare politics and policies have developed since Medicare's enactment in 1965 and what the program's future holds, Oberlander's timely and accessible analysis will interest anyone concerned with American politics and public policy, health care politics, aging, and the welfare state.

The existence of health inequities across racial, ethnic, gender, and class lines in the United States has been well documented. Less well understood have been the attempts of major institutions, health programs, and other public policy domains to eliminate these inequities. This issue, a collaboration with the Robert Wood Johnson Foundation Investigator Awards in Health Policy Research Program, brings together respected historians, political scientists, economists, sociologists, and legal scholars to focus on the politics and challenges of achieving health equity in the United States.

Articles in this issue address the historical, legal, and political contexts of health equity in the United States. Contributors examine the role of the courts in shaping health equity; document the importance of political discourse in framing health equity and establishing agendas for action; look closely at particular policies to reveal current challenges and the potential to achieve health equity in the future; and examine policies in both health and nonhealth domains, including state Medicaid programs, the use of mobile technology, and education and immigration policies. The issue concludes with a commentary on the future of health equity under the Trump administration and an analysis of how an ACA repeal would impact health equity.

Contributors. Alan B. Cohen, Keon L. Gilbert, Daniel Q. Gillion, Colleen M. Grogan, Mark A. Hall, Jedediah N. Horwitt, Tiffany D. Joseph, Alana M.W. LeBron, Julia F. Lynch, Jamila D. Michener, Vanessa Cruz Nichols, Francisco Pedraza, Isabel M. Perera, Rashawn Ray, Jennifer D. Roberts, Sara Rosenbaum, Sara Schmucker, Abigail A. Sewell, Deborah Stone, Keith Wailoo

Designed for busy medical students, The Radiology Handbook is a quick and easy reference for any practitioner who needs information on ordering or interpreting images.

The book is divided into three parts:

- Part I presents a table, organized from head to toe, with recommended imaging tests for common clinical conditions.

- Part II is organized in a question and answer format that covers the following topics: how each major imaging modality works to create an image; what the basic precepts of image interpretation in each body system are; and where to find information and resources for continued learning.

- Part III is an imaging quiz beginning at the head and ending at the foot. Sixty images are provided to self-test knowledge about normal imaging anatomy and common imaging pathology.

Published in collaboration with the Ohio University College of Osteopathic Medicine, The Radiology Handbook is a convenient pocket-sized resource designed for medical students and non radiologists.

More than ten million children suffer from severe acute malnutrition globally each year. In Uganda, longstanding efforts to understand, treat, and then prevent the condition initially served to medicalize it, in the eyes of both biomedical personnel and Ugandans who brought their children to the hospital for treatment and care. Medicalization meant malnutrition came to be seen as a disease—as a medical emergency—not a preventable condition, further compromising nutritional health in Uganda.

Rather than rely on a foreign-led model, physicians in Uganda responded to this failure by developing a novel public health program known as Mwanamugimu. The new approach prioritized local expertise and empowering Ugandan women, blending biomedical knowledge with African sensibilities and cultural competencies.

In The Riddle of Malnutrition, Jennifer Tappan examines how over the course of half a century Mwanamugimu tackled the most fatal form of childhood malnutrition—kwashiorkor—and promoted nutritional health in the midst of postcolonial violence, political upheaval, and neoliberal resource constraints. She draws on a diverse array of sources to illuminate the interplay between colonialism, the production of scientific knowledge, and the delivery of health services in contemporary Africa.

Duke University Press is pleased to announce the second edition of the bestselling Social Medicine Reader. The Reader provides a survey of the challenging issues facing today’s health care providers, patients, and caregivers by bringing together moving narratives of illness, commentaries by physicians, debates about complex medical cases, and conceptually and empirically based writings by scholars in medicine, the social sciences, and the humanities. The first edition of The Social Medicine Reader was a single volume. This significantly revised and expanded second edition is divided into three volumes to facilitate use by different audiences with varying interests.

Praise for the 3-volume second edition of The Social Medicine Reader:
“A superb collection of essays that illuminate the role of medicine in modern society. Students and general readers are not likely to find anything better.”—Arnold S. Relman, Professor Emeritus of Medicine and Social Medicine, Harvard Medical School

Praise for the first edition:
“This reviewer strongly recommends The Social Medicine Reader to the attention of medical educators.”—Samuel W. Bloom, JAMA: The Journal of the American Medical Association

Volume 3:

Over the past four decades the American health care system has witnessed dramatic changes in private health insurance, campaigns to enact national health insurance, and the rise (and perhaps fall) of managed care. Bringing together seventeen pieces new to this second edition of The Social Medicine Reader and four pieces from the first edition, Health Policy, Markets, and Medicine draws on a broad range of disciplinary perspectives—including political science, economics, history, and bioethics—to consider changes in health care and the future of U.S. health policy. Contributors analyze the historical and moral foundation of today’s policy debates, examine why health care spending is so hard to control in the United States, and explain the political dynamics of Medicare and Medicaid. Selections address the rise of managed care, its impact on patients and physicians, and the ethical implications of applying a business ethos to medical care; they also compare the U.S. health care system to the systems in European countries, Canada, and Japan. Additional readings probe contemporary policy issues, including the emergence of consumer-driven health care, efforts to move quality of care to the top of the policy agenda, and the implications of the aging of America for public policy.

Contributors: Henry J. Aaron, Drew E. Altman, George J. Annas, Robert H. Binstock, Thomas Bodenheimer, Troyen A. Brennan, Robert H. Brook, Lawrence D. Brown, Daniel Callahan, Jafna L. Cox, Victor R. Fuchs, Kevin Grumbach, Rudolf Klein, Robert Kuttner, Larry Levitt, Donald L. Madison, Wendy K. Mariner, Elizabeth A. McGlynn, Jonathan Oberlander, Geov Parrish, Sharon Redmayne, Uwe E. Reinhardt, Michael S. Sparer, Deborah Stone

Duke University Press is pleased to announce the second edition of the bestselling Social Medicine Reader. The Reader provides a survey of the challenging issues facing today’s health care providers, patients, and caregivers by bringing together moving narratives of illness, commentaries by physicians, debates about complex medical cases, and conceptually and empirically based writings by scholars in medicine, the social sciences, and the humanities. The first edition of The Social Medicine Reader was a single volume. This significantly revised and expanded second edition is divided into three volumes to facilitate use by different audiences with varying interests.

Praise for the 3-volume second edition of The Social Medicine Reader:
“A superb collection of essays that illuminate the role of medicine in modern society. Students and general readers are not likely to find anything better.”—Arnold S. Relman, Professor Emeritus of Medicine and Social Medicine, Harvard Medical School

Praise for the first edition:
“This reviewer strongly recommends The Social Medicine Reader to the attention of medical educators.”—Samuel W. Bloom, JAMA: The Journal of the American Medical Association

Volume 1:

A woman with what is quite probably a terminal illness must choose between courses of treatment based on contradictory diagnoses. A medical student causes acute pain in his patients as he learns to insert a central line. One doctor wonders how to react when a patient asks him to pray with her; another struggles to come to terms with his mistakes. A physician writes in a prominent medical journal about facilitating a dying woman’s wish to end her life on her own terms; letters to the editor reflect passionate responses both in support of and in opposition to his actions. These experiences and many more are vividly rendered in Patients, Doctors, and Illness, which brings together nineteen pieces that appeared in the first edition of The Social Medicine Reader and eighteen pieces new to this edition. This volume examines the roles and training of health care professionals and their relationship with patients, ethics in health care, and end-of-life experiences and decisions. It includes fiction and nonfiction narratives and poetry; definitions and case-based discussions of moral precepts in health care, such as truth telling, informed consent, privacy, and autonomy; and readings that provide legal, ethical, and practical perspectives on many familiar but persistent ethical and social questions raised by illness and care.

Contributors: Yehuda Amichai, Marcia Angell, George J. Annas, Marc D. Basson, Doris Betts, Amy Bloom, Abenaa Brewster, Raymond Carver, Eric J. Cassell, Larry R. Churchill, James Dickey, Gerald Dworkin, James Dwyer, Miles J. Edwards, Charles R. Feldstein, Chris Feudtner, Leonard Fleck, Arthur Frank, Benjamin Freedman, Atul Gawande, Jerome Groopman, Lawrence D. Grouse, David Hilfiker, Nancy M. P. King, Perri Klass, Melvin Konner, Bobbie Ann Mason, Steven H. Miles, Sharon Olds, Katha Pollitt, Timothy E. Quill, David Schenck, Daniel Shapiro, Susan W. Tolle, Alice Stewart Trillin, William Carlos Williams

Duke University Press is pleased to announce the second edition of the bestselling Social Medicine Reader. The Reader provides a survey of the challenging issues facing today’s health care providers, patients, and caregivers by bringing together moving narratives of illness, commentaries by physicians, debates about complex medical cases, and conceptually and empirically based writings by scholars in medicine, the social sciences, and the humanities. The first edition of The Social Medicine Reader was a single volume. This significantly revised and expanded second edition is divided into three volumes to facilitate use by different audiences with varying interests.

Praise for the 3-volume second edition of The Social Medicine Reader:
“A superb collection of essays that illuminate the role of medicine in modern society. Students and general readers are not likely to find anything better.”—Arnold S. Relman, Professor Emeritus of Medicine and Social Medicine, Harvard Medical School

Praise for the first edition:
“This reviewer strongly recommends The Social Medicine Reader to the attention of medical educators.”—Samuel W. Bloom, JAMA: The Journal of the American Medical Association

Volume 2:

Ranging from a historical look at eugenics to an ethnographic description of parents receiving the news that their child has Down syndrome, from analyses of inequalities in the delivery of health services to an examination of the meaning of race in genomics research, and from a meditation on the loneliness of the long-term caregiver to a reflection on what children owe their elderly parents, this volume explores health and illness. Social and Cultural Contributions to Health, Difference, and Inequality brings together seventeen pieces new to this edition of The Social Medicine Reader and five pieces that appeared in the first edition. It focuses on how difference and disability are defined and experienced in contemporary America, how the social categories commonly used to predict disease outcomes—such as gender, race and ethnicity, and social class—have become contested terrain, and why some groups have more limited access to health care services than others. Juxtaposing first-person narratives with empirical and conceptual studies, this compelling collection draws on several disciplines, including cultural and medical anthropology, sociology, and the history of medicine.

Contributors: Laurie K. Abraham, Raj Bhopal, Ami S. Brodoff, Daniel Callahan, David Diamond, Liam Donaldson, Alice Dreger, Sue E. Estroff, Paul Farmer, Anne Fausto-Sterling, Jerome Groopman, Gail E. Henderson, Linda M. Hunt, Barbara A. Koenig, Donald R. Lannin, Sandra Soo-Jin Lee, Carol Levine, Judith Lorber, Nancy Mairs, Holly F. Mathews, James P. Mitchell, Joanna Mountain, Alan R. Nelson, Martin S. Pernick, Rayna Rapp, Sally L. Satel, Robert S. Schwartz, Brian D. Smedley, Adrienne Y. Stith, Sharon Sytsma, Gordon Weaver, Bruce Wilson, Irving Kenneth Zola

Based on the author’s fieldwork among the people of Zezuru, this study focuses on children as clients and as healers in training. In Reynolds’s ethnographic investigation of possession and healing, she pays particular attention to the way healers are identified and authenticated in communities, and how they are socialized in the use of medicinal plants, dreams, and ritual healing practices. Reynolds examines spiritual interpretation and remediation of children’s problems, including women’s roles in these activities, and the Zezuru concepts of trauma, evil, illness, and death. Because this study was undertaken just after the War of Liberation in Zimbabwe, it also documents the devastating effects of the war.