Results by title

A bracing spotlight on the avoidable causes of the COVID-19 Eldercide in the United States.

Twenty percent of the Americans who have died of COVID since 2020 have been older and disabled adults residing in nursing homes—even though they make up fewer than 1 percent of the US population. Something about this catastrophic loss of life in government-monitored facilities has never added up.

Until now. In American Eldercide, activist and scholar Margaret Morganroth Gullette investigates this tragic public health crisis with a passionate voice and razor-sharp attention to detail, showing us that nothing about it was inevitable. By unpacking the decisions that led to discrimination against nursing home residents, revealing how governments, doctors, and media reinforced ageist or ableist biases, and collecting the previously little-heard voices of the residents who survived, Gullette helps us understand the workings of what she persuasively calls an eldercide.

Gullette argues that it was our collective indifference, fueled by the heightened ageism of the COVID-19 era, that prematurely killed this vulnerable population. Compounding that deadly indifference is our own panic about aging and a social bias in favor of youth-based decisions about lifesaving care. The compassion this country failed to muster for the residents of our nursing facilities motivated Gullette to pen an act of remembrance, issuing a call for pro-aging changes in policy and culture that would improve long-term care for everyone.

Examining trans- healthcare as a key site through which struggles for health and justice take shape

 

Over the past two decades, medical and therapeutic approaches to transgender patients have changed radically, from treating a supposed pathology to offering gender-affirming care. Based on ethnographic fieldwork in New York City and Buenos Aires, Care without Pathology moves across the Americas to show how trans- health activists have taken on the project of depathologization.

In New York, Christoph Hanssmann examines activist attempts to overturn bans on using public health dollars to fund trans- health care. In Argentina, he traces how trans- activists marshaled medical statistics and personal biographies to reveal state violence directed against trans- people and travestis. Hanssmann also demonstrates the importance of understanding transphobia in the broader context of gendered racism, ableism, and antipoverty, arguing for the rise of a thoroughly coalition-based mass mobilization.

Care without Pathology highlights the distributive arguments activists made to access state funding for health care, combating state arguments that funding trans- health care is too specialized, too expensive, and too controversial. Hanssmann situates trans- health as a crucible within which sweeping changes are taking place—with potentially far-reaching effects on the economic and racial barriers to accessing care.

A doctor, a disinvested neighborhood, and a radical experiment to close America’s death gap. 

Two girls are born in the same Chicago hospital. Their neighborhoods—just seven train stops apart—will shape their futures and help determine how long they live. One will celebrate her eighty-fifth birthday. The other will die before sixty-five.

This is the death gap: lives lost too soon. Crossing the Gap asks how a city with world-class hospitals can tolerate an epidemic of premature death—and tells the story of the people fighting to end it.

In his landmark book The Death Gap, physician and health equity leader David A. Ansell exposed how structural racism and poverty shorten lives. He moves beyond diagnosis in Crossing the Gap to explore what happens when a major medical center joins forces with pastors, community organizers, residents, and young leaders on Chicago’s West Side to redefine what a hospital owes its neighbors. Part medical memoir and part urban chronicle, Crossing the Gap follows groundbreaking initiatives such as West Side United and the Sankofa Wellness Village as they confront decades of disinvestment and work to build healthier communities. 

Through stories of collaboration, courage, conflict, and community leadership, Ansell shows how neighborhood voices, rigorous data, and moral imagination can transform health systems from bystanders into partners for change—not just in one city but throughout the nation. 

Kristine McCusker charts the dramatic transformation that took place when southerners in particular and Americans in general changed their thinking about when one should die, how that death could occur, and what decent burial really means. As she shows, death care evolved from being a community act to a commercial one where purchasing a purple coffin and hearse ride to the cemetery became a political statement and the norm. That evolution also required interactions between perfect strangers, especially during the world wars as families searched for their missing soldiers. In either case, being put away decent, as southerners called burial, came to mean something fundamentally different in 1955 than it had just fifty years earlier.

How functional medicine leverages systems biology and epigenetic science to treat the microbiome and reverse chronic disease.

Each body is a system within a system—an ecology within the larger context of social, political, economic, cultural, and environmental factors. This is one of the lessons of epigenetics, whereby structural inequalities are literally encoded in our genes. But our ecological embeddedness extends beyond DNA, for each body also teems with trillions of bacteria, yeast, and fungi, all of them imprints of our individual milieus. Nested Ecologies asks what it would mean to take seriously our microbial being, given that our internal ecologies are shaped by inequalities embedded in our physical and social environments.

Further, Rosalynn Vega argues that health practices focused on patients’ unique biology inadvertently reiterate systemic inequities. In particular, functional medicine—which attempts to heal chronic disease by leveraging epigenetic science and treating individual microbiomes—reduces illness to problems of “lifestyle,” principally diet, while neglecting the inability of poor people to access nutrition. Functional medicine thus undermines its own critique of the economics of health care. Drawing on novel digital ethnographies and reflecting on her own experience of chronic illness, Vega challenges us to rethink not only the determinants of well-being but also what it is to be human.

Recent anthropological scholarship on “new midwifery” centers on how professional midwives in various countries are helping women reconnect with “nature,” teaching them to trust in their bodies, respecting women’s “choices,” and fighting for women’s right to birth as naturally as possible. In No Alternative, Rosalynn A. Vega uses ethnographic accounts of natural birth practices in Mexico to complicate these narratives about new midwifery and illuminate larger questions of female empowerment, citizenship, and the commodification of indigenous culture, by showing how alternative birth actually reinscribes traditional racial and gender hierarchies.

Vega contrasts the vastly different birthing experiences of upper-class and indigenous Mexican women. Upper-class women often travel to birthing centers to be delivered by professional midwives whose methods are adopted from and represented as indigenous culture, while indigenous women from those same cultures are often forced by lack of resources to use government hospitals regardless of their preferred birthing method. Vega demonstrates that women’s empowerment, having a “choice,” is a privilege of those capable of paying for private medical services—albeit a dubious privilege, as it puts the burden of correctly producing future members of society on women’s shoulders. Vega’s research thus also reveals the limits of citizenship in a neoliberal world, as indigeneity becomes an object of consumption within a transnational racialized economy.

WINNER OF THE JAMES F. SULZBY AWARD

Healing against the odds—Black doctors, bold resistance, and the fight for medical justice in Alabama.

Physicians for the People chronicles the remarkable stories of 241 Black doctors who practiced medicine in Alabama during the Jim Crow era. Historian Jack D. Ellis reveals the ingenuity and resilience of these trailblazing doctors who defied segregation by establishing hospitals and clinics and providing vital healthcare to underserved Black communities.

This meticulously researched work draws on archival sources, oral histories, and an unparalleled database to dismantle the myth of a monolithic medical system in the Jim Crow South. Jack D. Ellis argues that the post–Civil War lives of Black physicians, dentists, pharmacists, nurses, and midwives hold special significance, illuminating both the causes of health care disparities among African Americans and the reasons for their continued underrepresentation in the medical professions.

Offering much of interest to students and scholars of Black history, medical history, and the civil rights movement, Physicians for the People exposes the deliberate exclusion faced by Black doctors within the white medical establishment and their ongoing fight for racial equality in medicine.

Medical clinicians, who are already overworked and burned out, are increasingly expected to understand and treat systemic social issues like poverty and racism. One aspect of this is documenting patient’s social risk factors in electronic health records (EHRs). But EHRs do not aways give the full story. Critically, they omit patients’ voices and perspectives about their lives, care, and whether their needs are being met. In Seen But Not Heard, sociologist Jennifer M. Silva and epidemiologist Annemarie G. Hirsch explore the gaps between what clinicians document in EHRs and women’s lived experiences.

Drawing on interviews with 87 non-college-educated, economically disadvantaged women living in rural America and their health records from a large, non-profit health system, Silva and Hirsch find that the stories that medical records provide and the stories that women tell about themselves differ dramatically. Medical charts often translate women’s suffering into sterile diagnostic codes, prescriptions, and treatment plans. Some women felt heard by their clinicians, believed they received adequate care. Many of these women thought their clinicians went above and beyond to help meet their needs by offering them information on how to apply for benefits like food stamps or childcare subsidies and helping them obtain necessary items like mattress covers and winter coats. More often, however, women felt that clinicians were detached from their everyday struggles to survive, whether that meant keeping their families intact even in the face of violence or finding money to pay the never-ending string of bills.

Silva and Hirsch argue that because the system of healthcare delivery interprets social problems as individual failings it often reproduces long-standing injurious stereotypes of women as hysterical, recalcitrant, impure, and gluttonous. For some healthcare providers, knowledge about patients’ social risk factors can become a source of control and punishment, such as denying patients care or reporting patients to child welfare services. Patients described clinicians mobilizing harmful stereotypes about marriage and motherhood, race, and poverty during their appointments. Some of the women’s most traumatic experiences in the healthcare system were completely missing from their EHRs. These troubling experiences ultimately deter women from accessing healthcare, discourages them from sharing their experiences with clinicians, and in some cases, makes their health and social problems worse. Silva and Hirsch offer several policies and practices that would improve women’s experiences in clinical encounters, such as training clinicians in trauma-informed and culturally responsive care, as well as national investments in housing, food security, transportation, and environmental justice.

Seen But Not Heard is a disturbing but necessary examination of the ways vulnerable women are often failed by the healthcare system and offers solutions that will allow healthcare workers to better address the structural barriers faced by their patients. 

An event-by-event look at how institutionalized racism harms the health of African Americans in the twenty-first century
 

A crucial component of anti-Black racism is the unconscionable disparity in health outcomes between Black and white Americans. Sickening examines this institutionalized inequality through dramatic, concrete events from the past two decades, revealing how unequal living conditions and inadequate medical care have become routine. 

From the spike in chronic disease after Hurricane Katrina to the lack of protection for Black residents during the Flint water crisis—and even the life-threatening childbirth experience for tennis star Serena Williams—author Anne Pollock takes readers on a journey through the diversity of anti-Black racism operating in healthcare. She goes beneath the surface to deconstruct the structures that make these events possible, including mass incarceration, police brutality, and the hypervisibility of Black athletes’ bodies. Ultimately, Sickening shows what these shocking events reveal about the everyday racialization of health in the United States.

Concluding with a vital examination of racialized healthcare during the COVID pandemic and the Black Lives Matter rebellions of 2020, Sickening cuts through the mind-numbing statistics to vividly portray healthcare inequalities. In a gripping and passionate style, Pollock shows the devastating reality and consequences of systemic racism on the lives and health of Black Americans. 

A pointed look at the state of tech-based mental healthcare and what we must do to change it
 

Proponents of technology trumpet it as the solution to the massive increase in the mental distress that confronts our nation. They herald the arrival of algorithms, intelligent chatbots, smartphone applications, telemental healthcare services, and more—but are these technological fixes really as good as they seem? In Therapy Tech, Emma Bedor Hiland presents the first comprehensive study of how technology has transformed mental healthcare, showing that this revolution can’t deliver what it promises.

Far from providing a solution, technological mental healthcare perpetuates preexisting disparities while relying on the same failed focus on personal responsibility that has let us down before. Through vivid, in-depth case studies, Therapy Tech reveals these problems, covering issues including psychosurveillance on websites like Facebook and 7 Cups of Tea, shortcomings of popular AI “doctors on demand” like Woebot, Wysa, and Joy, and even how therapists are being conscripted into the gig economy.

Featuring a vital coda that brings Therapy Tech up to date for the COVID era, this book is the first to give readers a large-scale analysis of mental health technologies and the cultural changes they have enabled. Both a sobering dissection of the current state of mental health and a necessary warning of where things are headed, Therapy Tech makes an important assertion about how to help those in need of mental health services today.