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This is an auto-narrated audiobook edition of this book.

There is little debate that health care in the United States is in need of reform. But where should those improvements begin? With insurers? Drug makers? The doctors themselves? In Big Med, David Dranove and Lawton Robert Burns argue that we’re overlooking the most ubiquitous cause of our costly and underperforming system: megaproviders, the expansive health care organizations that have become the face of American medicine. Your local hospital is likely part of one. Your doctors, too. And the megaproviders are bad news for your health and your wallet.

Drawing on decades of combined expertise in health care consolidation, Dranove and Burns trace Big Med’s emergence in the 1990s, followed by its swift rise amid false promises of scale economies and organizational collaboration. In the decades since, megaproviders have gobbled up market share and turned independent physicians into salaried employees of big bureaucracies, while delivering on none of their early promises. For patients this means higher costs and lesser care. Meanwhile, physicians report increasingly low morale, making it all but impossible for most systems to implement meaningful reforms.

In Big Med, Dranove and Burns combine their respective skills in economics and management to provide a nuanced explanation of how the provision of health care has been corrupted and submerged under consolidation. They offer practical recommendations for improving competition policies that would reform megaproviders to actually achieve the efficiencies and quality improvements they have long promised.
This is an essential read for understanding the current state of the health care system in America—and the steps urgently needed to create an environment of better care for all of us.

An authoritative student guide for how to evaluate complex public health interventions.

Public health interventions include any effort or policy that attempts to improve the well-being of individuals or an entire population. They can be run by governmental health departments or non-governmental organizations and can include educational programs, screening programs, vaccination programs, environmental improvements, and health promotion campaigns. Interventions that include multiple independent or interacting components are referred to as complex. Evaluating and predicting the efficacy of any public health intervention, as well as calculating the cost effectiveness, is essential. Using examples from multiple published studies conducted around the world, this textbook shows readers how to evaluate public health interventions in real-world settings. It will enable readers to understand how to investigate whether a public health intervention works, for whom, when, where, how, and why. It provides a comprehensive introduction to key areas of evaluation, including understanding complex interventions, developing program theories, community engagement in evaluation, and the main methods used in process, impact, and economic evaluation. It explains how different methods can be used individually and in combination to answer different kinds of evaluation questions and at different phases in an evaluation cycle and considers how the results of evaluations can be brought together to inform action.

Despite intense political debate, attitudes on abortion were remarkably stable for decades. However, after the 2022 Dobbs decision, Americans’ opinions began to change. Not Going Back explores the shifts in public opinion on this hot-button issue from the landmark passing of Roe v. Wade in 1973 through the 2024 election and into 2025.

The authors ask, “What role do Americans want their government to play in protecting, regulating, or restricting abortion access?” and, “How will changing attitudes on abortion reshape American politics?” They offer cohesive, theoretically grounded explanations for both the continuity and the change in Americans’ attitudes on this contentious topic. Using national data, they take a deep dive into the personal experiences and social forces behind these changes.

Not Going Back ends with an examination of the consequences of these changes for election outcomes. While there has been a striking reversal in the prioritization of abortion as an issue among Democrats and Republicans, the full impact of this shift in thinking will be influenced by future policies, court decisions, and party reactions.

An eye-opening look at how Republican policies have affected health outcomes in rural communities and why poor, rural white voters are turning to the Republican Party—not despite this harm, but because of it.

Over the last four decades, the health of rural Americans has been in free fall. Just as opioid and gun deaths have ripped apart rural communities, hospitals have closed at alarming rates, leaving millions desperately far from care. At the same time, voters in struggling rural communities have increasingly come to vote for the Republican Party.

In Rural Pain, Republican Gain, Michael E. Shepherd demonstrates that these two trends are closely connected. At both the federal and state levels, the Republican Party has increasingly enacted policies that worsen rural health. Rural voters are not indifferent to this development (quite the contrary), but they misassign blame, in part, because the Democratic Party is more commonly associated with health-related policy initiatives and has ownership of health as an issue area. Republican politicians can reap rewards from their own destructive policies by appealing to the shared grievances of rural people.

Shepherd draws on new, wide-ranging data, including in-depth studies of the opioid epidemic, hospital closures, and COVID-19. In so doing, he quantifies the harm of Republican policymaking and its disproportionate effect on rural communities, recasting how readers understand growing Republican support among less healthy, lower-income rural white Americans.

Latinos living in the United States continue to face institutional racism and systemic oppression in many aspects of their lives. This volume focuses on discriminatory policies and practices in the health sector and reveals how they compound contemporary health inequities among Latinos. Through a combination of rigorous data analysis and personal narratives, the contributors explore critical dimensions of Latino health, including systemic disparities in healthcare access and insurance, the effects of state immigration policies on health outcomes, unique challenges facing undocumented immigrants, adolescent socio-emotional development, aging populations, Latina women’s physical and mental health, farmworker occupational hazards, and pathways toward health equity. Together, the chapters show that Latinos in the United States continue to face four fundamental barriers to health equity, namely immigrant legal status restrictions, anti-immigrant policies, inadequate quality care from healthcare systems lacking cultural competency, and limited occupational protections. This timely work provides essential evidence for policymakers, public health practitioners, and researchers seeking to understand and address persistent health disparities affecting America's largest ethnic minority population.

A searing study of how modern reproductive politics shapes women's bodily agency

Pregnancy indisputably takes place within a woman's body. But as reproductive power finds its way into the hands of medical professionals, lobbyists, and policymakers, the geographies of pregnancy are shifting, and the boundaries need to be redrawn, argues Laura R. Woliver. The Political Geographies of Pregnancy is a vigorous analysis of the ways modern reproductive politics are shaped by long-standing debates on abortion and adoption, surrogacy arrangements, new reproductive technologies, medical surveillance, and the mapping of the human genome.

Across a politically charged backdrop of reproductive issues, Woliver exposes strategies that claim to uphold the best interests of children, families, and women but in reality complicate women's struggles to have control over their own bodies. Utilizing feminist standpoint theory and promoting a feminist ethic of care, Woliver looks at abortion politics, modern adoption laws that cater to male-headed families, regulations that allow the state to monitor pregnant women but not always provide care for them, and the power structures behind the seemingly benign world of egg-selling and surrogate parenting. She also considers the potentially staggering political implications of mapping the human genome, and the exclusion of women's perspectives in discussions about legislation and advancements in reproductive technologies.

COVID-19 vaccines were a historic triumph, with less than a year between the initial identification of the microbe and effective vaccines being administered. They were also a public administration challenge, demanding that governments of the world procure and administer billions of doses in widely different contexts. In many countries they were intensely polarizing, catalyzing a rise in anti-vaccination politics.

Vaccination Politics brings together public health and political science expertise for a global, systematic comparison of vaccination politics. The authors look at 32 countries’ experiences—from Austria to Malawi and the United States to Hong Kong—to understand how trust, wealth, pharmaceutical industries, regulators, international organizations, and health systems succeeded or failed at acquiring vaccines and vaccinating citizens. It shows how different governments and populations navigated challenges. Global inequality, political trust, contestation over health system priorities, and opportunistic politicians all played roles in shaping the subsequent politics of health and vaccination around the world. A conclusion brings together lessons for policy and key issues for further research. While the next pandemic is unknown to us today, the response to it will be shaped by the positive and negative legacies of COVID-19 vaccination politics.

A provocative chronicle of how US public health has strayed from its liberal roots.

The Covid-19 response was a crucible of politics and public health—a volatile combination that produced predictably bad results. As scientific expertise became entangled with political motivations, the public-health establishment found itself mired in political encampment.

It was, as Sandro Galea argues, a crisis of liberalism: a retreat from the principles of free speech, open debate, and the pursuit of knowledge through reasoned inquiry that should inform the work of public health.

Across fifty essays, Within Reason chronicles how public health became enmeshed in the insidious social trends that accelerated under Covid-19. Galea challenges this intellectual drift towards intolerance and absolutism while showing how similar regressions from reason undermined social progress during earlier eras. Within Reason builds an incisive case for a return to critical, open inquiry as a guiding principle for the future public health we want—and a future we must work to protect.