Communities in Action
Communities in Action

Author: National Academies of Sciences, Engineering, and Medicine

Publisher: National Academies Press

Published: 2017-04-27

Total Pages: 583

ISBN-13: 0309452961

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In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.

Unequal Treatment
Unequal Treatment

Author: Institute of Medicine

Publisher: National Academies Press

Published: 2009-02-06

Total Pages: 781

ISBN-13: 030908265X

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Racial and ethnic disparities in health care are known to reflect access to care and other issues that arise from differing socioeconomic conditions. There is, however, increasing evidence that even after such differences are accounted for, race and ethnicity remain significant predictors of the quality of health care received. In Unequal Treatment, a panel of experts documents this evidence and explores how persons of color experience the health care environment. The book examines how disparities in treatment may arise in health care systems and looks at aspects of the clinical encounter that may contribute to such disparities. Patients' and providers' attitudes, expectations, and behavior are analyzed. How to intervene? Unequal Treatment offers recommendations for improvements in medical care financing, allocation of care, availability of language translation, community-based care, and other arenas. The committee highlights the potential of cross-cultural education to improve provider-patient communication and offers a detailed look at how to integrate cross-cultural learning within the health professions. The book concludes with recommendations for data collection and research initiatives. Unequal Treatment will be vitally important to health care policymakers, administrators, providers, educators, and students as well as advocates for people of color.

Measuring the Quality of Health Care
Measuring the Quality of Health Care

Author: The National Roundtable on Health Care Quality

Publisher: National Academies Press

Published: 1999-02-23

Total Pages: 42

ISBN-13: 0309570689

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The National Roundtable on Health Care Quality was established in 1995 by the Institute of Medicine. The Roundtable consists of experts formally appointed through procedures of the National Research Council (NRC) who represent both public and private-sector perspectives and appropriate areas of substantive expertise (not organizations). From the public sector, heads of appropriate Federal agencies serve. It offers a unique, nonadversarial environment to explore ongoing rapid changes in the medical marketplace and the implications of these changes for the quality of health and health care in this nation. The Roundtable has a liaison panel focused on quality of care in managed care organizations. The Roundtable convenes nationally prominent representatives of the private and public sector (regional, state and federal), academia, patients, and the health media to analyze unfolding issues concerning quality, to hold workshops and commission papers on significant topics, and when appropriate, to produce periodic statements for the nation on quality of care matters. By providing a structured opportunity for regular communication and interaction, the Roundtable fosters candid discussion among individuals who represent various sides of a given issue.

Understanding Racial and Ethnic Differences in Health in Late Life
Understanding Racial and Ethnic Differences in Health in Late Life

Author: National Research Council

Publisher: National Academies Press

Published: 2004-09-08

Total Pages: 184

ISBN-13: 0309165865

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As the population of older Americans grows, it is becoming more racially and ethnically diverse. Differences in health by racial and ethnic status could be increasingly consequential for health policy and programs. Such differences are not simply a matter of education or ability to pay for health care. For instance, Asian Americans and Hispanics appear to be in better health, on a number of indicators, than White Americans, despite, on average, lower socioeconomic status. The reasons are complex, including possible roles for such factors as selective migration, risk behaviors, exposure to various stressors, patient attitudes, and geographic variation in health care. This volume, produced by a multidisciplinary panel, considers such possible explanations for racial and ethnic health differentials within an integrated framework. It provides a concise summary of available research and lays out a research agenda to address the many uncertainties in current knowledge. It recommends, for instance, looking at health differentials across the life course and deciphering the links between factors presumably producing differentials and biopsychosocial mechanisms that lead to impaired health.

Medical Apartheid
Medical Apartheid

Author: Harriet A. Washington

Publisher: Vintage

Published: 2008-01-08

Total Pages: 530

ISBN-13: 076791547X

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NATIONAL BOOK CRITICS CIRCLE AWARD WINNER • The first full history of Black America’s shocking mistreatment as unwilling and unwitting experimental subjects at the hands of the medical establishment. No one concerned with issues of public health and racial justice can afford not to read this masterful book. "[Washington] has unearthed a shocking amount of information and shaped it into a riveting, carefully documented book." —New York Times From the era of slavery to the present day, starting with the earliest encounters between Black Americans and Western medical researchers and the racist pseudoscience that resulted, Medical Apartheid details the ways both slaves and freedmen were used in hospitals for experiments conducted without their knowledge—a tradition that continues today within some black populations. It reveals how Blacks have historically been prey to grave-robbing as well as unauthorized autopsies and dissections. Moving into the twentieth century, it shows how the pseudoscience of eugenics and social Darwinism was used to justify experimental exploitation and shoddy medical treatment of Blacks. Shocking new details about the government’s notorious Tuskegee experiment are revealed, as are similar, less-well-known medical atrocities conducted by the government, the armed forces, prisons, and private institutions. The product of years of prodigious research into medical journals and experimental reports long undisturbed, Medical Apartheid reveals the hidden underbelly of scientific research and makes possible, for the first time, an understanding of the roots of the African American health deficit. At last, it provides the fullest possible context for comprehending the behavioral fallout that has caused Black Americans to view researchers—and indeed the whole medical establishment—with such deep distrust.

Community Health Equity
Community Health Equity

Author: Fernando De Maio

Publisher: University of Chicago Press

Published: 2019-03-29

Total Pages: 466

ISBN-13: 022661476X

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Perhaps more than any other American city, Chicago has been a center for the study of both urban history and economic inequity. Community Health Equity assembles a century of research to show the range of effects that Chicago’s structural socioeconomic inequalities have had on patients and medical facilities alike. The work collected here makes clear that when a city is sharply divided by power, wealth, and race, the citizens who most need high-quality health care and social services have the greatest difficulty accessing them. Achieving good health is not simply a matter of making the right choices as an individual, the research demonstrates: it’s the product of large-scale political and economic forces. Understanding these forces, and what we can do to correct them, should be critical not only to doctors but to sociologists and students of the urban environment—and no city offers more inspiring examples for action to overcome social injustice in health than Chicago.

Global Applications of Culturally Competent Health Care: Guidelines for Practice
Global Applications of Culturally Competent Health Care: Guidelines for Practice

Author: Marilyn "Marty" Douglas

Publisher: Springer

Published: 2018-07-02

Total Pages: 365

ISBN-13: 3319693328

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This book is unique in its global approach to applying the Guidelines for Culturally Competent Nursing Practice that were recently endorsed by the International Council of Nurses (ICN) and distributed to all of its 130 national nursing associations. The purpose of this book is to illustrate how these guidelines can be put into clinical practice and to show how practitioners from different countries with diverse populations can implement them. The first chapter provides the conceptual basis for Culturally Competent Health Care and describes how the guidelines were developed. Each of the next 10 sections presents a chapter describing a specific guideline followed by three or four chapters with detailed case studies to illustrate how the guideline was implemented in a particular cultural setting. All case studies follow a similar format and are written by international authors with clinical expertise and work experience in the culture being presented. This book will be useful for advanced practice nurses, healthcare students, clinicians, administrators, educators, researchers, and those who provide community health or population-based care.

Case Studies in Public Health
Case Studies in Public Health

Author: Theodore H. Tulchinsky

Publisher: Academic Press

Published: 2018-03-12

Total Pages: 605

ISBN-13: 0128045868

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Case Studies in Public Health contains selected case studies of some of the most important and influential moments in medicine and epidemiology. The cases chosen for this collection represent a wide array of public health issues that go into the makeup of what can be termed the New Public Health (NPH), which includes traditional public health, such as sanitation, hygiene and infectious disease control, but widens its perspective to include the organization, financing and quality of health care services in a much broader sense. Each case study is presented in a systematic fashion to facilitate learning, with the case, background, current relevance, economic issues, ethical issues, conclusions, recommendation and references discussed for each case. The book is a valuable resource for advanced students and researchers with specialized knowledge who need further information on the general background and history of public health and important scientific discoveries within the field. It is an ideal resource for students in public health, epidemiology, medicine, anthropology, and sociology, and for those interested in how to apply lessons from the past to present and future research. - Explores the history of public health through important scientific events and flashpoints - Presents case studies in a clear, direct style that is easy to follow - Uses a systematic approach to help learn lessons from the past and apply them to the present

Just Medicine
Just Medicine

Author: Dayna Bowen Matthew

Publisher: NYU Press

Published: 2016-10-25

Total Pages: 310

ISBN-13: 1479888567

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Offers an innovative plan to eliminate inequalities in American health care and save the lives they endanger Over 84,000 black and brown lives are needlessly lost each year due to health disparities: the unfair, unjust, and avoidable differences between the quality and quantity of health care provided to Americans who are members of racial and ethnic minorities and care provided to whites. Health disparities have remained stubbornly entrenched in the American health care system—and in Just Medicine Dayna Bowen Matthew finds that they principally arise from unconscious racial and ethnic biases held by physicians, institutional providers, and their patients. Implicit bias is the single most important determinant of health and health care disparities. Because we have missed this fact, the money we spend on training providers to become culturally competent, expanding wellness education programs and community health centers, and even expanding access to health insurance will have only a modest effect on reducing health disparities. We will continue to utterly fail in the effort to eradicate health disparities unless we enact strong, evidence-based legal remedies that accurately address implicit and unintentional forms of discrimination, to replace the weak, tepid, and largely irrelevant legal remedies currently available. Our continued failure to fashion an effective response that purges the effects of implicit bias from American health care, Matthew argues, is unjust and morally untenable. In this book, she unites medical, neuroscience, psychology, and sociology research on implicit bias and health disparities with her own expertise in civil rights and constitutional law. In a time when the health of the entire nation is at risk, it is essential to confront the issues keeping the health care system from providing equal treatment to all.