The Health Gap
The Health Gap

Author: Michael Marmot

Publisher: Bloomsbury Publishing

Published: 2015-09-10

Total Pages: 426

ISBN-13: 1408857987

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'Punchily written ... He leaves the reader with a sense of the gross injustice of a world where health outcomes are so unevenly distributed' Times Literary Supplement 'Splendid and necessary' Henry Marsh, author of Do No Harm, New Statesman There are dramatic differences in health between countries and within countries. But this is not a simple matter of rich and poor. A poor man in Glasgow is rich compared to the average Indian, but the Glaswegian's life expectancy is 8 years shorter. The Indian is dying of infectious disease linked to his poverty; the Glaswegian of violent death, suicide, heart disease linked to a rich country's version of disadvantage. In all countries, people at relative social disadvantage suffer health disadvantage, dramatically so. Within countries, the higher the social status of individuals the better is their health. These health inequalities defy usual explanations. Conventional approaches to improving health have emphasised access to technical solutions – improved medical care, sanitation, and control of disease vectors; or behaviours – smoking, drinking – obesity, linked to diabetes, heart disease and cancer. These approaches only go so far. Creating the conditions for people to lead flourishing lives, and thus empowering individuals and communities, is key to reduction of health inequalities. In addition to the scale of material success, your position in the social hierarchy also directly affects your health, the higher you are on the social scale, the longer you will live and the better your health will be. As people change rank, so their health risk changes. What makes these health inequalities unjust is that evidence from round the world shows we know what to do to make them smaller. This new evidence is compelling. It has the potential to change radically the way we think about health, and indeed society.

The Health Gap
The Health Gap

Author: Michael Marmot

Publisher: Bloomsbury Publishing USA

Published: 2015-11-03

Total Pages: 426

ISBN-13: 1632860791

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In Baltimore's inner-city neighborhood of Upton/Druid Heights, a man's life expectancy is sixty-three; not far away, in the Greater Roland Park/Poplar neighborhood, life expectancy is eighty-three. The same twenty-year avoidable disparity exists in the Calton and Lenzie neighborhoods of Glasgow, and in other cities around the world. In Sierra Leone, one in 21 fifteen-year-old women will die in her fertile years of a maternal-related cause; in Italy, the figure is one in 17,100; but in the United States, which spends more on healthcare than any other country in the world, it is one in 1,800 (and now, with the new administration chipping away at Obamacare, the statistics stand to grow even more devastating). Why? Dramatic differences in health are not a simple matter of rich and poor; poverty alone doesn't drive ill health, but inequality does. Indeed, suicide, heart disease, lung disease, obesity, and diabetes, for example, are all linked to social disadvantage. In every country, people at relative social disadvantage suffer health disadvantage and shorter lives. Within countries, the higher the social status of individuals, the better their health. These health inequalities defy the usual explanations. Conventional approaches to improving health have emphasized access to technical solutions and changes in the behavior of individuals, but these methods only go so far. What really makes a difference is creating the conditions for people to have control over their lives, to have the power to live as they want. Empowerment is the key to reducing health inequality and thereby improving the health of everyone. Marmot emphasizes that the rate of illness of a society as a whole determines how well it functions; the greater the health inequity, the greater the dysfunction. Marmot underscores that we have the tools and resources materially to improve levels of health for individuals and societies around the world, and that to not do so would be a form of injustice. Citing powerful examples and startling statistics (“young men in the U.S. have less chance of surviving to sixty than young men in forty-nine other countries”), The Health Gap presents compelling evidence for a radical change in the way we think about health and indeed society, and inspires us to address the societal imbalances in power, money, and resources that work against health equity.

The Death Gap
The Death Gap

Author: David A. Ansell, MD

Publisher: University of Chicago Press

Published: 2021-06-16

Total Pages: 270

ISBN-13: 022679671X

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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. As the COVID-19 mortality rates in underserved communities proved, inequality is all around us, and often the distance between high and low life expectancy can be a matter of just a few blocks. Updated with a new foreword by Chicago mayor Lori Lightfoot and an afterword by Ansell, The Death Gap speaks to the urgency to face this national health crisis head-on.

Closing the Gap in a Generation
Closing the Gap in a Generation

Author: WHO Commission on Social Determinants of Health

Publisher: World Health Organization

Published: 2008

Total Pages: 257

ISBN-13: 9241563702

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Social justice is a matter of life and death. It affects the way people live, their consequent chance of illness, and their risk of premature death. We watch in wonder as life expectancy and good health continue to increase in parts of the world and in alarm as they fail to improve in others.

Mind the Gap
Mind the Gap

Author: Richard G. Wilkinson

Publisher: Yale University Press

Published: 2001-01-01

Total Pages: 92

ISBN-13: 9780300089530

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Inequality kills. Both rich and poor die younger in countries with the greatest inequalities in income. Countries such as the United States with big gaps between rich and poor have higher death rates than those with smaller gaps such as Sweden and Japan. Why? In this provocative book, Richard Wilkinson provides a novel Darwinian approach to the question. Wilkinson points out that inequality is new to our species: in our two-million-year history, human societies became hierarchical only about ten thousand years ago. Because our minds and bodies are adapted to a more egalitarian life, today's hierarchical structures may be considered unnatural. To people at the bottom of the heap, the world seems hostile and the stress is harmful. If you are not in control, you're at risk. This is a penetrating analysis of patterns of health and disease that has implications for social policy. Wilkinson concludes that rather than relying on more police, prisons, social workers, or doctors, we must tackle the corrosive social effects of income differences in our society.

Disease Control Priorities, Third Edition (Volume 4)
Disease Control Priorities, Third Edition (Volume 4)

Author: Vikram Patel

Publisher: World Bank Publications

Published: 2016-03-10

Total Pages: 307

ISBN-13: 1464804281

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Mental, neurological, and substance use disorders are common, highly disabling, and associated with significant premature mortality. The impact of these disorders on the social and economic well-being of individuals, families, and societies is large, growing, and underestimated. Despite this burden, these disorders have been systematically neglected, particularly in low- and middle-income countries, with pitifully small contributions to scaling up cost-effective prevention and treatment strategies. Systematically compiling the substantial existing knowledge to address this inequity is the central goal of this volume. This evidence-base can help policy makers in resource-constrained settings as they prioritize programs and interventions to address these disorders.

Global Health Disparities
Global Health Disparities

Author: Enku Kebede-Francis

Publisher: Jones & Bartlett Publishers

Published: 2010-09-15

Total Pages: 489

ISBN-13: 1449619347

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One hundred countries—more than half of the world’s population—have made significant strides in the last 30 years, improving life expectancy and the health of their populations. Despite socioeconomic limitations, extended wars, embargos, and geographic limitations, these countries managed to provide basic health care, primary education, and clean water for their populations. In this unique book, the author puts these, and many other countries, under the microscope through a detailed examination of best practices and best outcomes. Anchored on landmark UN declarations, and based on numerous indices including the World Development Index, Global Health Disparities: Closing the Gap Through Good Governance covers relevant policies and laws in international health and offers many data, tables, and figures. Discussion questions are included in each chapter to be used as assignments, debate topics, and to facilitate classroom learning. Ideal for graduate level global/international public health courses as well as courses in international relations and international policy.

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.

The Political Determinants of Health
The Political Determinants of Health

Author: Daniel E. Dawes

Publisher: Johns Hopkins University Press

Published: 2020-03-24

Total Pages: 241

ISBN-13: 1421437899

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How do policy and politics influence the social conditions that generate health outcomes? Reduced life expectancy, worsening health outcomes, health inequity, and declining health care options—these are now realities for most Americans. However, in a country of more than 325 million people, addressing everyone's issues is challenging. How can we effect beneficial change for everyone so we all can thrive? What is the great equalizer? In this book, Daniel E. Dawes argues that political determinants of health create the social drivers—including poor environmental conditions, inadequate transportation, unsafe neighborhoods, and lack of healthy food options—that affect all other dynamics of health. By understanding these determinants, their origins, and their impact on the equitable distribution of opportunities and resources, we will be better equipped to develop and implement actionable solutions to close the health gap. Dawes draws on his firsthand experience helping to shape major federal policies, including the Affordable Care Act, to describe the history of efforts to address the political determinants that have resulted in health inequities. Taking us further upstream to the underlying source of the causes of inequities, Dawes examines the political decisions that lead to our social conditions, makes the social determinants of health more accessible, and provides a playbook for how we can address them effectively. A thought-provoking and evocative account that considers both the policies we think of as "health policy" and those that we don't, The Political Determinants of Health provides a novel, multidisciplinary framework for addressing the systemic barriers preventing the United States from becoming the healthiest nation in the world.

Coming to Narrative
Coming to Narrative

Author: Arthur P Bochner

Publisher: Left Coast Press

Published: 2014-04-15

Total Pages: 351

ISBN-13: 1611327679

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Reflecting on a 50 year university career, Distinguished Professor Arthur Bochner, former President of the National Communication Association, discloses a lived history, both academic and personal, that has paralleled many of the paradigm shifts in the human sciences inspired by the turn toward narrative. He shows how the human sciences—especially in his own areas of interpersonal, family, and communication theory—have evolved from sciences directed toward prediction and control to interpretive ones focused on the search for meaning through qualitative, narrative, and ethnographic modes of inquiry. He outlines the theoretical contributions of such luminaries as Bateson, Laing, Goffman, Henry, Gergen, and Richardson in this transformation. Using diverse forms of narration, Bochner seamlessly layers theory and story, interweaving his professional and personal life with the social and historical contexts in which they developed.