The Health Gap
The Health Gap

Author: Michael Marmot

Publisher: Bloomsbury Publishing

Published: 2015-09-10

Total Pages: 400

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.

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.

The Death Gap
The Death Gap

Author: David A. Ansell, MD

Publisher: University of Chicago Press

Published: 2021-06-16

Total Pages: 256

ISBN-13: 022679685X

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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.

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.

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.

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.

Social Determinants of Health
Social Determinants of Health

Author: Richard G. Wilkinson

Publisher: World Health Organization

Published: 2003

Total Pages: 34

ISBN-13: 9289013710

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Poorer people live shorter lives and suffer higher levels of ill health than the more affluent in society, and this disparity highlights the sensitivity of human health to socio-economic factors. This booklet examines this social gradient in health and explains how psychological and social influences affect physical health and longevity. It also considers the role of public policy in promoting a social environment that is more conducive to better health. Topics discussed include: stress, early childhood health, social exclusion, work, unemployment and job insecurity, social support networks, the effects of alcohol and other drug addictions, food and nutrition, and healthier transport systems.

Coming to Narrative
Coming to Narrative

Author: Arthur P Bochner

Publisher: Routledge

Published: 2016-06-16

Total Pages: 351

ISBN-13: 1315432080

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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.