Introduction -- How the Uninsured Are Criminalized -- Who Deserves Health Care? -- Why Latina Women Sacrifice Their Coverage -- The Role Gender Plays in Access to Health Care -- The Power of Social Networks to Secure Insurance -- Conclusion.
The amazing tale of “County” is the story of one of America’s oldest and most unusual urban hospitals. From its inception as a “poor house” dispensing free medical care to indigents, Chicago’s Cook County Hospital has been renowned as a teaching hospital and the healthcare provider of last resort for the city’s uninsured. Ansell covers more than thirty years of its history, beginning in the late 1970s when the author began his internship, to the “Final Rounds” when the enormous iconic Victorian hospital building was replaced. Ansell writes of the hundreds of doctors who underwent rigorous training with him. He writes of politics, from contentious union strikes to battles against “patient dumping,” and public health, depicting the AIDS crisis and the Out of Printening of County’s HIV/AIDS clinic, the first in the city. And finally it is a coming-of-age story for a young doctor set against a backdrOut of Print of race, segregation, and poverty. This is a riveting account.
Why millions of Latinx people don’t access the healthcare system, even in times of need More than a decade after the passage of the Affordable Care Act, around eleven million Latinx citizens around the country remain uninsured. In Uninsured in Chicago, Robert Vargas explores the roots of this crisis, showing us why, despite their eligibility, Latinx people are the racial group least likely to enroll in health insurance. Following the lives of forty uninsured Latinx people in Chicago, Vargas provides an up-close look at America’s broken healthcare system, and how it impacts marginalized groups. From excruciatingly long waits and expensive medical bills, to humiliating interactions with health navigators and emergency room staff, he shows us why millions of Latinx people avoid the healthcare system, even in times of need. With a compassionate eye, Vargas highlights the unique struggles Latinx people face as the largest racial group without health insurance in the United States. An intimate account of the lives of uninsured Latinos, this book imagines new, powerful ways to strengthen our social safety net to better serve our most vulnerable communities.
"This book offers insight into how redevelopment policy is implemented on the ground, articulates the political and social benefits of collective skepticism for communities of color, and critiques the partial perspectives dominant in social capital and community development studies"--
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.
Roughly 40 million Americans have no health insurance, private or public, and the number has grown steadily over the past 25 years. Who are these children, women, and men, and why do they lack coverage for essential health care services? How does the system of insurance coverage in the U.S. operate, and where does it fail? The first of six Institute of Medicine reports that will examine in detail the consequences of having a large uninsured population, Coverage Matters: Insurance and Health Care, explores the myths and realities of who is uninsured, identifies social, economic, and policy factors that contribute to the situation, and describes the likelihood faced by members of various population groups of being uninsured. It serves as a guide to a broad range of issues related to the lack of insurance coverage in America and provides background data of use to policy makers and health services researchers.
Through an ethnographic case study of Chicago's Little Village, Wounded City demonstrates how competition for political power and state resources undermined efforts to reduce gang violence. Robert Vargas argues that the state, through different patterns of governance, can contribute to distrust and division among community members.
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.