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Health Care in World Cities

New York, Paris, and London

Michael K. Gusmano, Ph.D., Victor G. Rodwin, Ph.D., M.P.H., and Daniel Weisz, M.D., M.P.A.

Publication Year: 2010

New York. London. Paris. Although these cities have similar sociodemographic characteristics, including income inequalities and ethnic diversity, they have vastly different health systems and services. This book compares the three and considers lessons that can be applied to current and future debates about urban health care. Highlighting the importance of a national policy for city health systems, the authors use well-established indicators and comparable data sources to shed light on urban health policy and practice. Their detailed comparison of the three city health systems and the national policy regimes in which they function provides information about access to health care in the developed world’s largest cities. The authors first review the current literature on comparative analysis of health systems and offer a brief overview of the public health infrastructure in each city. Later chapters illustrate how timely and appropriate disease prevention, primary care, and specialty health care services can help cities control such problems as premature mortality and heart disease. In providing empirical comparisons of access to care in these three health systems, the authors refute inaccurate claims about health care outside of the United States.

Published by: The Johns Hopkins University Press

Contents

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pp. v-

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Preface

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pp. vii-x

New York, Paris, and London are among the largest cities in some of the wealthiest nations of the world. They are strategic locations for transnational corporations, as well as for governments and international organizations. Although they consider themselves unique, these cities share many characteristics and problems. As centers for specialized financial and legal services, media, and culture, they exercise a powerful influence...

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Acknowledgments

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pp. xi-xii

This book would not have been possible without extensive contributions from family, friends, and colleagues. Our families have endured our long absences during trips to France and England— and even longer absences due to time spent at the International Longevity Center– USA in Manhattan, where we completed much of the analysis and writing for this book. ...

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1. A New Approach to Comparing Health Systems

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pp. 1-20

Much has been written about New York, Paris, and London, but comparative studies of these cities are scarce, and those that do exist have not examined the health care systems and population health of these cities. Beyond the temptation of exploring uncharted territory, the most compelling reason for comparing health systems across these world cities is that, in spite of the trumpeted claims by each city as being ...

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2. Comparable Cities within Contrasting Health Systems

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pp. 21-55

In this chapter we provide a context for comparing access to health care in New York City, Paris, and London. We review the evolution of health systems in wealthy nations and compare their salient features in the United States, France, and England. We then describe the defining characteristics of the health care systems and public health infrastructure in these three cities. Finally, we develop our rationale and framework for ...

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3. Overall Performance of the Health System: Avoidable Mortality

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pp. 56-73

Our health status may depend on behavior and lifestyle, the environment in which we live, and our genes more than on the health care we receive, but for people with illness for which treatment exists, access to timely and effective health care is crucial. Health services can reduce rates of premature mortality due to certain conditions, such as leukemia, breast cancer, and a host of infectious diseases. If the rate ...

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4. Access to Primary Care: Avoidable Hospital Conditions

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pp. 74-92

Avoidable mortality is a useful summary measure of health system performance, reflecting a range of health care interventions, from primary and secondary prevention to tertiary care. Its breadth is both a strength and weakness. An exclusive focus on avoidable deaths, however, does not identify the contributions of public health, primary health care, or specialty medical services. In this chapter, we refine our analysis of ...

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5. Access to Specialty Care: The Treatment of Heart Disease

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pp. 93-114

Despite a recent decline in its incidence, ischemic heart disease (IHD) remains the world’s leading cause of death as well as a major contributor to health care expenditures. France has a much lower IHD mortality rate than most other nations belonging to the Organization for Economic Cooperation and Development (OECD). Indeed, the IHD mortality rate in France is less than half that of the United States and England. ...

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6. Conclusions

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pp. 115-128

The three cities we compare in this book are among a small set of unique urban environments, with populations that are uncommonly large, diverse, and mobile. These world cities are also exceptionally well endowed with health care resources, innovative public health systems, sophisticated urban infrastructures, and financial markets that attract capital from around the world. Despite the density of their ...

Appendix: Data and Methods

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pp. 129-152

References

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pp. 153-174

Index

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pp. 175-181


E-ISBN-13: 9780801898471
E-ISBN-10: 0801898471
Print-ISBN-13: 9780801894442
Print-ISBN-10: 0801894441

Page Count: 200
Illustrations: 2 line drawings, 1 map
Publication Year: 2010

Research Areas

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Subject Headings

  • Health status indicators -- New York (State) -- New York.
  • Health status indicators -- France -- Paris.
  • Urban health.
  • Health status indicators -- England -- London.
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