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Local Responses to Health Care Needs
In community after community, pro bono and student-run health clinics have sprung up over the past 30 years, providing critically needed care to medically underserved populations. Free Clinics is a mosaic formed by accounts of such clinics around the United States. These wide-ranging narratives—from urban to rural, from primary care to behavioral health care—provide examples that will assist other communities seeking to find the model that best fits their needs. The Patient Protection and Affordable Care Act has improved access to health care for many Americans, but millions remain and will remain uninsured or underinsured. Free clinics provide non-emergency care to those in need. Nationwide, professionals can be found offering volunteer services at these clinics. Contributors to this volume—typically people with personal familiarity (as clinicians or area residents) with the clinics they write about—cover a variety of topics, including a review of the literature, data-driven accounts of clinic usage, and ethical guidelines for student-run clinics. They describe the motivations of clinic staff, the day-to-day work of a family nurse practitioner working in clinics and teaching at a university, the challenges and rewards of providing health care for homeless people, and more. Student-run clinics are the topic of the second section: in addition to providing care to a small subset of those in need, student-run clinics are an important venue for training future clinicians and helping the seeds of altruism with which many enter their professions to germinate. Free Clinics will be useful to policymakers, students and faculty in public health and health policy programs, and clinicians and students who are embarking on launching new clinics.
Disease Prevention and the Environmental Breast Cancer Movement
Challenging the broader cultural milieu of pink ribbon symbolism and breast cancer "awareness" campaigns, this movement has grown from a handful of community-based organizations into a national entity, shaping the cultural, political, and public health landscape. Much of the activists' everyday work revolves around describing how the so called "cancer industry" downplays possible environmental links to protect their political and economic interests and they demand that the public play a role in scientific, policy, and public health decision-making to build a new framework of breast cancer prevention.
From Pink to Green successfully explores the intersection between breast cancer activism and the environmental health sciences, incorporating public and scientific debates as well as policy implications to public health and environmental agendas.
Health and Medical Care in America
One of America's leading public health experts finds a host of ills in this country's health care system: • The United States spends nearly twice as much on health care as the rest of the developed world, yet has higher infant mortality rates and shorter longevity than most nations. • We have access to many different drugs that accomplish the same end at varying costs, and nearly all are cheaper abroad. • Our life span had doubled over the past century before we developed effective drugs to treat most diseases or even considered altering the human genome. • The benefits of almost all newly developed treatments are marginal, while their costs are high. In his blunt assessment of the state of public health in America, Alfred Sommer argues that human behavior has a stronger effect on wellness than almost any other factor. Despite exciting advances in genomic research and cutting-edge medicine, Sommer explains, most illness can be avoided or managed with simple, low-tech habits such as proper hand washing, regular exercise, a balanced diet, and not smoking. But, as he also shows, this is easier said than done. Sommer finds that our fascination with medical advances sometimes keeps us from taking responsibility for our individual well-being. Instead of focusing on prevention, we wait for medical science to cure us once we become sick. Humorous, sometimes acerbic, and always well informed, Sommer’s thought-provoking book will change the way you look at health care in America.
Contesting Community and Defining Difference in U.S. Public Health Programs
As local governments and organizations assume more responsibility for ensuring the public health, identity politics play an increasing yet largely unexamined role in public and policy attitudes toward local problems. In Governing How We Care, medical anthropologist Susan Shaw examines the relationship between government and citizens using case studies of needle exchange and Welfare-to-Work programs to illustrate the meanings of cultural difference, ethnicity, and inequality in health care.
Drawing on ethnographic research conducted over six years in a small New England city, Shaw presents critical perspectives on public health intervention efforts. She looks at online developments in health care and makes important correlations between poverty and health care in the urban United States. Shaw also highlights the new concepts of community and forms of identity that emerge in our efforts to provide effective health care. Governing How We Care shows how government-sponsored community health and health care programs operate in an age of neoliberalism.
Late in the summer of 1880, a wave of odors emanated from the sewers of Paris. As the stench lingered, outraged residents feared that the foul air would breed an epidemic. Fifteen years later—when the City of Light was in the grips of another Great Stink—the landscape of health and disease had changed dramatically. Parisians held their noses and protested, but this time few feared that the odors would spread disease. Historian David S. Barnes examines the birth of a new microbe-centered science of public health during the 1880s and 1890s, when the germ theory of disease burst into public consciousness. Tracing a series of developments in French science, medicine, politics, and culture, Barnes reveals how the science and practice of public health changed during the heyday of the Bacteriological Revolution. Despite its many innovations, however, the new science of germs did not entirely sweep away the older "sanitarian" view of public health. The longstanding conviction that disease could be traced to filthy people, places, and substances remained strong, even as it was translated into the language of bacteriology. Ultimately, the attitudes of physicians and the French public were shaped by political struggles between republicans and the clergy, by aggressive efforts to educate and "civilize" the peasantry, and by long-term shifts in the public's ability to tolerate the odor of bodily substances. This fascinating study sheds new light on the scientific and social factors that continue to influence the public's lingering uncertainty over how disease can—and cannot—be spread.
The Health Care Safety Net in a Post-Reform World examines how national health care reform will impact safety net programs that serve low-income and uninsured patients. The “safety net” refers to the collection of hospitals, clinics, and doctors who treat disadvantaged people, including those without insurance, regardless of their ability to pay. Despite comprehensive national health care reform, over twenty million people will remain uninsured. And many of those who obtain insurance from reform will continue to face shortages of providers in their communities willing or able to serve them. As the demand for care grows with expanded insurance, so will the pressure on an overstretched safety net.
This book, with contributions from leading health care scholars, is the first comprehensive assessment of the safety net in over a decade. Rather than view health insurance and the health care safety net as alternatives to each other, it examines their potential to be complementary aspects of a broader effort to achieve equity and quality in health care access. It also considers whether the safety net can be improved and strengthened to a level that can provide truly universal access, both through expanded insurance and the creation of a well-integrated and reasonably supported network of direct health care access for the uninsured.
Seeing safety net institutions as key components of post-health care reform in the United States—as opposed to stop-gap measures or as part of the problem—is a bold idea. And as presented in this volume, it is an idea whose time has come.
A Social and Structural Approach
It is estimated that more than 50 million Latinos live in the United States. This is projected to more than double by 2050. In Health Issues in Latino Males experts from public health, medicine, and sociology examine the issues affecting Latino men's health and recommend policies to overcome inequities and better serve this population. It includes an extensive appendix charting epidemiological data on Latino health.
Perspectives on the Long Twentieth Century
Health patterns in Southeast Asia have changed profoundly over the past century. In that period, epidemic and chronic diseases, environmental transformations, and international health institutions have created new connections within the region and the increased interdependence of Southeast Asia with China and India. In this volume leading scholars provide a new approach to the history of health in Southeast Asia. Framed by a series of synoptic pieces on the "Landscapes of Health" in Southeast Asia in 1914, 1950, and 2014 the essays interweave local, national, and regional perspectives. They range from studies of long-term processes such as changing epidemics, mortality and aging, and environmental history to detailed accounts of particular episodes: the global cholera epidemic and the hajj, the influenza epidemic of 1918, WWII, and natural disasters. The writers also examine state policy on healthcare and the influence of organizations, from NGOs such as the China Medical Board and the Rockefeller Foundation to grassroots organizations in Thailand, Indonesia, and the Philippines.
This significant book conveys Dr. William E. Paul’s enduring enthusiasm for the field of immunology, the incredible accomplishments of the past half-century, and the future’s untapped promises. The immune system has incredible power to protect us from the ravages of infection by killing disease-causing microbes or eliminating them from the body. Boosted by vaccines, it can protect us individually and as a “herd” from diseases such as measles. As Dr. Paul explains, however, the power of the immune system is a double-edged sword: an overactive immune system can wreak havoc, destroying normal tissue and causing diseases such as type I diabetes, rheumatoid arthritis, and multiple sclerosis. The consequences of an impaired immune system, on the other hand, are all too evident in the clinical agonies of AIDS and other immunodeficiency diseases. Packed with illustrations, stories from Dr. Paul’s distinguished career, and compelling narratives of scientific discovery, Immunity presents the three laws of the human immune system—universality, tolerance, and appropriateness—and explains how the system protects and harms us. From the tale of how smallpox was overcome to the lessons of the Ebola epidemic to the utility of vaccines and the hope that the immune system can be used to treat or prevent cancer, Dr. Paul argues that we must position ourselves to take advantage of cutting-edge technologies and promising new tools in immunological research, including big data and the microbiome.
Chronic Disease and Slow Death in Nineteenth-Century France
Incurable and Intolerable looks at the history of incurable illness from a variety of perspectives, including doctors, patients, families, religious counsel, and policy makers. This compellingly documented history illuminates the physical, emotional, social, and existential consequences of chronic disease and terminal illness, and offers an original look at the world of palliative medicine, politics, religion, and charity. Jason Szabo encourages a more careful scrutiny of today's attitudes, policies, and practices surrounding "imminent death" and its effects on society.