Rutgers University Press

Critical Issues in Health and Medicine

Edited by Janet Golden and Rima D. Apple

Published by: Rutgers University Press

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Critical Issues in Health and Medicine

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An Alternative History of Hyperactivity

Food Additives and the Feingold Diet

Matthew Smith

In 1973, San Francisco allergist Ben Feingold created an uproar by claiming that synthetic food additives triggered hyperactivity, then the most commonly diagnosed childhood disorder in the United States. He contended that the epidemic should not be treated with drugs such as Ritalin but, instead, with a food additive-free diet. Parents and the media considered his treatment, the Feingold diet, a compelling alternative. Physicians, however, were skeptical and designed dozens of trials to challenge the idea. The resulting medical opinion was that the diet did not work and it was rejected. Matthew Smith asserts that those scientific conclusions were, in fact, flawed. An Alternative History of Hyperactivity explores the origins of the Feingold diet, revealing why it became so popular, and the ways in which physicians, parents, and the public made decisions about whether it was a valid treatment for hyperactivity. Arguing that the fate of Feingold's therapy depended more on cultural, economic, and political factors than on the scientific protocols designed to test it, Smith suggests the lessons learned can help resolve medical controversies more effectively.

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American Catholic Hospitals

A Century of Changing Markets and Missions

Barbra Mann Wall

In American Catholic Hospitals, Barbra Mann Wall chronicles changes in Catholic hospitals during the twentieth century, many of which are emblematic of trends in the American healthcare system.

Wall explores the Church's struggle to safeguard its religious values. As hospital leaders reacted to increased political, economic, and societal secularization, they extended their religious principles in the areas of universal health care and adherence to the Ethical and Religious Values in Catholic Hospitals, leading to tensions between the Church, government, and society. The book also examines the power of women--as administrators, Catholic sisters wielded significant authority--as well as the gender disparity in these institutions which came to be run, for the most part, by men. Wall also situates these critical transformations within the context of the changing Church policy during the 1960s. She undertakes unprecedented analyses of the gendered politics of post-Second Vatican Council Catholic hospitals, as well as the effect of social movements on the practice of medicine.

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American Melancholy

Constructions of Depression in the Twentieth Century

Laura D. Hirshbein

In American Melancholy, Laura D. Hirshbein traces the growth of depression as an object of medical study and as a consumer commodity and illustrates how and why depression came to be such a huge medical, social, and cultural phenomenon. This is the first book to address gender issues in the construction of depression, explores key questions of how its diagnosis was developed, how it has been used, and how we should question its application in American society.

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Beyond Health, Beyond Choice

Breastfeeding Constraints and Realities

Edited by Paige Hall Smith, Bernice L Hausman, and Miriam Labbok

Current public health promotion of breastfeeding relies heavily on health messaging and individual behavior change. Women are told that “breast is best” but too little serious attention is given to addressing the many social, economic, and political factors that combine to limit women’s real choice to breastfeed beyond a few days or weeks. The result: women’s, infants’, and public health interests are undermined.  Beyond Health, Beyond Choice examines how feminist perspectives can inform public health support for breastfeeding.

 

Written by authors from diverse disciplines, perspectives, and countries, this collection of essays is arranged thematically and considers breastfeeding in relation to public health and health care; work and family; embodiment (specifically breastfeeding in public); economic and ethnic factors; guilt; violence; and commercialization. By examining women’s experiences and bringing feminist insights to bear on a public issue, the editors attempt to reframe the discussion to better inform public health approaches and political action. Doing so can help us recognize the value of breastfeeding for the public’s health and the important productive and reproductive contributions women make to the world.

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Broadcasting Birth Control

Mass Media and Family Planning

Manon Parry

Traditionally, the history of the birth control movement has been told through the accounts of the leaders, organizations, and legislation that shaped the campaign. Recently, historians have begun examining the cultural work of printed media, including newspapers, magazines, and even novels in fostering support for the cause. Broadcasting Birth Control builds on this new scholarship to explore the films and radio and television broadcasts developed by twentieth-century birth control advocates to promote family planning at home in the United States, and in the expanding international arena of population control.

Mass media, Manon Parry contends, was critical to the birth control movement’s attempts to build support and later to publicize the idea of fertility control and the availability of contraceptive services in the United States and around the world. Though these public efforts in advertising and education were undertaken initially by leading advocates, including Margaret Sanger, increasingly a growing class of public communications experts took on the role, mimicking the efforts of commercial advertisers to promote health and contraception in short plays, cartoons, films, and soap operas. In this way, they made a private subject—fertility control—appropriate for public discussion.

Parry examines these trends to shed light on the contested nature of the motivations of birth control advocates. Acknowledging that supporters of contraception were not always motivated by the best interests of individual women, Parry concludes that family planning advocates were nonetheless convinced of women’s desire for contraception and highly aware of the ethical issues involved in the use of the media to inform and persuade.

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The Business of Private Medical Practice

Doctors, Specialization, and Urban Change in Philadelphia, 1900-1940

by James A. Schafer Jr.

Unevenly distributed resources and rising costs have become enduring problems in the American health care system. Health care is more expensive in the United States than in other wealthy nations, and access varies significantly across space and social classes. James A. Schafer Jr. shows that these problems are not inevitable features of modern medicine, but instead reflect the informal organization of health care in a free market system in which profit and demand, rather than social welfare and public health needs, direct the distribution and cost of crucial resources.The Business of Private Medical Practice is a case study of how market forces influenced the office locations and career paths of doctors in one early twentieth-century city, Philadelphia, the birthplace of American medicine. Without financial incentives to locate in poor neighborhoods, Philadelphia doctors instead clustered in central business districts and wealthy suburbs. In order to differentiate their services in a competitive marketplace, they also began to limit their practices to particular specialties, thereby further restricting access to primary care. Such trends worsened with ongoing urbanization.Illustrated with numerous maps of the Philadelphia neighborhoods he studies, Schafer’s work helps underscore the role of economic self-interest in shaping the geography of private medical practice and the growth of medical specialization in the United States.

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Classrooms and Clinics

Urban Schools and the Protection and Promotion of Child Health, 1870-1930

Richard A. Meckel

Classrooms and Clinics is the first book-length assessment of the development of public school health policies from the late nineteenth century through the early years of the Great Depression. Richard A. Meckel examines the efforts of early twentieth-century child health care advocates and reformers to utilize urban schools to deliver health care services to socioeconomically disadvantaged and medically underserved children in the primary grades. Their goal, Meckel shows, was to improve the children’s health and thereby improve their academic performance.

Meckel situates these efforts within a larger late nineteenth- and early twentieth-century public discourse relating schools and schooling, especially in cities and towns, to child health. He describes and explains how that discourse and the school hygiene movement it inspired served as critical sites for the constructive negotiation of the nature and extent of the public school’s—and by extension the state’s—responsibility for protecting and promoting the physical and mental health of the children for whom it was providing a compulsory education.

Tracing the evolution of that negotiation through four overlapping stages, Meckel shows how, why, and by whom the health of schoolchildren was discursively constructed as a sociomedical problem and charts and explains the changes that construction underwent over time.  He also connects the changes in problem construction to the design and implementation of various interventions and services and evaluates how that design and implementation were affected by the response of the civic, parental, professional, educational, public health, and social welfare groups that considered themselves stakeholders and took part in the discourse. And, most significantly, he examines the responses called forth by the question at the heart of the negotiations: what services are necessitated by the state’s and school’s taking responsibility for protecting and promoting the health and physical and mental development of schoolchildren.  He concludes that the negotiations resulted both in the partial medicalization of American primary education and in the articulation and adoption of a school health policy that accepted the school’s responsibility for protecting and promoting the health of its students while largely limiting the services called for to the preventive and educational.

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Communities of Health Care Justice

By Charlene Galarneau

U.S. health care has often been conceived as a social good, and more specifically as a national good. Communities of Health Care Justice presents an alternate model, making a powerful ethical argument for why smaller communities—bound together by culture, religion, gender, race, and place—should be regarded as critical moral actors that play key roles in defining and upholding just health policy. Furthermore, it outlines the systemic, conceptual, and structural changes required to move toward this health care justice.

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Community Health Centers

A Movement and the People Who Made It Happen

Bonnie Lefkowitz

The aftermath of Hurricane Katrina has placed a national spotlight on the shameful state of healthcare for America's poor. In the face of this highly publicized disaster, public health experts are more concerned than ever about persistent disparities that result from income and race.

This book tells the story of one groundbreaking approach to medicine that attacks the problem by focusing on the wellness of whole neighborhoods. Since their creation during the 1960s, community health centers have served the needs of the poor in the tenements of New York, the colonias of Texas, the working class neighborhoods of Boston, and the dirt farms of the South. As products of the civil rights movement, the early centers provided not only primary and preventive care, but also social and environmental services, economic development, and empowerment.

Bonnie Lefkowitz-herself a veteran of community health administration-explores the program's unlikely transformation from a small and beleaguered demonstration effort to a network of close to a thousand modern health care organizations serving nearly 15 million people. In a series of personal accounts and interviews with national leaders and dozens of health care workers, patients, and activists in five communities across the United States, she shows how health centers have endured despite cynicism and inertia, the vagaries of politics, and ongoing discrimination.

 

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Comrades in Health

U.S. Health Internationalists, Abroad and at Home

Edited by Anne-Emanuelle Birn and Theodore M. Brown

Since the early twentieth century, politically engaged and socially committed U.S. health professionals have worked in solidarity with progressive movements around the world. Often with roots in social medicine, political activism, and international socialism, these doctors, nurses, and other health workers became comrades who joined forces with people struggling for social justice, equity, and the right to health.

Anne-Emanuelle Birn and Theodore M. Brown bring together a group of professionals and activists whose lives have been dedicated to health internationalism. By presenting a combination of historical accounts and first-hand reflections, this collection of essays aims to draw attention to the longstanding international activities of the American health left and the lessons they brought home. The involvement of these progressive U.S. health professionals is presented against the background of foreign and domestic policy, social movements, and global politics.

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