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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Cultivating Health

Los Angeles Women and Public Health Reform

Jennifer Lisa Koslow

Cultivating Health, an interdisciplinary chronicle, details women's impact on remaking health policy, despite the absence of government support. Jennifer Lisa Koslow explores community nursing, housing reform, milk sanitation, childbirth, and the campaign against venereal disease in late nineteenth and early twentieth century Los Angeles. She demonstrates how women implemented health care reform and civic programs and highlights women's home health care, urban policy-changing accomplishments, and pays tribute to what would become the model for similar service-based systems in other American centers.

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Diagnosis, Therapy, and Evidence

Conundrums in Modern American Medicine

Gerald N. Grob and Allan V. Horwitz

In Diagnosis, Therapy, and Evidence, Gerald N. Grob and Allan V. Horwitz employ historical and contemporary data and case studies, combining into one book a variety of medical and psychiatric conditions. They utilize case studies and examine tonsillectomy, cancer, heart disease, PTSD, anxiety, and depression, and identify differences between rhetoric and reality and the weaknesses in diagnosis and treatment.

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The Dilemma of Federal Mental Health Policy

Radical Reform or Incremental Change?

Gerald N. Grob and Howard Goldman

Severe and persistent mental illnesses are among the most pressing health and social problems in contemporary America. Recent estimates suggest that more than three million people in the U.S. have disabling mental disorders. The direct and indirect costs of their care exceed 180 billion dollars nationwide each year. Effective treatments and services exist, but many such individuals do not have access to these services because of limitations in mental health and social policies.

For nearly two centuries Americans have grappled with the question of how to serve individuals with severe disorders. During the second half of the twentieth century, mental health policy advocates reacted against institutional care, claiming that community care and treatment would improve the lives of people with mental disorders. Once the exclusive province of state governments, the federal government moved into this policy arena after World War II. Policies ranged from those focused on mental disorders, to those that focused more broadly on health and social welfare.

In this book, Gerald N. Grob and Howard H. Goldman trace how an ever-changing coalition of mental health experts, patients' rights activists, and politicians envisioned this community-based system of psychiatric services. The authors show how policies shifted emphasis from radical reform to incremental change. Many have benefited from this shift, but many are left without the care they require.

 

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Doctors Serving People

Restoring Humanism to Medicine through Student Community Service

Edward J. Eckenfels

Today's physicians are medical scientists, drilled in the basics of physiology, anatomy, genetics, and chemistry. They learn how to crunch data, interpret scans, and see the human form as a set of separate organs and systems in some stage of disease. Missing from their training is a holistic portrait of the patient as a person and as a member of a community. Yet a humanistic passion and desire to help people often are the attributes that compel a student toward a career in medicine. So what happens along the way to tarnish that idealism? Can a new approach to medical education make a difference? Doctors Serving People is just such a prescriptive. While a professor at Rush Medical College in Chicago, Edward J. Eckenfels helped initiate and direct a student-driven program in which student doctors worked in the poor, urban communities during medical school, voluntarily and without academic credit. In addition to their core curriculum and clinical rotations, students served the social and health needs of diverse and disadvantaged populations. Now more than ten years old, the program serves as an example for other medical schools throughout the country. Its story provides a working model of how to reform medical education in America.

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The Door of Last Resort

Memoirs of a Nurse Practitioner

Frances Ward

Having spent decades in urban clinical practice while working simultaneously as an academic administrator, teacher, and writer, Frances Ward is especially well equipped to analyze the American health care system. In this memoir, she explores the practice of nurse practitioners through her experiences in Newark and Camden, New Jersey, and in north Philadelphia.

Ward views nurse practitioners as important providers of primary health care (including the prevention of and attention to the root causes of ill health) in independent practice and as equal members of professional teams of physicians, registered nurses, and other health care personnel. She describes the education of nurse practitioners, their scope of practice, their abilities to prescribe medications and diagnostic tests, and their overall management of patients’ acute and chronic illnesses. Also explored are the battles that nurse practitioners have waged to win the right to practice—battles with physicians, health insurance companies, and even other nurses.

The Door of Last Resort
, though informed by Ward’s experiences, is not a traditional memoir. Rather, it explores issues in primary health care delivery to poor, urban populations from the perspective of nurse practitioners and is intended to be their voice. In doing so, it investigates the factors affecting health care delivery in the United States that have remained obscure throughout the current national debate

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Fit to Be Tied

Sterilization and Reproductive Rights in America, 1950-1980

Rebecca M. Kluchin

Fit to Be Tied provides a history of sterilization and what would become, at once, socially divisive and a popular form of birth control. Utilizing first-person narratives, court cases, and official records, Rebecca M. Kluchin examines the evolution of forced sterilization of poor women, especially women of color, in the second half of the century and contrasts it with demands for contraceptive sterilization made by white women and men. She chronicles public acceptance during an era of reproductive and sexual freedom, the shift away from sterilization and how it influenced many aspects of American life.

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From Pink to Green

Disease Prevention and the Environmental Breast Cancer Movement

Barbara L. Ley

From the early 1980s, the U.S. environmental breast cancer movement has championed the goal of eradicating the disease by emphasizing the importance of reducingùeven eliminating exposure to chemicals and toxins. From Pink to Green chronicles the movement's disease prevention philosophy from the beginning.

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.

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The Health Care Safety Net in a Post-Reform World

Edited by Mark A. Hall and Sara Rosenbaum

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.

 

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Health Issues in Latino Males

A Social and Structural Approach

Edited by Marilyn Aguirre-Molina, Luisa N. Borrell, and William Vega

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.

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History and Health Policy in the United States

Putting the Past Back In

Rosemary A. Stevens

In our rapidly advancing scientific and technological world, many take great pride and comfort in believing that we are on the threshold of new ways of thinking, living, and understanding ourselves. But despite dramatic discoveries that appear in every way to herald the future, legacies still carry great weight. Even in swiftly developing fields such as health and medicine, most systems and policies embody a sequence of earlier ideas and preexisting patterns.

In History and Health Policy in the United States, seventeen leading scholars of history, the history of medicine, bioethics, law, health policy, sociology, and organizational theory make the case for the usefulness of history in evaluating and formulating health policy today. In looking at issues as varied as the consumer economy, risk, and the plight of the uninsured, the contributors uncover the often unstated assumptions that shape the way we think about technology, the role of government, and contemporary medicine. They show how historical perspectives can help policymakers avoid the pitfalls of partisan, outdated, or merely fashionable approaches, as well as how knowledge of previous systems can offer alternatives when policy directions seem unclear.

Together, the essays argue that it is only by knowing where we have been that we can begin to understand health services today or speculate on policies for tomorrow.

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