The Health Gap: The Challenge of an Unequal World


Michael G. Marmot - 2015
    The same twenty-year avoidable disparity exists in the Calton and Lenzie neighborhoods of Glasgow, and in other cities around the world.In Sierra Leone, one in 21 fifteen-year-old women will die in her fertile years of a maternal-related cause; in Italy, the figure is one in 17,100; but in the United States, which spends more on healthcare than any other country in the world, it is one in 1,800. Why?Dramatic differences in health are not a simple matter of rich and poor; poverty alone doesn't drive ill health, but inequality does. Indeed, suicide, heart disease, lung disease, obesity, and diabetes, for example, are all linked to social disadvantage. In every country, people at relative social disadvantage suffer health disadvantage and shorter lives. Within countries, the higher the social status of individuals, the better their health. These health inequalities defy the usual explanations. Conventional approaches to improving health have emphasized access to technical solutions and changes in the behavior of individuals, but these methods only go so far. What really makes a difference is creating the conditions for people to have control over their lives, to have the power to live as they want. Empowerment is the key to reducing health inequality and thereby improving the health of everyone. Marmot emphasizes that the rate of illness of a society as a whole determines how well it functions; the greater the health inequity, the greater the dysfunction.Marmot underscores that we have the tools and resources materially to improve levels of health for individuals and societies around the world, and that to not do so would be a form of injustice. Citing powerful examples and startling statistics ("young men in the U.S. have less chance of surviving to sixty than young men in forty-nine other countries"), The Health Gap presents compelling evidence for a radical change in the way we think about health and indeed society, and inspires us to address the societal imbalances in power, money, and resources that work against health equity.

One by One by One: Making a Small Difference Amid a Billion Problems


Aaron Berkowitz - 2020
    Aaron Berkowitz had just finished his neurology training when he was sent to Haiti on his first assignment with Partners In Health. There, he meets Janel, a 23-year-old man with the largest brain tumor Berkowitz or any of his neurosurgeon colleagues at Harvard Medical School have ever seen. Determined to live up to Partners In Health’s mission statement “to bring the benefits of modern medical science to those most in need,” Berkowitz tries to save Janel’s life by bringing him back to Boston for a 12-hour surgery.  In One by One by One, Berkowitz traces what he learns and grapples with as a young doctor trying to bridge the gap between one of the world’s richest countries and one of the world’s poorest to make the first big save of his medical career.As Janel and Berkowitz travel back and forth between the high-tech neurosurgical operating rooms of Harvard’s hospitals and Janel’s dirt-floored hut in rural Haiti, they face countless heart-wrenching twists and turns. Janel remains comatose for months after his surgery. It’s not clear he will recover enough to return to Haiti and be able to survive there. So he goes for a second brain surgery, a third, a fourth. Berkowitz brings the reader to the front lines of global humanitarian work as he struggles to overcome the challenges that arise when well-meaning intentions give rise to unintended consequences, when cultures and belief systems clash, and when it’s not clear what the right thing to do is, let alone the right way to do it. One by One by One is a gripping account of the triumphs, tragedies, and confusing spaces in between as an idealistic young doctor learns the hard but necessary lessons of living by the Haitian proverb tout moun se moun—every person is a person.

Stuffed And Starved: Markets, Power And The Hidden Battle For The World Food System


Raj Patel - 2007
    It took him from the colossal supermarkets of California to India’s wrecked paddy-fields and Africa’s bankrupt coffee farms, while along the way he ate genetically engineered soy beans and dodged flying objects in the protestor-packed streets of South Korea.What he found was shocking, from the false choices given us by supermarkets to a global epidemic of farmer suicides, and real reasons for famine in Asia and Africa.Yet he also found great cause for hope—in international resistance movements working to create a more democratic, sustainable and joyful food system. Going beyond ethical consumerism, Patel explains, from seed to store to plate, the steps to regain control of the global food economy, stop the exploitation of both farmers and consumers, and rebalance global sustenance.

The Viral Storm: The Dawn of a New Pandemic Age


Nathan Wolfe - 2011
    In The Viral Storm, award-winning biologist Nathan Wolfe tells the story of how viruses and human beings have evolved side by side through history; how deadly viruses like HIV, swine flu, and bird flu almost wiped us out in the past; and why modern life has made our species vulnerable to the threat of a global pandemic.Wolfe's research missions to the jungles of Africa and the rain forests of Borneo have earned him the nickname "the Indiana Jones of virus hunters," and here Wolfe takes readers along on his groundbreaking and often dangerous research trips—to reveal the surprising origins of the most deadly diseases and to explain the role that viruses have played in human evolution.In a world where each new outbreak seems worse than the one before, Wolfe points the way forward, as new technologies are brought to bear in the most remote areas of the world to neutralize these viruses and even harness their power for the good of humanity. His provocative vision of the future will change the way we think about viruses, and perhaps remove a potential threat to humanity's survival.

Crazy Like Us: The Globalization of the American Psyche


Ethan Watters - 2009
    But is it possible America's most troubling impact on the globalizing world has yet to be accounted for? In "Crazy Like Us," Ethan Watters reveals that the most devastating consequence of the spread of American culture has not been our golden arches or our bomb craters but our bulldozing of the human psyche itself: We are in the process of homogenizing the way the world goes mad. America has been the world leader in generating new mental health treatments and modern theories of the human psyche. We export our psychopharmaceuticals packaged with the certainty that our biomedical knowledge will relieve the suffering and stigma of mental illness. We categorize disorders, thereby defining mental illness and health, and then parade these seemingly scientific certainties in front of the world. The blowback from these efforts is just now coming to light: It turns out that we have not only been changing the way the world talks about and treats mental illness -- we have been changing the mental illnesses themselves.For millennia, local beliefs in different cultures have shaped the experience of mental illness into endless varieties." Crazy Like Us" documents how American interventions have discounted and worked to change those indigenous beliefs, often at a dizzying rate. Over the last decades, mental illnesses popularized in America have been spreading across the globe with the speed of contagious diseases. Watters travels from China to Tanzania to bring home the unsettling conclusion that the virus is us: As we introduce Americanized ways of treating mental illnesses, we are in fact spreading the diseases.In post-tsunami Sri Lanka, Watters reports on the Western trauma counselors who, in their rush to help, inadvertently trampled local expressions of grief, suffering, and healing. In Hong Kong, he retraces the last steps of the teenager whose death sparked an epidemic of the American version of anorexia nervosa. Watters reveals the truth about a multi-million-dollar campaign by one of the world's biggest drug companies to change the Japanese experience of depression -- literally marketing the disease along with the drug.But this book is not just about the damage we've caused in faraway places. Looking at our impact on the psyches of people in other cultures is a gut check, a way of forcing ourselves to take a fresh look at our own beliefs about mental health and healing. When we examine our assumptions from a farther shore, we begin to understand how our own culture constantly shapes and sometimes creates the mental illnesses of our time. By setting aside our role as the world's therapist, we may come to accept that we have as much to learn from other cultures' beliefs about the mind as we have to teach.

The Woman in the Body: A Cultural Analysis of Reproduction


Emily Martin - 1987
    Contrasting the views of medical science with those of ordinary women from diverse social and economic backgrounds, anthropologist Emily Martin presents unique fieldwork on American culture and uncovers the metaphors of economy and alienation that pervade women's imaging of themselves and their bodies. A new preface examines some of the latest medical ideas about women's reproductive cycles.

Critical Condition: How Health Care in America Became Big Business--and Bad Medicine


Donald L. Barlett - 2004
    . . Health care executives pulling in millions in bonuses for denying treatment to the sick . . . More than 100 million people with inadequate or no medical coverage . . . This may sound like the predicament of a third-world nation, but this is America’s health care reality today. The U.S. spends more on health care than any other nation, yet our benefits are shrinking and life expectancy is shorter here than in countries that spend significantly less per capita. Meanwhile, HMOs, pharmaceutical companies, and hospital chains reap tremendous profits, while politicians—beholden to insurers and drug companies—enact legislation for the benefit of the few rather than the many, while the entire system is on the verge of collapse. In Critical Condition, award-winning investigative journalists Donald L. Barlett and James B. Steele expose the horror of what health care in America has become. They profile patients and doctors trapped by the system and offer startling personal stories that illuminate what’s gone wrong. Doctors tell of being second-guessed and undermined by health care insurers; nurses recount chilling tales of hospital meltdowns; patients explain how they’ve been victimized by a system that is meant to care for them. Drug companies profit by selling pills in the same manner that Madison Avenue sells soap, while Wall Street rakes in billions by building up and then tearing down health care businesses. And politicians pass legislation perpetuating the injustices and out-right fraud the system encourages. By analyzing the industry and offering an insightful prescription for getting it back on the right track, Critical Condition is an enormously compelling investigative work that addresses the concerns of every American.

Level 4: Virus Hunters of the CDC


Joseph B. McCormick - 1996
    In this gripping, true account of the war against worldwide epidemics, one of medicine's frontline generals, Dr. Joseph McCormick, developer of the CDC's legendary hot zone, chronicles his decades as a virus hunter, working to combat the virus as predator. 16-pages of photos.

The Price of Thirst: Global Water Inequality and the Coming Chaos


Karen Piper - 2014
    The CEO of Nestlé, purveyor of bottled water, heartily agrees. It is important to give water a market value, he says in a promotional video, so “we're all aware that it has a price.” But for those who have no access to clean water, a fifth of the world's population, the price is thirst. This is the frightening landscape that Karen Piper conducts us through in The Price of Thirst—one where thirst is political, drought is a business opportunity, and more and more of our most necessary natural resource is controlled by multinational corporations.In visits to the hot spots of water scarcity and the hotshots in water finance, Piper shows us what happens when global businesses with mafia-like powers buy up the water supply and turn off the taps of people who cannot pay: border disputes between Iraq and Turkey, a “revolution of the thirsty” in Egypt, street fights in Greece, an apartheid of water rights in South Africa. The Price of Thirst takes us to Chile, the first nation to privatize 100 percent of its water supplies, creating a crushing monopoly instead of a thriving free market in water; to New Delhi, where the sacred waters of the Ganges are being diverted to a private water treatment plant, fomenting unrest; and to Iraq, where the U.S.-mandated privatization of water resources destroyed by our military is further destabilizing the volatile region. And in our own backyard, where these same corporations are quietly buying up water supplies, Piper reveals how “water banking” is drying up California farms in favor of urban sprawl and private towns.The product of seven years of investigation across six continents and a dozen countries, and scores of interviews with CEOs, activists, environmentalists, and climate change specialists, The Price of Thirst paints a harrowing picture of a world out of balance, with the distance between the haves and have-nots of water inexorably widening and the coming crisis moving ever closer.

Poor Economics: A Radical Rethinking of the Way to Fight Global Poverty


Abhijit V. Banerjee - 2011
    But much of their work is based on assumptions that are untested generalizations at best, harmful misperceptions at worst.Abhijit Banerjee and Esther Duflo have pioneered the use of randomized control trials in development economics. Work based on these principles, supervised by the Poverty Action Lab, is being carried out in dozens of countries. Drawing on this and their 15 years of research from Chile to India, Kenya to Indonesia, they have identified wholly new aspects of the behavior of poor people, their needs, and the way that aid or financial investment can affect their lives. Their work defies certain presumptions: that microfinance is a cure-all, that schooling equals learning, that poverty at the level of 99 cents a day is just a more extreme version of the experience any of us have when our income falls uncomfortably low.This important book illuminates how the poor live, and offers all of us an opportunity to think of a world beyond poverty.Learn more at www.pooreconomics.com

Plagues and the Paradox of Progress: Why the World Is Getting Healthier in Worrisome Ways


Thomas J. Bollyky - 2018
    This book tells that story, but it is not about the resurgence of pestilence. It is the story of its decline. For the first time in recorded history, virus, bacteria, and other infectious diseases are not the leading cause of death or disability in any region of the world. People are living longer, and fewer mothers are giving birth to many children in the hopes that some might survive. And yet, the news is not all good. Recent reductions in infectious disease have not been accompanied by the same improvements in income, job opportunities, and governance that occurred with these changes in wealthier countries decades ago. There have also been unintended consequences. In this book, Thomas Bollyky explores the paradox in our fight against infectious disease: the world is getting healthier in ways that should make us worry.Bollyky interweaves a grand historical narrative about the rise and fall of plagues in human societies with contemporary case studies of the consequences. Bollyky visits Dhaka--one of the most densely populated places on the planet--to show how low-cost health tools helped enable the phenomenon of poor world megacities. He visits China and Kenya to illustrate how dramatic declines in plagues have affected national economies. Bollyky traces the role of infectious disease in the migrations from Ireland before the potato famine and to Europe from Africa and elsewhere today.Historic health achievements are remaking a world that is both worrisome and full of opportunities. Whether the peril or promise of that progress prevails, Bollyky explains, depends on what we do next.A Council on Foreign Relations Book

The Secret History of the War on Cancer


Devra Davis - 2007
    Left untouched were many of the things known to cause cancer, including tobacco, the workplace, radiation, or the global environment. Proof of how the world in which we live and work affects whether we get cancer was either overlooked or suppressed. This has been no accident. The War on Cancer was run by leaders of industries that made cancer-causing products, and sometimes also profited from drugs and technologies for finding and treating the disease. Filled with compelling personalities and never-before-revealed information, The Secret History of the War on Cancer shows how we began fighting the wrong war, with the wrong weapons, against the wrong enemies-a legacy that persists to this day. This is the gripping story of a major public health effort diverted and distorted for private gain. A portion of the profits from this book will go to support research on cancer prevention.

Drug Use for Grown-Ups: Chasing Liberty in the Land of Fear


Carl L. Hart - 2021
    . . when it comes to the legacy of this country's war on drugs, we should all share his outrage." --The New York Times Book Review From one of the world's foremost experts on the subject, a powerful argument that the greatest damage from drugs flows from their being illegal, and a hopeful reckoning with the possibility of their use as part of a responsible and happy lifeDr. Carl L. Hart, Ziff Professor at Columbia University and former chair of the Department of Psychology, is one of the world's preeminent experts on the effects of so-called recreational drugs on the human mind and body. Dr. Hart is open about the fact that he uses drugs himself, in a happy balance with the rest of his full and productive life as a colleague, husband, father, and friend. In Drug Use for Grown-Ups, he draws on decades of research and his own personal experience to argue definitively that the criminalization and demonization of drug use--not drugs themselves--have been a tremendous scourge on America, not least in reinforcing this country's enduring structural racism.Dr. Hart did not always have this view. He came of age in one of Miami's most troubled neighborhoods at a time when many ills were being laid at the door of crack cocaine. His initial work as a researcher was aimed at proving that drug use caused bad outcomes. But one problem kept cropping up: the evidence from his research did not support his hypothesis. From inside the massively well-funded research arm of the American war on drugs, he saw how the facts did not support the ideology. The truth was dismissed and distorted in order to keep fear and outrage stoked, the funds rolling in, and Black and brown bodies behind bars.Drug Use for Grown-Ups will be controversial, to be sure: the propaganda war, Dr. Hart argues, has been tremendously effective. Imagine if the only subject of any discussion about driving automobiles was fatal car crashes. Drug Use for Grown-Ups offers a radically different vision: when used responsibly, drugs can enrich and enhance our lives. We have a long way to go, but the vital conversation this book will generate is an extraordinarily important step.

Twice Dead: Organ Transplants and the Reinvention of Death


Margaret M. Lock - 2001
    In the majority of cases individuals diagnosed as "brain dead" are the source of the organs without which transplants could not take place. In this compelling and provocative examination, Margaret Lock traces the discourse over the past thirty years that contributed to the locating of a new criterion of death in the brain, and its routinization in clinical practice in North America. She compares this situation with that in Japan where, despite the availability of the necessary technology and expertise, brain death was legally recognized only in 1997, and then under limited and contested circumstances. Twice Dead explores the cultural, historical, political, and clinical reasons for the ready acceptance of the new criterion of death in North America and its rejection, until recently, in Japan, with the result that organ transplantation has been severely restricted in that country. This incisive and timely discussion demonstrates that death is not self-evident, that the space between life and death is historically and culturally constructed, fluid, multiple, and open to dispute. In addition to an analysis of that professional literature on and popular representations of the subject, Lock draws on extensive interviews conducted over ten years with physicians working in intensive care units, transplant surgeons, organ recipients, donor families, members of the general public in both Japan and North America, and political activists in Japan opposed to the recognition of brain death. By showing that death can never be understood merely as a biological event, and that cultural, medical, legal, and political dimensions are inevitably implicated in the invention of brain death, Twice Dead confronts one of the most troubling questions of our era.

A Life in Medicine: A Literary Anthology


Randy-Michael TestaWalt Whitman - 2002
    Organized around the central themes of altruism, knowledge, skill, and duty, the book includes contributions from well-known authors, doctors, nurses, practitioners, and patients. Provocative and moving pieces address what it means to care for a life in a century of unprecedented scientific advances, examining issues of hope and healing from both ends of the stethoscope.