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.
The Panic Virus: A True Story of Medicine, Science, and Fear
Seth Mnookin - 2011
The media seized hold of the story and, in the process, helped to launch one of the most devastating health scares ever. In the years to come Wakefield would be revealed as a profiteer in league with class-action lawyers, and he would eventually lose his medical license. Meanwhile, one study after another failed to find any link between childhood vaccines and autism. Yet the myth that vaccines somehow cause developmental disorders lives on. Despite the lack of corroborating evidence, it has been popularized by media personalities such as Oprah Winfrey and Jenny McCarthy and legitimized by journalists who claim that they are just being fair to “both sides” of an issue about which there is little debate. Meanwhile, millions of dollars have been diverted from potential breakthroughs in autism research; families have spent their savings on ineffective “miracle cures"; and declining vaccination rates have led to outbreaks of deadly illnesses like Hib, measles, and whooping cough. Most tragic of all is the increasing number of children dying from vaccine-preventable diseases. In The Panic Virus Seth Mnookin draws on interviews with parents, public-health advocates, scientists, and anti-vaccine activists to tackle a fundamental question: How do we decide what the truth is? The fascinating answer helps explain everything from the persistence of conspiracy theories about 9/11 to the appeal of talk-show hosts who demand that President Obama “prove” he was born in America. The Panic Virus is the ultimate cautionary tale for our time.
Prescription for the Future: The Twelve Transformational Practices of Highly Effective Medical Organizations
Ezekiel J. Emanuel - 2017
Ezekiel J. Emanuel looks at individual physician practices and organizations who are already successfully driving change, and the specific practices they have instituted. They are not the titans everyone seems to know and assume to be the "best"; instead, Emanuel has chosen a select group -- from small physician offices to large multi-specialty group practices, accountable care organizations, and even for-profit companies--that are genuinely transforming care.Prescription for the Future shines a bright diagnostic light on the state of American healthcare and provides invaluable insights for healthcare workers, investors, and patients. The book gives all of us the tools to recognize the places that will deliver high-quality, effective care when we need it.
Being Mortal by Atul Gawande - A 20-minute Summary: Medicine and What Matters in the End
Instaread Summaries - 2014
Being Mortal by Atul Gawande - A 20-minute Summary Inside this Instaread Summary: • Overview of the entire book• Introduction to the important people in the book• Summary and analysis of all the chapters in the book• Key Takeaways of the book• A Reader's Perspective Preview of this summary: Chapter 1 Gawande grew up in Ohio. His parents were immigrants from India and both were doctors. His grandparents stayed in India, and there were few older people in his neighborhood, so he had little experience with aging or death until he met his wife’s grandmother, Alice Hobson. Hobson was seventy-seven and living on her own in Virginia. She was a spirited widow who fixed her own plumbing and volunteered with Meals On Wheels. However, Hobson was losing strength and height steadily each year as her arthritis worsened.Gawande’s father enthusiastically adopted the customs of his new country, but he could not understand the way in which seniors were treated in the US. In India, the elderly were treated with great respect and lived out their lives with family.In the United States, Sitaram Gawande, Gawande’s grandfather, likely would have been sent to a nursing home like most of the elderly who cannot handle the basics of daily living by themselves. However, in India, Sitaram Gawande was able to live in his own home and manage his own affairs, with family constantly around him. He died at the age of one hundred and ten when he fell off a bus during a business trip.Until recently, most elderly people stayed with their families. Even as the nuclear family unit became predominant, replacing the multi-generational family unit, people cared for their elderly relatives. Families were large and one child, usually a daughter, would not marry in order to take care of the parents.This has changed in much of the world, where elderly people end up struggling to live alone, like Hobson, rather than living with dignity amid family, like Sitaram Gawande.One cause of this change can be found in the nature of knowledge. When few people lived to be very old, elders were honored. Their store of knowledge was greatly useful. People often portrayed themselves as older to command respect. Modern society’s emphasis on youth is a complete reversal of this attitude. Technological advances are perceived as the territory of the young, and everyone wants to be younger. High-tech job opportunities are all over the world, and young people do not hesitate to leave their parents behind to pursue them.In developed countries, parents embrace the concept of a retirement filled with leisure activities. Parents are happy to begin living for themselves once children are grown. However, this system only works for young, healthy retirees, but not for those who cannot continue to be independent. Hobson, for example, was falling frequently and suffering memory lapses. Her doctor did tests and wrote prescriptions, but did not know what to do about her deteriorating condition. Neither did her family… About the Author With Instaread Summaries, you can get the summary of a book in 30 minutes or less. We read every chapter, summarize and analyze it for your convenience.
Janesville: An American Story
Amy Goldstein - 2017
Most observers record the immediate shock of vanished jobs, but few stay around long enough to notice what happens next, when a community with a can-do spirit tries to pick itself up.Pulitzer Prize winner Amy Goldstein has spent years immersed in Janesville, Wisconsin where the nation’s oldest operating General Motors plant shut down in the midst of the Great Recession, two days before Christmas of 2008. Now, with intelligence, sympathy, and insight into what connects and divides people in an era of economic upheaval, she makes one of America’s biggest political issues human. Her reporting takes the reader deep into the lives of autoworkers, educators, bankers, politicians, and job re-trainers to show why it’s so hard in the twenty-first century to recreate a healthy, prosperous working class. For this is not just a Janesville story or a Midwestern story. It’s an American story.
Overdosed America: The Broken Promise of American Medicine
John Abramson - 2004
Before you see a doctor, you should read this book.” —Eric Schlosser, author of Fast Food NationUsing the examples of Vioxx, Celebrex, cholesterol-lowering statin drugs, and anti-depressants, Overdosed America shows that at the heart of the current crisis in American medicine lies the commercialization of medical knowledge itselfFor twenty years, John Abramson, M.D., cared for patients of all ages in a small town north of Boston. But increasingly his role as family doctor was undermined as pressure mounted to use the latest drugs and high-tech solutions for nearly every problem. Drawing on his background in statistics and health policy research, he began to investigate the radical changes that were quietly taking place in American medicine.At the heart of the crisis, he found, lies the changed purpose of medical knowledge—from seeking to optimize health to searching for the greatest profits. The lack of transparency that has become normal in commercially sponsored medical research now taints the scientific evidence published in even our most prestigious medical journals. And unlike the recent scandals in other industries that robbed Americans of money and jobs, this one is undermining our health.Commercial distortion pervades the information that doctors rely upon to guide the prevention and treatment of common health problems, from heart disease to stroke, osteoporosis, diabetes, and osteoarthritis. The good news, as Dr. Abramson explains, is that the real scientific evidence shows that many of the things that you can do to protect and preserve your own health are far more effective than what the drug companies' top-selling products can do for you—which is why the drug companies work so hard to keep this information under wraps.In what is sure to be one of the most important and eye-opening books you or your doctor will ever read, John Abramson offers conclusive evidence that American medicine has broken its promise to best improve our health and is squandering more than $500 billion each year in the process.
The Great Escape: Health, Wealth, and the Origins of Inequality
Angus Deaton - 2013
People are healthier, wealthier, and live longer. Yet the escapes from destitution by so many has left gaping inequalities between people and nations. In "The Great Escape," Angus Deaton--one of the foremost experts on economic development and on poverty--tells the remarkable story of how, beginning 250 years ago, some parts of the world experienced sustained progress, opening up gaps and setting the stage for today's disproportionately unequal world. Deaton takes an in-depth look at the historical and ongoing patterns behind the health and wealth of nations, and addresses what needs to be done to help those left behind.Deaton describes vast innovations and wrenching setbacks: the successes of antibiotics, pest control, vaccinations, and clean water on the one hand, and disastrous famines and the HIV/AIDS epidemic on the other. He examines the United States, a nation that has prospered but is today experiencing slower growth and increasing inequality. He also considers how economic growth in India and China has improved the lives of more than a billion people. Deaton argues that international aid has been ineffective and even harmful. He suggests alternative efforts--including reforming incentives to drug companies and lifting trade restrictions--that will allow the developing world to bring about its own Great Escape.Demonstrating how changes in health and living standards have transformed our lives, "The Great Escape" is a powerful guide to addressing the well-being of all nations.
Healing Politics: A Doctor’s Journey into the Heart of Our Political Epidemic
Abdul El-Sayed - 2020
He threw himself into the study of medicine and excelled—winning a Rhodes Scholarship, earning two advanced degrees, and landing a tenure-track position at Columbia University. At 30, he became the youngest city health official in America, tasked with rebuilding Detroit's health department after years of austerity policies. But El-Sayed found himself disillusioned. He could heal the sick—even build healthier and safer communities—but that wouldn’t address the social and economic conditions causing illness in the first place. So he left health for politics, running for Governor of Michigan and earning the support of progressive champions like Congresswoman Alexandria Ocasio-Cortez-Cortez and Senator Bernie Sanders. In Healing Politics, El-Sayed traces the life of a young idealist, weaving together powerful personal stories and fascinating forays into history and science. Marrying his unique perspective with the science of epidemiology, El-Sayed diagnoses an underlying epidemic afflicting our country, an epidemic of insecurity. And to heal the rifts this epidemic has created, he lays out a new direction for the progressive movement. This is a bold, personal, and compellingly original book from a prominent young leader.
Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present
Harriet A. Washington - 2007
Starting with the earliest encounters between black Americans and Western medical researchers and the racist pseudoscience that resulted, it details the ways both slaves and freedmen were used in hospitals for experiments conducted without their knowledge—a tradition that continues today within some black populations. It reveals how blacks have historically been prey to grave-robbing as well as unauthorized autopsies and dissections. Moving into the twentieth century, it shows how the pseudoscience of eugenics and social Darwinism was used to justify experimental exploitation and shoddy medical treatment of blacks, and the view that they were biologically inferior, oversexed, and unfit for adult responsibilities. Shocking new details about the government’s notorious Tuskegee experiment are revealed, as are similar, less-well-known medical atrocities conducted by the government, the armed forces, prisons, and private institutions.The product of years of prodigious research into medical journals and experimental reports long undisturbed, Medical Apartheid reveals the hidden underbelly of scientific research and makes possible, for the first time, an understanding of the roots of the African American health deficit. At last, it provides the fullest possible context for comprehending the behavioral fallout that has caused black Americans to view researchers—and indeed the whole medical establishment—with such deep distrust. No one concerned with issues of public health and racial justice can afford not to read Medical Apartheid, a masterful book that will stir up both controversy and long-needed debate.
No One Cares About Crazy People: The Chaos and Heartbreak of Mental Health in America
Ron Powers - 2017
Braided with that history is the moving story of Powers's beloved son Kevin--spirited, endearing, and gifted--who triumphed even while suffering from schizophrenia until finally he did not, and the story of his courageous surviving son Dean, who is also schizophrenic.A blend of history, biography, memoir, and current affairs ending with a consideration of where we might go from here, this is a thought-provoking look at a dreaded illness that has long been misunderstood.
Twilight of the Elites: America After Meritocracy
Christopher L. Hayes - 2012
In the wake of the Fail Decade, Americans have historically low levels of trust in their institutions; the social contract between ordinary citizens and elites lies in tatters.How did we get here? With Twilight of the Elites, Christopher Hayes offers a radically novel answer. Since the 1960s, as the meritocracy elevated a more diverse group of men and women into power, they learned to embrace the accelerating inequality that had placed them near the very top. Their ascension heightened social distance and spawned a new American elite--one more prone to failure and corruption than any that came before it.Mixing deft political analysis, timely social commentary, and deep historical understanding, Twilight of the Elites describes how the society we have come to inhabit – utterly forgiving at the top and relentlessly punitive at the bottom – produces leaders who are out of touch with the people they have been trusted to govern. Hayes argues that the public's failure to trust the federal government, corporate America, and the media has led to a crisis of authority that threatens to engulf not just our politics but our day-to-day lives.Upending well-worn ideological and partisan categories, Hayes entirely reorients our perspective on our times. Twilight of the Elites is the defining work of social criticism for the post-bailout age.
The Rules of Contagion: Why Things Spread - and Why They Stop
Adam Kucharski - 2020
But how does virality actually work? In The Rules of Contagion, epidemiologist Adam Kucharski explores topics including gun violence, online manipulation, and, of course, outbreaks of disease to show how much we get wrong about contagion, and how astonishing the real science is.Why did the president retweet a Mussolini quote as his own? Why do financial bubbles take off so quickly? And why are disinformation campaigns so effective? By uncovering the crucial factors driving outbreaks, we can see how things really spread -- and what we can do about it.Whether you are an author seeking an audience, a defender of truth, or simply someone interested in human social behavior, The Rules of Contagion is an essential guide to modern life.
Detroit: An American Autopsy
Charlie LeDuff - 2013
Detroit, once the richest city in the nation, is now its poorest. Once the vanguard of America’s machine age—mass production, automobiles, and blue-collar jobs—Detroit is now America’s capital for unemployment, illiteracy, foreclosure, and dropouts. A city the size of San Francisco and Manhattan could neatly fit into Detroit’s vacant lots. In another life, Charlie LeDuff won the Pulitzer Prize reporting for The New York Times. But all that is behind him now, after returning to find his hometown in total freefall. Detroit is where his mother’s flower shop was firebombed; where his sister lost herself to drugs; where his brother works in a factory cleaning Chinese-manufactured screws so they can be repackaged as “Made in America.” With the steel-eyed reportage that has become his trademark—and the righteous indignation only a native son possesses—LeDuff sets out to uncover what destroyed his city. He embeds with a local fire brigade struggling to defend its neighborhood against systemic arson and bureaucratic corruption. He investigates state senators and career police officials, following the money to discover who benefits from Detroit’s decline. He befriends union organizers, homeless do-gooders, embattled businessmen, and struggling homeowners, all ordinary people holding the city together by sheer determination. Americans have hoped for decades that Detroit was an exception, an outlier. What LeDuff reveals is that Detroit is, once and for all, America’s city: It led us on the way up, and now it is leading us on the way down. Detroit can no longer be ignored because what happened there is happening out here. Redemption is thin on the ground in this ghost of a city, but Detroit: An American Autopsy is no hopeless parable. Instead, LeDuff shares a deeply human drama of colossal greed, ignorance, endurance, and courage. Detroit is an unbelievable story of a hard town in a rough time filled with some of the strangest and strongest people our country has to offer—and a black comic tale of the absurdity of American life in the twenty-first century.
Methland: The Death and Life of an American Small Town
Nick Reding - 2009
Methland tells the story of Oelwein, Iowa (pop. 6,159), which, like thousands of other small towns across the country, has been left in the dust by the consolidation of the agricultural industry, a depressed local economy, and an out-migration of people. As if this weren t enough to deal with, an incredibly cheap, longlasting, and highly addictive drug has rolled into town.Over a period of four years, journalist Nick Reding brings us into the heart of Oelwein through a cast of intimately drawn characters, including: Clay Hallburg, the town doctor, who fights meth even as he struggles with his own alcoholism; Nathan Lein, the town prosecutor, whose caseload is filled almost exclusively with meth-related crime; and Jeff Rohrick, a meth addict, still trying to kick the habit after twenty years. Tracing the connections between the lives touched by the drug and the global forces that set the stage for the epidemic, Methland offers a vital and unique perspective on a pressing contemporary tragedy.
The Idealist: Jeffrey Sachs and the Quest to End Poverty
Nina Munk - 2013
Jeffrey Sachs—celebrated economist, special advisor to the Secretary General of the United Nations, and author of the influential bestseller The End of Poverty—disagrees. In his view, poverty is a problem that can be solved. With single-minded determination he has attempted to put into practice his theories about ending extreme poverty, to prove that the world's most destitute people can be lifted onto "the ladder of development." In 2006, Sachs launched the Millennium Villages Project, a daring five-year experiment designed to test his theories in Africa. The first Millennium village was in Sauri, a remote cluster of farming communities in western Kenya. The initial results were encouraging. With his first taste of success, and backed by one hundred twenty million dollars from George Soros and other likeminded donors, Sachs rolled out a dozen model villages in ten sub-Saharan countries. Once his approach was validated it would be scaled up across the entire continent. At least that was the idea. For the past six years, Nina Munk has reported deeply on the Millennium Villages Project, accompanying Sachs on his official trips to Africa and listening in on conversations with heads-of-state, humanitarian organizations, rival economists, and development experts. She has immersed herself in the lives of people in two Millennium villages: Ruhiira, in southwest Uganda, and Dertu, in the arid borderland between Kenya and Somalia. Accepting the hospitality of camel herders and small-hold farmers, and witnessing their struggle to survive, Munk came to understand the real-life issues that challenge Sachs's formula for ending global poverty. The Idealist is the profound and moving story of what happens when the abstract theories of a brilliant, driven man meet the reality of human life.