Administrations of Lunacy: A Story of Racism and Psychiatry at the Milledgeville Asylum


Mab Segrest - 2020
    After more than a decade of research, the celebrated scholar and activist Mab Segrest locates the deep historical roots of this startling fact, turning her sights on a long-forgotten cauldron of racial ideology: the state mental asylum system in which psychiatry was born and whose influences extend into our troubled present.In December 1841, the Georgia State Lunatic, Idiot, and Epileptic Asylum was founded. A hundred years later, it had become the largest insane asylum in the world with over ten thousand patients. Administrations of Lunacy tells the story of this iconic and infamous southern institution, a history that was all but erased from popular memory and within the psychiatric profession.Through riveting accounts of historical characters, Segrest reveals how modern psychiatric practice was forged in the traumas of slavery, the Civil War, Reconstruction, and Jim Crow. Deftly connecting this history to the modern era, Segrest then shows how a single asylum helped set the stage for the eugenics theories of the twentieth century and the persistent racial ideologies of our own times. She also traces the connections to today’s dissident psychiatric practices that offer sanity and create justice.A landmark of scholarship, Administrations of Lunacy restores a vital thread between past and present, revealing the tangled racial roots of psychiatry in America.

Mama Might Be Better Off Dead: The Failure of Health Care in Urban America


Laurie Kaye Abraham - 1993
    Both disturbing and illuminating, it immerses readers in the lives of four generations of a poor, African-American family beset with the devastating illnesses that are all too common in America's inner-cities.The story takes place in North Lawndale, a neighborhood that lies in the shadows of Chicago's Loop. Although surrounded by some of the city's finest medical facilities, North Lawndale is one of the sickest, most medically underserved communities in the country. Headed by Jackie Banes, who oversees the care of a diabetic grandmother, a husband on kidney dialysis, an ailing father, and three children, the Banes family contends with countless medical crises. From visits to emergency rooms and dialysis units, to trials with home care, to struggles for Medicaid eligibility, Abraham chronicles their access (or lack of access) to medical care.Told sympathetically but without sentimentality, their story reveals an inadequate health care system that is further undermined by the direct and indirect effects of poverty. When people are poor, they become sick easily. When people are sick, their families quickly become poorer.Embedded in the family narrative is a lucid analysis of the gaps, inconsistencies, and inequalities the poor face when they seek health care. This book reveals what health care policies crafted in Washington, D. C. or state capitals look like when they hit the street. It shows how Medicaid and Medicare work and don't work, the Catch-22s of hospital financing in the inner city, the racial politics of organ transplants, the failure of childhood immunization programs, the vexed issues of individual responsibility and institutional paternalism. One observer puts it this way: "Show me the poor woman who finds a way to get everything she's entitled to in the system, and I'll show you a woman who could run General Motors."Abraham deftly weaves these themes together to make a persuasive case for health care reform while unflinchingly presenting the complexities that will make true reform as difficult as it is necessary. Mama Might Be Better Off Dead is a book with the power to change the way health care is understood in America. For those seeking to learn what our current system of health care promises and what it delivers, it offers a place for the debate to begin.

Medical Bondage: Race, Gender, and the Origins of American Gynecology


Deirdre Cooper Owens - 2017
    It is also no secret that these nineteenth-century gynecologists performed experimental caesarean sections, ovariotomies, and obstetric fistula repairs primarily on poor and powerless women. Medical Bondage breaks new ground by exploring how and why physicians denied these women their full humanity yet valued them as "medical superbodies" highly suited for medical experimentation.In Medical Bondage, Cooper Owens examines a wide range of scientific literature and less formal communications in which gynecologists created and disseminated medical fictions about their patients, such as their belief that black enslaved women could withstand pain better than white "ladies." Even as they were advancing medicine, these doctors were legitimizing, for decades to come, groundless theories related to whiteness and blackness, men and women, and the inferiority of other races or nationalities. Medical Bondage moves between southern plantations and northern urban centers to reveal how nineteenth-century American ideas about race, health, and status influenced doctor-patient relationships in sites of healing like slave cabins, medical colleges, and hospitals. It also retells the story of black enslaved women and of Irish immigrant women from the perspective of these exploited groups and thus restores for us a picture of their lives.

Inflamed: Deep Medicine and the Anatomy of Injustice


Rupa Marya - 2021
    The surge in inflammatory illnesses such as gastrointestinal disorders and asthma. Mass uprisings around the world in response to systemic racism and violence. Rising numbers of climate refugees. Our bodies, societies, and planet are inflamed.Boldly original, Inflamed takes us on a medical tour through the human body--our digestive, endocrine, circulatory, respiratory, reproductive, immune, and nervous systems. Unlike a traditional anatomy book, this groundbreaking work illuminates the hidden relationships between our biological systems and the profound injustices of our political and economic systems. Inflammation is connected to the food we eat, the air we breathe, and the diversity of the microbes living inside us, which regulate everything from our brain's development to our immune system's functioning. It's connected to the number of traumatic events we experienced as children and to the traumas endured by our ancestors. It's connected not only to access to health care but to the very models of health that physicians practice.Raj Patel, the renowned political economist and New York Times bestselling author of The Value of Nothing, teams up with the physician Rupa Marya to offer a radical new cure: the deep medicine of decolonization. Decolonizing heals what has been divided, reestablishing our relationships with the Earth and one another. Combining the latest scientific research and scholarship on globalization with the stories of Marya's work with patients in marginalized communities, activist passion, and the wisdom of Indigenous groups, Inflamed points the way toward a deep medicine that has the potential to heal not only our bodies, but the world.

Patient Zero and the Making of the AIDS Epidemic


Richard A. McKay - 2017
    Yet the term itself did not exist before the emergence of the HIV/AIDS epidemic in the 1980s. How did this idea so swiftly come to exert such a strong grip on the scientific, media, and popular consciousness? In Patient Zero, Richard A. McKay interprets a wealth of archival sources and interviews to demonstrate how this seemingly new concept drew upon centuries-old ideas—and fears—about contagion and social disorder. McKay presents a carefully documented and sensitively written account of the life of Gaétan Dugas, a gay man whose skin cancer diagnosis in 1980 took on very different meanings as the HIV/AIDS epidemic developed—and who received widespread posthumous infamy when he was incorrectly identified as patient zero of the North American outbreak. McKay shows how investigators from the US Centers for Disease Control inadvertently created the term amid their early research into the emerging health crisis; how an ambitious journalist dramatically amplified the idea in his determination to reframe national debates about AIDS; and how many individuals grappled with the notion of patient zero—adopting, challenging and redirecting its powerful meanings—as they tried to make sense of and respond to the first fifteen years of an unfolding epidemic. With important insights for our interconnected age, Patient Zero untangles the complex process by which individuals and groups create meaning and allocate blame when faced with new disease threats. What McKay gives us here is myth-smashing revisionist history at its best.

The Origins of AIDS


Jacques Pepin - 2011
    Inspired by his own experiences working as an infectious diseases physician in Africa, Jacques Pepin looks back to the early twentieth-century events in Africa that triggered the emergence of HIV/AIDS and traces its subsequent development into the most dramatic and destructive epidemic of modern times. He shows how the disease was first transmitted from chimpanzees to man and then how urbanization, prostitution, and large-scale colonial medical campaigns intended to eradicate tropical diseases combined to disastrous effect to fuel the spread of the virus from its origins in Leopoldville to the rest of Africa, the Caribbean and ultimately worldwide. This is an essential new perspective on HIV/AIDS and on the lessons that must be learnt if we are to avoid provoking another pandemic in the future.

A Heart for the Work: Journeys through an African Medical School


Claire L. Wendland - 2010
    But, as A Heart for the Work makes clear, Malawian medical students learn to confront poverty creatively, experiencing fatigue and frustration but also joy and commitment on their way to becoming physicians. The first ethnography of medical training in the global South, Claire L. Wendland’s book is a moving and perceptive look at medicine in a world where the transnational movement of people and ideas creates both devastation and possibility.Wendland, a physician anthropologist, conducted extensive interviews and worked in wards, clinics, and operating theaters alongside the student doctors whose stories she relates. From the relative calm of Malawi’s College of Medicine to the turbulence of training at hospitals with gravely ill patients and dramatically inadequate supplies, staff, and technology, Wendland’s work reveals the way these young doctors engage the contradictions of their circumstances, shedding new light on debates about the effects of medical training, the impact of traditional healing, and the purposes of medicine.

Bad Blood: The Tuskegee Syphilis Experiment


James H. Jones - 1981
    The Tuskegee Study had nothing to do with treatment. Its purpose was to trace the spontaneous evolution of the disease in order to learn how syphilis affected black subjects.The men were not told they had syphilis; they were not warned about what the disease might do to them; and, with the exception of a smattering of medication during the first few months, they were not given health care. Instead of the powerful drugs they required, they were given aspirin for their aches and pains. Health officials systematically deceived the men into believing they were patients in a government study of “bad blood”, a catch-all phrase black sharecroppers used to describe a host of illnesses. At the end of this 40 year deathwatch, more than 100 men had died from syphilis or related complications.“Bad Blood” provides compelling answers to the question of how such a tragedy could have been allowed to occur. Tracing the evolution of medical ethics and the nature of decision making in bureaucracies, Jones attempted to show that the Tuskegee Study was not, in fact, an aberration, but a logical outgrowth of race relations and medical practice in the United States.Now, in this revised edition of “Bad Blood”, Jones traces the tragic consequences of the Tuskegee Study over the last decade. A new introduction explains why the Tuskegee Study has become a symbol of black oppression and a metaphor for medical neglect, inspiring a prize-winning play, a Nova special, and a motion picture. A new concluding chapter shows how the black community's wide-spread anger and distrust caused by the Tuskegee Study has hampered efforts by health officials to combat AIDS in the black community. “Bad Blood” was nominated for the Pulitzer Prize and was one of the “N.Y. Times” 12 best books of the year.

Just Medicine: A Cure for Racial Inequality in American Health Care


Dayna Matthew - 2015
    Health disparities have remained stubbornly entrenched in the American health care system--and in Just Medicine Dayna Bowen Matthew finds that they principally arise from unconscious racial and ethnic biases held by physicians, institutional providers, and their patients.Implicit bias is the single most important determinant of health and health care disparities. Because we have missed this fact, the money we spend on training providers to become culturally competent, expanding wellness education programs and community health centers, and even expanding access to health insurance will have only a modest effect on reducing health disparities. We will continue to utterly fail in the effort to eradicate health disparities unless we enact strong, evidence-based legal remedies that accurately address implicit and unintentional forms of discrimination, to replace the weak, tepid, and largely irrelevant legal remedies currently available.Our continued failure to fashion an effective response that purges the effects of implicit bias from American health care, Matthew argues, is unjust and morally untenable. In this book, she unites medical, neuroscience, psychology, and sociology research on implicit bias and health disparities with her own expertise in civil rights and constitutional law. In a time when the health of the entire nation is at risk, it is essential to confront the issues keeping the health care system from providing equal treatment to all.

Fresh Fruit, Broken Bodies: Migrant Farmworkers in the United States


Seth Holmes - 2013
       An anthropologist and MD in the mold of Paul Farmer and Didier Fassin, Seth Holmes shows how market forces, anti-immigrant sentiment, and racism undermine health and healthcare. Holmes’s material is visceral and powerful. He trekked with his companions illegally through the desert into Arizona and was jailed with them before they were deported. He lived with indigenous families in the mountains of Oaxaca and in farm labor camps in the U.S., planted and harvested corn, picked strawberries, and accompanied sick workers to clinics and hospitals. This “embodied anthropology” deepens our theoretical understanding of how health equity is undermined by a normalization of migrant suffering, the natural endpoint of systemic dehumanization, exploitation, and oppression that clouds any sense of empathy for “invisible workers.”  Fresh Fruit, Broken Bodies is far more than an ethnography or supplementary labor studies text; Holmes tells the stories of food production workers from as close to the ground as possible, revealing often theoretically-discussed social inequalities as irreparable bodily damage done. This book substantiates the suffering of those facing the danger of crossing the border, threatened with deportation, or otherwise caught up in the structural violence of a system promising work but endangering or ignoring the human rights and health of its workers.All of the book award money and royalties from the sales of this book have been donated to farm worker unions, farm worker organizations and farm worker projects in consultation with farm workers who appear in the book.

Race Against Time


Stephen Lewis - 2005
    Lewis's determination to bear witness to the desperate plight of so many in Africa and elsewhere is balanced by his unique, personal, and often searing insider's perspective on our ongoing failure to help.Lewis recounts how, in 2000, the United Nations Millennium Summit in New York introduced eight Millennium Development Goals, which focused on fundamental issues such as education, health, and cutting poverty in half by 2015. In audacious prose, alive with anecdotes ranging from maddening to hilarious to heartbreaking, Lewis shows why and how the international community is falling desperately short of these goals.This edition includes an afterword by Lewis, covering events after the lectures were delivered in fall 2005.

Essentials of the U.S. Health Care System


Leiyu Shi - 2004
    Health System, This Condensed Distillation Of The Important Topics Covered In Delivering Health Care In America Is The Perfect Resource For Courses In Health Policy, Allied Health, Health Administration And More. It Clarifies The Complexities Of Health Care Organization And Finance And Presents A Solid Overview Of How The Various Components Fit Together. The Second Edition Of Essentials Of The US Health Care System Has Been Updated To Include New Data, Charts, Tables And Accompanying Information Throughout The Book. Use As A Stand-Alone Text, Or A Supplement In Various Courses. New Content Includes: Medicare, Medicaid And SCHIP. Ongoing Evolution In U.S. Health Care As A Result Of Corporatization And Globalization. The Role Of Hospitalists. Updated Content On Parts C And D Of Medicare. Including Information On High-Deductible Health Plans/Health Savings Accounts As An Insurance Option. Updated Content On Primary Care And Community Oriented Health Care Development Current Development On Hospital Extensions To The Community. Current Development On Nano Technology. Current Health Policy Issues. Current Discussion On Healthcare Reforms, Including Future Challenges Posed By The Increased Need For Long-Term Care. New Third Edition Now Available!

The Political Determinants of Health


Daniel E. Dawes - 2020
    However, in a country of more than 325 million people, addressing everyone's issues is challenging. How can we effect beneficial change for everyone so we all can thrive? What is the great equalizer?In this book, Daniel E. Dawes argues that political determinants of health create the social drivers--including poor environmental conditions, inadequate transportation, unsafe neighborhoods, and lack of healthy food options--that affect all other dynamics of health. By understanding these determinants, their origins, and their impact on the equitable distribution of opportunities and resources, we will be better equipped to develop and implement actionable solutions to close the health gap.Dawes draws on his firsthand experience helping to shape major federal policies, including the Affordable Care Act, to describe the history of efforts to address the political determinants that have resulted in health inequities. Taking us further upstream to the underlying source of the causes of inequities, Dawes examines the political decisions that lead to our social conditions, makes the social determinants of health more accessible, and provides a playbook for how we can address them effectively. A thought-provoking and evocative account that considers both the policies we think of as health policy and those that we don't, The Political Determinants of Health provides a novel, multidisciplinary framework for addressing the systemic barriers preventing the United States from becoming the healthiest nation in the world.

Sizwe's Test: A Young Man's Journey Through Africa's AIDS Epidemic


Jonny Steinberg - 2008
    Dr. Hermann Reuter, a son of old South West African stock, wants to show the world that if you provide decent treatment, people will come and get it, no matter their circumstances. Sizwe and Hermann live at the epicenter of the greatest plague of our times, the African AIDS epidemic. In South Africa alone, nearly 6 million people in a population of 46 million are HIV-positive. Already, Sizwe has watched several neighbors grow ill and die, yet he himself has pushed AIDS to the margins of his life and associates it obliquely with other people's envy, with comeuppance, and with misfortune. When Hermann Reuter establishes an antiretroviral treatment program in Sizwe's district and Sizwe discovers that close family members have the virus, the antagonism between these two figures from very different worlds -- one afraid that people will turn their backs on medical care, the other fearful of the advent of a world in which respect for traditional ways has been lost and privacy has been obliterated -- mirrors a continent-wide battle against an epidemic that has corrupted souls as much as bodies. A heartbreaking tale of shame and pride, sex and death, and a continent's battle with its demons, Steinberg's searing account is a tour-de-force of literary journalism.

From Outrage to Courage: The Unjust and Unhealthy Situation of Women in Poor Countries and What They Are Doing About It


Anne Firth Murray - 2008
    In this searing cradle-to-grave review, Murray tackles health issues from prenatal care to challenges faced by aging women. Looking at how gender inequality affects basic nutrition, Murray makes clear the issues are political more than they are medical. In an inspiring look, From Outrage to Courage shows how women are organizing the world over. Women’s courage to transform their situations and communities provides inspiration and models for change. From China to India, from Indonesia to Kenya, Anne Firth Murray takes readers on a whirlwind tour of devastation—and resistance.