U.S. Health in International Perspective


Book Description

The United States is among the wealthiest nations in the world, but it is far from the healthiest. Although life expectancy and survival rates in the United States have improved dramatically over the past century, Americans live shorter lives and experience more injuries and illnesses than people in other high-income countries. The U.S. health disadvantage cannot be attributed solely to the adverse health status of racial or ethnic minorities or poor people: even highly advantaged Americans are in worse health than their counterparts in other, "peer" countries. In light of the new and growing evidence about the U.S. health disadvantage, the National Institutes of Health asked the National Research Council (NRC) and the Institute of Medicine (IOM) to convene a panel of experts to study the issue. The Panel on Understanding Cross-National Health Differences Among High-Income Countries examined whether the U.S. health disadvantage exists across the life span, considered potential explanations, and assessed the larger implications of the findings. U.S. Health in International Perspective presents detailed evidence on the issue, explores the possible explanations for the shorter and less healthy lives of Americans than those of people in comparable countries, and recommends actions by both government and nongovernment agencies and organizations to address the U.S. health disadvantage.




Communities in Action


Book Description

In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.




Relieving Pain in America


Book Description

Chronic pain costs the nation up to $635 billion each year in medical treatment and lost productivity. The 2010 Patient Protection and Affordable Care Act required the Department of Health and Human Services (HHS) to enlist the Institute of Medicine (IOM) in examining pain as a public health problem. In this report, the IOM offers a blueprint for action in transforming prevention, care, education, and research, with the goal of providing relief for people with pain in America. To reach the vast multitude of people with various types of pain, the nation must adopt a population-level prevention and management strategy. The IOM recommends that HHS develop a comprehensive plan with specific goals, actions, and timeframes. Better data are needed to help shape efforts, especially on the groups of people currently underdiagnosed and undertreated, and the IOM encourages federal and state agencies and private organizations to accelerate the collection of data on pain incidence, prevalence, and treatments. Because pain varies from patient to patient, healthcare providers should increasingly aim at tailoring pain care to each person's experience, and self-management of pain should be promoted. In addition, because there are major gaps in knowledge about pain across health care and society alike, the IOM recommends that federal agencies and other stakeholders redesign education programs to bridge these gaps. Pain is a major driver for visits to physicians, a major reason for taking medications, a major cause of disability, and a key factor in quality of life and productivity. Given the burden of pain in human lives, dollars, and social consequences, relieving pain should be a national priority.




Health and Suffering in America


Book Description

Health and Suffering in America analyzes how we came to see various forms of suffering as "mental illness," and argues that social and historical dynamics, not scientific discovery, gave us this notion. Robert Fancher argues that the beliefs of mental health professionals have less to do with science than with the professions' own values and ideologies. The image we have of mental health care hides vast realms of unexamined assumptions. In effect, the author maintains that "mental health" consists of mental health professionals' ideas about how people ought to live and act, not discoveries about human nature. The body of the book consists of detailed analyses and critiques of four infl uential American cultures of therapy: psychoanalysis, behaviorism, cognitive therapy, and biological therapy. Fancher emphasizes how heavily their concepts and methods are determined by their cultures rather than by empirical data. Furthermore, our notions of mental health are not scientifi c discoveries, but moral ideals. Yet mental health workers often fail to understand this. As a result, they misunderstand their own authority and, worse, fail to subject their moral ideals to appropriate moral and cultural criticism. The new introduction by the author explores how the rise of managed health care coalesces with insistence on parity for mental health problems, supported by continuing claims that mental health care is science-based.




Uncertain Suffering


Book Description

On average, black Americans are sicker and die earlier than white Americans. Uncertain Suffering provides a richly nuanced examination of what this fact means for health care in the United States through the lens of sickle cell anemia, a disease that primarily affects blacks. In a wide ranging analysis that moves from individual patient cases to the compassionate yet distanced professionalism of health care specialists to the level of national policy, Carolyn Moxley Rouse uncovers the cultural assumptions that shape the quality and delivery of care for sickle cell patients. She reveals a clinical world fraught with uncertainties over how to treat black patients given resource limitations and ambivalence. Her book is a compelling look at the ways in which the politics of racism, attitudes toward pain and suffering, and the reliance on charity for healthcare services for the underclass can create disparities in the U.S. Instead of burdening hospitals and clinics with the task of ameliorating these disparities, Rouse argues that resources should be redirected to community-based health programs that reduce daily forms of physical and mental suffering.




This Republic of Suffering


Book Description

NATIONAL BESTSELLER • NATIONAL BOOK AWARD FINALIST • An "extraordinary ... profoundly moving" history (The New York Times Book Review) of the American Civil War that reveals the ways that death on such a scale changed not only individual lives but the life of the nation. An estiated 750,000 soldiers lost their lives in the American Civil War. An equivalent proportion of today's population would be seven and a half million. In This Republic of Suffering, Drew Gilpin Faust describes how the survivors managed on a practical level and how a deeply religious culture struggled to reconcile the unprecedented carnage with its belief in a benevolent God. Throughout, the voices of soldiers and their families, of statesmen, generals, preachers, poets, surgeons, nurses, northerners and southerners come together to give us a vivid understanding of the Civil War's most fundamental and widely shared reality. With a new introduction by the author, and a new foreword by Mike Mullen, 17th Chairman of the Joint Chiefs of Staff.




To Err Is Human


Book Description

Experts estimate that as many as 98,000 people die in any given year from medical errors that occur in hospitals. That's more than die from motor vehicle accidents, breast cancer, or AIDSâ€"three causes that receive far more public attention. Indeed, more people die annually from medication errors than from workplace injuries. Add the financial cost to the human tragedy, and medical error easily rises to the top ranks of urgent, widespread public problems. To Err Is Human breaks the silence that has surrounded medical errors and their consequenceâ€"but not by pointing fingers at caring health care professionals who make honest mistakes. After all, to err is human. Instead, this book sets forth a national agendaâ€"with state and local implicationsâ€"for reducing medical errors and improving patient safety through the design of a safer health system. This volume reveals the often startling statistics of medical error and the disparity between the incidence of error and public perception of it, given many patients' expectations that the medical profession always performs perfectly. A careful examination is made of how the surrounding forces of legislation, regulation, and market activity influence the quality of care provided by health care organizations and then looks at their handling of medical mistakes. Using a detailed case study, the book reviews the current understanding of why these mistakes happen. A key theme is that legitimate liability concerns discourage reporting of errorsâ€"which begs the question, "How can we learn from our mistakes?" Balancing regulatory versus market-based initiatives and public versus private efforts, the Institute of Medicine presents wide-ranging recommendations for improving patient safety, in the areas of leadership, improved data collection and analysis, and development of effective systems at the level of direct patient care. To Err Is Human asserts that the problem is not bad people in health careâ€"it is that good people are working in bad systems that need to be made safer. Comprehensive and straightforward, this book offers a clear prescription for raising the level of patient safety in American health care. It also explains how patients themselves can influence the quality of care that they receive once they check into the hospital. This book will be vitally important to federal, state, and local health policy makers and regulators, health professional licensing officials, hospital administrators, medical educators and students, health caregivers, health journalists, patient advocatesâ€"as well as patients themselves. First in a series of publications from the Quality of Health Care in America, a project initiated by the Institute of Medicine




Homelessness, Health, and Human Needs


Book Description

There have always been homeless people in the United States, but their plight has only recently stirred widespread public reaction and concern. Part of this new recognition stems from the problem's prevalence: the number of homeless individuals, while hard to pin down exactly, is rising. In light of this, Congress asked the Institute of Medicine to find out whether existing health care programs were ignoring the homeless or delivering care to them inefficiently. This book is the report prepared by a committee of experts who examined these problems through visits to city slums and impoverished rural areas, and through an analysis of papers written by leading scholars in the field.




Faith in the Great Physician


Book Description

This history of evangelical faith healing in nineteenth-century America examines the nation’s shifting attitudes about sickness, suffering, and health. Faith in the Great Physician tells the story of how participants in the divine healing movement transformed the ways Americans coped with physical affliction and pursued bodily wellbeing. Heather D. Curtis offers critical reflection on the theological, cultural, and social forces that come into play when one questions the purpose of suffering and the possibility of healing. Belief in divine healing ran counter to a deep-seated Christian ethic that linked physical suffering with spiritual holiness. By engaging in devotional disciplines and participating in social reform efforts, proponents of faith cure embraced a model of spiritual experience that endorsed active service, rather than passive endurance, as the proper Christian response to illness and pain. Emphasizing the centrality of religious practices to the enterprise of divine healing, Curtis sheds light on the relationship among Christian faith, medical science, and the changing meanings of suffering and healing in American culture. Recipient of the Frank S. and Elizabeth D. Brewer Prize of the American Society of Church History for 2007




Sick from Freedom


Book Description

Sick from Freedom provides the first study of the health conditions of emancipated slaves and reveals the epidemics, illnesses, and poverty that former slaves suffered from when slavery ended and freedom began.