An American Health Dilemma: Race, Medicine, and Health Care in the United States 1900-2000

by Byrd,W. Michael

• ISBN13: 9780415927376
• ISBN10: 0415927374
• Edition: 1st
• Format: Hardcover
• Copyright: 2001-12-21
• Publisher: Routledge

Summary

Today Blacks live five to seven fewer years than Whites. Black infant mortality is 2.2 times that of Whites. Blacks lead in death rates in 14 of 16 leading diseases, many preventable. Diabetes is 33% more common in Blacks, and cancer mortality has increased 50% for Blacks since 1950 but only 10% for Whites. Breakthroughs such as vaccinations, invasive cardiac procedures, cancer therapies, MRIs, and organ transplants have dramatically improved the health of Americans in the last century, but health care for African Americans has been dangerously deficient, even unavailable. An American Health Dilemmais the first comprehensive effort to place African Americans'deficit health in its full socio-cultural context. In the highly anticipated volume two, Byrd and Clayton complete the story begun in the first Pulitzer Prize nominated volume, bringing us from the turn of the century to the health care disparities that persist even now. Backed by exhaustive research, Byrd and Clayton argue thatrace- and class-based inequities, bias, and inequalities are systemic, culturally embedded problems that in the last hundred years have been marked by small gains, disastrous setbacks, and a passive acceptance of African Americans, and other disadvantaged groups, as a permanent health underclass. Even gains made in the 1960s, they maintain, didn't do enough to advance the health care of African Americans. A monumental and original work of scholarship,An American Health Dilemmawill be the essential reference about the Black medical and health experience for years to come.

Table of Contents

List of Figures and Tables	p. xi
Foreword	p. xv
Foreword to Volume One	p. xix
Acknowledgments	p. xxiii
Preface	p. xxix
Introduction	p. 1
Race, Medicine, and Health Care: A Problematic American Relationship	p. 1
On the Gap in Health Status between Black and White Americans	p. 1
A Different Perspective	p. 2
Race as a Sociocultural Concept and Tool for Analysis	p. 4
Race, Society, and Health in America: A Background	p. 8
Race, Society, and the Life Sciences: The Evolution of Western Health Systems	p. 9
Ancient Scientific Precursors	p. 9
The Renaissance, Race, and the Life Sciences	p. 11
Race and the Ages of Science and Enlightenment	p. 11
Medicine, Biology, and Slavery in an Age of Scientific Dominance	p. 13
Race, Medicine, Biology and Education Reform: Late Nineteenth-Century and Early Twentieth-Century America	p. 15
Race, Medicine, Health Care, and Civil Rights	p. 17
Scientific Racism: The U.S. Archetype	p. 18
American Scientific Racism and the "Blind Spot"	p. 22
Tracing the Evolution of a Race- and Class-Based Health System	p. 25
New Challenges	p. 29
To Serve This Present Age?	p. 30
Race, Medicine, and Health in Early Twentieth-Century America	p. 33
Black Americans and the Health System in the Early Twentieth Century, 1901-1929	p. 35
The Medical-Social Environment in the Early Twentieth Century, 1901-1929	p. 35
Health System Arise: 1901-1929	p. 46
The Health System as Arbiter of Racial, Reproductive, and Social Control	p. 65
The Evidence of Things Not Seen: Black Health in the Early Twentieth Century	p. 77
A Golden Age of Medical Suzerainty: The European American Experience	p. 85
Another Golden Age of Medical Suzerainty: The African American Experience	p. 113
Black Americans and the Health System during the Great Depression and World War II, 1930-1945	p. 132
A Health System Stressed: The Years of the Great Depression, 1930-1941	p. 138
World War II: The Health System, 1942-1945	p. 148
African American Health: 1930-1945	p. 150
Hegemony Denied: The Seeds Are Planted for White Medicine's Descent	p. 165
Black Doctors Come of Age: Fighting Back for Black Patients during the Depression and the War, 1930-1945	p. 174
Race, Medicine, and Health before, during, and after the Black Civil Rights Era	p. 193
Black Americans and the Health System from World War II through the Civil Rights Era, 1945-1965	p. 195
Peace Be Still	p. 195
Health Reform Resisted: Accommodation in the U.S. Health System, 1945-1965	p. 203
The Last Best Chance for Poor Americans: State and Charity Efforts	p. 220
Prelude To Progress: Black Health, 1945-1965	p. 223
A Profession under Siege: White Medicine, 1945-1965	p. 234
Wade in the Water: Blacks in Medicine and Health, 1945-1965	p. 249
An Era of Liberation Accompanies Health and Health Care Advance	p. 270
Persistent Old Problems: Universal Access and Scientific Racism	p. 280
Civil Rights Gains, Conservative Retrenchment, and Black Health, 1965-1980	p. 291
On the Cusp of Equality: Justice Denied	p. 291
Health System Accommodation, "Crisis," and Separate Development	p. 300
A Conflagration of Costs and Failed Government Control	p. 300
Hospitals and Health Care Institutions: A Part of the "Crisis"	p. 309
Big Government Health Care, Regulatory Failure, and Emerging Health Care Financial Markets	p. 313
The Health Care Work Force and Attempts at Regulation	p. 321
Pharmaceutical, Medical Supply, Medical Education, and Research Infrastructures: Adjusting to Market Forces	p. 327
The Ascendancy of Ambulatory Care and Voluntary Health Agencies: Separate Development and Moral Ambiguity	p. 333
The Health "Crisis" Endgame: Government as the Culprit and Enemy	p. 342
Sun Pierces the Shadows: One Step Forward, Two Steps Backward--Black Health, 1965-1980	p. 346
The Medical Profession during an Era of Civil Rights Gains and Conservative Retrenchment, 1965-1980	p. 393
Bloody, But Unbowed: The White Medical Profession, 1965-1980	p. 393
Black Doctors Defending Poor and Underserved Health Battlements: Struggling to Maintain Hard-Won Gains, 1965-1980	p. 403
Western Science's Deep, Dark Secret and the U.S. Health System's Mendacious Legacy	p. 417
Questioning Scientific Traditions in the United States	p. 417
Science and the Right-Wing Defense of Segregation	p. 427
Science as Racialism	p. 430
America's Attempt at Reproductive Control as Social Policy	p. 448
Experimental Abuse and Exploitation in the Name of Medical Science	p. 459
Public and Official Responses to U.S. Medicine's and the Health System's Deep Secrets	p. 467
Disturbing Conclusions: The Best and Worst of Times	p. 475
The Coming of the Corporation	p. 477
Retrenchment and a Dream Deferred: The Black Health Crisis of the 1980s and 1990s	p. 479
Failed Liberalism: "Friendly" Authoritarian Conservatism Triumphant	p. 479
Health Markets and the Facade of Public Health	p. 485
Health Financing: The "Market" Becomes Dominant	p. 490
Hospitals and Nursing Homes: Changing Roles, Changing Masters	p. 499
Government's Changing Role in Health Care	p. 503
The Changing Health Care Work Force	p. 510
Health Care Sectors in Flux: Education-Research and Ambulatory Care	p. 514
Myths and Managed Care	p. 518
Black Health and the Threat of a Permanent "Health and Health Care Underclass"?	p. 519
An Opening Health System Gambit	p. 519
Health System en passant: Black and Disadvantaged Health	p. 522
The Medical Profession: A Waning Influence	p. 546
White Professional Complicity and the Loss of Authority and Relevance	p. 546
African American Physicians' Reaffirmation to Health and Health Care Justice and Equity: New Rivers to Cross	p. 549
Conclusions: The End Game--from "Crisis" to "Permanent Underclass"?	p. 560
Race, Medicine, Health Reform, and the Future	p. 567
Black and Disadvantaged Health, Health Reform, and the Future	p. 569
President Clinton's Failed Health Reform	p. 569
Background: A Perceived "Mainstream" Health Crisis	p. 569
Reality: A "Dual" Health Crisis in Black/Poor and White	p. 570
A Conscious Choice: Health Reform for the Mainstream and Corporate Interests	p. 573
A Changing World: New Standards	p. 578
Flawed Assumptions and Myths	p. 580
A Universal Health System: What Most Americans Want and the Nation Probably Needs	p. 585
Conclusions: A Permanent "Health and Health Care Underclass" as we Enter the Twenty-First Century?	p. 586
Appendixes	p. 589
Glossary	p. 605
Notes	p. 621
Select Bibliography	p. 749
A Note on Sources	p. 801
Credits	p. 809
Index	p. 811
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