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\"Plagued by geographic isolation, poverty, and acute shortages of health professionals and hospital beds, the South was dubbed by Surgeon General Thomas Parran \"the nation's number one health problem.\" The improvement of southern, rural, and black health would become a top priority of the U.S. Public Health Service during the Roosevelt and Truman administrations.Karen Kruse Thomas details how NAACP lawsuits pushed southern states to equalize public services and facilities for blacks just as wartime shortages of health personnel and high rates of draft rejections generated broad support for health reform. Southern Democrats leveraged their power in Congress and used the war effort to call for federal aid to uplift the South. The language of regional uplift, Thomas contends, allowed southern liberals to aid blacks while remaining silent on race. Reformers embraced, at least initially, the notion of \"deluxe Jim Crow\"--support for health care that maintained segregation. Thomas argues that this strategy was, in certain respects, a success, building much-needed hospitals and training more black doctors.By the 1950s, deluxe Jim Crow policy had helped to weaken the legal basis for segregation. Thomas traces this transformation at the national level and in North Carolina, where \"deluxe Jim Crow reached its fullest potential.\" This dual focus allows her to examine the shifting alliances--between blacks and liberal whites, southerners and northerners, activists and doctors--that drove policy. Deluxe Jim Crow provides insight into a variety of historical debates, including the racial dimensions of state building, the nature of white southern liberalism, and the role of black professionals during the long civil rights movement\"-- Provided by publisher.

Plagued by geographic isolation, poverty, and acute shortages of health professionals and hospital beds, the South was dubbed by Surgeon General Thomas Parran \"the nation's number one health problem.\" The improvement of southern, rural, and black health would become a top priority of the U.S. Public Health Service during the Roosevelt and Truman administrations. Karen Kruse Thomas details how NAACP lawsuits pushed southern states to equalize public services and facilities for blacks just as wartime shortages of health personnel and high rates of draft rejections generated broad support for health reform. Southern Democrats leveraged their power in Congress and used the war effort to call for federal aid to uplift the South. The language of regional uplift, Thomas contends, allowed southern liberals to aid blacks while remaining silent on race. Reformers embraced, at least initially, the notion of \"deluxe Jim Crow\"-support for health care that maintained segregation. Thomas argues that this strategy was, in certain respects, a success, building much-needed hospitals and training more black doctors. By the 1950s, deluxe Jim Crow policy had helped to weaken the legal basis for segregation. Thomas traces this transformation at the national level and in North Carolina, where \"deluxe Jim Crow reached its fullest potential.\" This dual focus allows her to examine the shifting alliances-between blacks and liberal whites, southerners and northerners, activists and doctors-that drove policy.Deluxe Jim Crowprovides insight into a variety of historical debates, including the racial dimensions of state building, the nature of white southern liberalism, and the role of black professionals during the long civil rights movement.

Between its founding in 1966 and its formal end in 1980, the Black Panther Party blazed a distinctive trail in American political culture. The Black Panthers are most often remembered for their revolutionary rhetoric and militant action. Here Alondra Nelson deftly recovers an indispensable but lesser-known aspect of the organization's broader struggle for social justice: health care. The Black Panther Party's health activism-its network of free health clinics, its campaign to raise awareness about genetic disease, and its challenges to medical discrimination-was an expression of its founding political philosophy and also a recognition that poor blacks were both underserved by mainstream medicine and overexposed to its harms. Drawing on extensive historical research as well as interviews with former members of the Black Panther Party, Nelson argues that the Party's focus on health care was both practical and ideological. Building on a long tradition of medical self-sufficiency among African Americans, the Panthers' People's Free Medical Clinics administered basic preventive care, tested for lead poisoning and hypertension, and helped with housing, employment, and social services. In 1971, the party launched a campaign to address sickle-cell anemia. In addition to establishing screening programs and educational outreach efforts, it exposed the racial biases of the medical system that had largely ignored sickle-cell anemia, a disease that predominantly affected people of African descent. The Black Panther Party's understanding of health as a basic human right and its engagement with the social implications of genetics anticipated current debates about the politics of health and race. That legacy-and that struggle-continues today in the commitment of health activists and the fight for universal health care.

In 1948, the Constitution of the World Health Organization declared, \"Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.\" Yet this idea was not predominant in the United States immediately after World War II, especially when it came to women's reproductive health. Both legal and medical institutions-and the male legislators and physicians who populated those institutions-reinforced women's second class social status and restricted their ability to make their own choices about reproductive health care. InMore Than Medicine, Jennifer Nelson reveals how feminists of the '60s and '70s applied the lessons of the new left and civil rights movements to generate a women's health movement. The new movement shifted from the struggle to revolutionize health care to the focus of ending sex discrimination and gender stereotypes perpetuated in mainstream medical contexts. Moving from the campaign for legal abortion to the creation of community clinics and feminist health centers, Nelson illustrates how these activists revolutionized health care by associating it with the changing social landscape in which women had power to control their own life choices. More Than Medicinepoignantly reveals how social justice activists in the United States gradually transformed the meaning of health care, pairing traditional notions of medicine with less conventional ideas of \"healthy\" social and political environments.

As the twentieth century began, Black and white southerners alike dealt with low life expectancy and poor healthcare in a region synonymous with early death. But the modernization of death care by a diverse group of actors changed not only death rituals but fundamental ideas about health and wellness. Kristine McCusker charts the dramatic transformation that took place when southerners in particular and Americans in general changed their thinking about when one should die, how that death could occur, and what decent burial really means. As she shows, death care evolved from being a community act to a commercial one where purchasing a purple coffin and hearse ride to the cemetery became a political statement and the norm. That evolution also required interactions between perfect strangers, especially during the world wars as families searched for their missing soldiers. In either case, being put away decent, as southerners called burial, came to mean something fundamentally different in 1955 than it had just fifty years earlier.

In Nursing Civil Rights, Charissa J. Threat investigates the parallel battles against occupational segregation by African American women and white men in the U.S. Army. As Threat reveals, both groups viewed their circumstances with the Army Nurse Corps as a civil rights matter. Each conducted separate integration campaigns to end the discrimination they suffered. Yet their stories defy the narrative that civil rights struggles inevitably arced toward social justice. Threat tells how progressive elements in the campaigns did indeed break down barriers in both military and civilian nursing. At the same time, she follows conservative threads to portray how some of the women who succeeded as agents of change became defenders of exclusionary practices when men sought military nursing careers. The ironic result was a struggle that simultaneously confronted and reaffirmed the social hierarchies that nurtured discrimination.

InPrecarious Prescriptions, Laurie B. Green, John Mckiernan-González, and Martin Summers bring together essays that place race, citizenship, and gender at the center of questions about health and disease. Exploring the interplay between disease as a biological phenomenon, illness as a subjective experience, and race as an ideological construct, this volume weaves together a complicated history to show the role that health and medicine have played throughout the past in defining the ideal citizen. By creating an intricate portrait of the close associations of race, medicine, and public health,Precarious Prescriptionshelps us better understand the long and fraught history of health care in America. Contributors: Jason E. Glenn, U of Texas Medical Branch at Galveston; Mark Allan Goldberg, U of Houston; Jean J. Kim; Gretchen Long, Williams College; Verónica Martínez-Matsuda, Cornell U; Lena McQuade-Salzfass, Sonoma State U; Natalia Molina, U of California, San Diego; Susan M. Reverby, Wellesley College; Jennifer Seltz, Western Washington U.

In this article, I examine how African American soldiers and veterans experienced and shaped federally sponsored health care during and after World War I. Building on studies of the struggles of Black leaders and health care providers to win professional and public health advancement in the 1920s and 1930s, and of advocates to mobilize for health care rights in the mid-20th century, I focus primarily on the experiences and activism of patients in the interwar years. Private and government correspondence, congressional testimony, and reports from Black newspapers reveal that African American soldiers and veterans communicated directly with policymakers and bureaucrats regarding unequal treatment, assuming roles as “policy actors” who viewed health and medical care as “politics by other means.” In the process, they drew attention to the paradoxes inherent in expanding government entitlements in the era of Jim Crow, and helped shape a veterans’ health system that emerged in the 1920s and remained in place for the following century. They also laid the groundwork for the system’s precedent-setting desegregation, referred to by advocates of the time as “a shining example to the rest of the country.”

We take advantage of unique data on specific activities conducted under the Sheppard-Towner Act from 1924 through 1929 to focus on how public health interventions affected infant mortality. Interventions that provided one-on-one contact and opportunities for follow-up care, such as home visits by nurses and the establishment of health clinics, reduced infant deaths more than did classes and conferences. These interventions were particularly effective for nonwhites, a population with limited access to physicians and medical care. Although limited data on costs prevent us from making systematic cost-benefit calculations, we estimate that one infant death could be avoided for every $1,600 (about $20,400 in 2010 dollars) spent on home nurse visits.

According to Flexner, “professional patriotism,” a sense amongst doctors that they owe the profession their best work and practice, is best cultivated with a more homogenous pool of doctors who are deserving of the subsequent societal privileges they should be afforded.3 The Flexner Report is an essential document that created the context for medical education as it is understood today, effectively constructing the conditions of optimal medical education, which included a privileging of visual information and the subsequent need for a particular type of student. Abraham Flexner travelled to all 150 medical schools within the United States and Canada between 1908 and 1910.4 He assessed the conditions at these institutions and made recommendations for a new curriculum.5 His findings addressed both the current and desirable state of medical education and most significantly called for streamlining curricula and limiting the number of institutions that would be allowed to grant medical degrees.6 By his selective estimate, only thirty-one schools were deemed worthy of survival, and those still needed a dramatic overhaul to become practical degree-granting institutions.7 Born in Louisville, Kentucky in 1866, Abraham Flexner came of age in a rapidly changing South.8 As a student at John Hopkins University, he set his sights on a career in education and became increasingly interested in pedagogy in different academic environments.9 Upon completing his undergraduate degree, he studied at Harvard and in Berlin, both experiences that furthered his interest in how education was imparted to young minds.10 His first book, The American College, took a critical look at the North American higher education system and came to the attention of members of the Carnegie Foundation.11 The foundation, under advisement from the American Medical Association, recruited Flexner as an impartial evaluator to review American medical colleges in the way that he had examined undergraduate institutions.12 Although earlier attempts to improve the state of American medical schools were conducted, many failed.13 Schools’ economic interests often superseded their interest in addressing curricular needs.14 Of particular concern for medical school reformers was the practice of curtailing the academic year to accommodate students’ desires for shorter semesters.15 Medical schools keen on generating income accepted many students and turned out many doctors, apparently flooding the market with more doctors than could be easily maintained by demand. Southern Schools … after specifying an impressive series of acceptable credentials ranging once more from university degrees downward, announce their satisfaction with a “grammar school followed by two years of high school,” or in default thereof a general assurance of adequate “scholastic attainments” by a state, city, or county superintendent, or some other person connected with education or purporting to be such; but the lack of such credentials is not very serious, for the student is admitted without them, with leave to procure them later.60 Flexner highlights the Atlanta School of Medicine as a particularly egregious offender, citing that seventy-three percent of the 1909 entering class were admitted on equivalent status or lacked the requirements for admission all together.61 As noted above, Grady Memorial Hospital is also chastised because their students did not regularly attend bedside clinic, a practice of learning pateint protocols by listening as a doctor interviews patients.62 Seventy percent of the 1909 class of The Atlanta College of Physicians and Surgeons dropped, conditioned (must meet additional requirements), or failed by the school year’s end.63 Flexner is particularly critical of Charlotte, North Carolina’s medical school, recounting the words of a senior administrator who said, “[I]t is idle to talk of real laboratory work for students so ignorant and clumsy. According to Flexner’s new system, a medical student should have some basic competencies.