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Major changes are occurring in the United States population and the nation's health care institutions and delivery systems. Significant disparities in health status exist across population groups. But the health care enterprise, with all its integrated and disparate parts, has been slow to respond. Written by three nationally known scholars and experts, Diversity and Cultural Competence in Health Care: A Systems Approach is designed to provide health care students and professionals with a clear understanding of foundations, philosophies, and processes that strengthen diversity management, inclusion, and culturally competent care delivery. Focusing on current practice and health care policy, including the recently passed Patient Protection and Affordable Care Act of 2010 (ACA), this textbook integrates strategic diversity management, self-reflective leadership, and the personal change process with culturally and linguistically appropriate care into a cohesive systems-oriented approach for health care professionals. The essentials of cultural competence and diversity management covered in this text will be helpful to a wide variety of students because they encompass principles and practices that can be realistically incorporated into the ongoing work of any health care field or organization. Each chapter contains learning objectives, summary, key terms, and review questions and activities designed to allow students to understand and explore concepts and practices identified throughout the text.

Reproducing Race, an ethnography of pregnancy and birth at a large New York City public hospital, explores the role of race in the medical setting. Khiara M. Bridges investigates how race--commonly seen as biological in the medical world--is socially constructed among women dependent on the public healthcare system for prenatal care and childbirth. Bridges argues that race carries powerful material consequences for these women even when it is not explicitly named, showing how they are marginalized by the practices and assumptions of the clinic staff. Deftly weaving ethnographic evidence into broader discussions of Medicaid and racial disparities in infant and maternal mortality, Bridges shines new light on the politics of healthcare for the poor, demonstrating how the \"medicalization\" of social problems reproduces racial stereotypes and governs the bodies of poor women of color.

What does it mean to be a “just” and “caring” society when we have only limited resources to meet unlimited health care needs? Do we believe that all lives are of equal value? Is human life priceless? Should a “just” and “caring” society refuse to put limits on health care spending? In Just Caring, Leonard Fleck reflects on the central moral and political challenges of health reform today. He cites the millions of Americans who go without health insurance, thousands of whom die prematurely, unable to afford the health care needed to save their lives. Fleck considers these deaths as contrary to our deepest social values, and makes a case for the necessity of health care rationing decisions. The core argument of this book is that no one has a moral right to impose rationing decisions on others if they are unwilling to impose those same rationing decisions on themselves in the same medical circumstances. Fleck argues we can make health care rationing fair, in ways that are mutually respectful, if we engage in honest rational democratic deliberation. Such civic engagement is rare in our society, but the alternative is endless destructive social controversy that is neither just nor caring.

Although efforts to reduce health disparities receive attention at the national level, information on the successes of state and local efforts are often not heard. On May 11, 2009, the Institute of Medicine held a public workshop to discuss the role of state and local policy initiatives to reduce health disparities. The workshop brought together stakeholders to learn more about what works in reducing health disparities and ways to focus on localized efforts when working to reduce health disparities.

It is estimated that more than 50 million Latinos live in the United States. This is projected to more than double by 2050. InHealth Issues in Latino Malesexperts from public health, medicine, and sociology examine the issues affecting Latino men's health and recommend policies to overcome inequities and better serve this population. The book addresses sexual and reproductive health; alcohol, tobacco, and drug use; mental and physical health among those in the juvenile justice or prison systems; chronic diseases; HIV/AIDS; Alzheimer's and dementia; and health issues among war veterans. It discusses utilization, insurance coverage, and research programs, and includes an extensive appendix charting epidemiological data on Latino health.

This new edition of the AJN Award-winning textbook analyzes the most current health care reforms and their effect on U.S. health system from a social justice perspective. It addresses the reforms of the landmark health care reform bill passed in March, 2010, and provides students of health care policy with a framework within which they can understand and evaluate the U.S. health system. The text provides a comprehensive description and analysis of the historical evolution and organization of the health care system that is framed by a forthright social justice critique. In addition to extensive coverage of the U.S. health care system structures, finances, and performance on a variety of population health indicators, the text analyzes disparities in access to health and health care in the U.S.A. - by race, ethnicity, class, age, gender, and geography. Issues of special focus include long-term care policy, the bioethical dimensions of health care policy, the transformation of health to an economic commodity, the politics of health care policymaking, and the global context of health care disparities. New to the Second Edition: Contains numerous chapters that have been extensively revised or completely rewritten; Explains the political goals of and barriers to each stage of the Patient Protection and Affordable Care Act's (PPACA) implementation plan; Provides two distinct critiques of the PPACA; Offers a social and political health care agenda based on a social justice perspective; Features a teaching guide.

Race, Ethnicity and Health, Second Edition, is a critical selection of hallmark articles that address health disparities in America. It effectively documents the need for equal treatment and equal health status for minorities. Intended as a resource for faculty and students in public health as well as the social sciences, it will be also be valuable to public health administrators and frontline staff who serve diverse racial and ethnic populations. The book brings together the best peer reviewed research literature from the leading scholars and faculty in this growing field, providing a historical and political context for the study of health, race, and ethnicity, with key findings on disparities in access, use, and quality. This volume also examines the role of health care providers in health disparities and discusses the issue of matching patients and doctors by race. New chapters cover: reflections on demographic changes in the US based on the current census; metrics and nomenclature for disparities; theories of genetic basis for disparities; the built environment; residential segregation; environmental health; occupational health; health disparities in integrated communities; Latino health; Asian populations; stress and health; physician/patient relationships; hospital treatment of minorities; the slavery hypertension hypothesis; geographic disparities; and intervention design.  

Klugman and Dalinis initiate a much-needed conversation about the ethical and policy concerns facing health care providers in the rural United States. This volume initiates a much-needed conversation about the ethical and policy concerns facing health care providers in the rural United States. Although 21 percent of the population lives in rural areas, only 11 percent of physicians practice there. What challenges do health care workers face in remote locations? What are the differences between rural and urban health care practices? What particular ethical issues arise in treating residents of small communities? Craig M. Klugman and Pamela M. Dalinis gather philosophers, lawyers, physicians, nurses, and researchers to discuss these and other questions, offering a multidisciplinary overview of rural health care in the United States. Rural practitioners often practice within small, tight-knit communities, socializing with their patients outside the examination room. The residents are more likely to have limited finances and to lack health insurance. Physicians may have insufficient resources to treat their patients, who often have to travel great distances to see a doctor. The first part of the book analyzes the differences between rural and urban cultures and discusses the difficulties in treating patients in rural settings. The second part features the personal narratives of rural health care providers, who share their experiences and insights. The last part introduces unique ethical challenges facing rural health care providers and proposes innovative solutions to those problems. This volume is a useful resource for bioethicists, members of rural bioethics committees and networks, policy makers, teachers of health care providers, and rural practitioners themselves.

Cancer is not randomly distributed in the United States. Its incidence varies by race, ethnicity, socioeconomic status, and other geographic and demographic factors. This volume, co-published with the American Cancer Society, is the first to examine the biological, racial, and socioeconomic factors that influence cancer incidence and survival. In addition, it presents 15 previously unpublished, evidence-based interventions to reduce and eliminate cancer disparities. The book explains the nature, scope, and causes of cancer disparities across different populations and then presents unique programs proven to reduce such inequalities in the areas of cancer prevention, screening and early detection, treatment, and survivorship. They represent a variety of cancers, populations, and communities across the U.S. Descriptions of each intervention include tests of effectiveness and are written in sufficient detail for readers to replicate them within their own communities.