We know more about cancer prevention, detection, and treatment than ever beforeâ€"yet not all segments of the U.S. population have benefited to the fullest extent possible from these advances. Some ethnic minorities experience more cancer than the majority population, and poor peopleâ€"no matter what their ethnicityâ€"often lack access to adequate cancer care. This book provides an authoritative view of cancer as it is experienced by ethnic minorities and the medically underserved. It offers conclusions and recommendations in these areas: Defining and understanding special populations, and improving the collection of cancer-related data. Setting appropriate priorities for and increasing the effectiveness of specific National Institutes of Health (NIH) research programs, to ensure that special populations are represented in clinical trials. Disseminating research results to health professionals serving these populations, with sensitivity to the issues of cancer survivorship. The book provides background data on the nation's struggle against cancer, activities and expenditures of the NIH, and other relevant topics.

The debt crisis and global economic changes of the 1980s caused Third World nations to restructure economic policies, community resources, the labor market, and intra-household divisions of labor. These changes swelled the ranks of the unemployed, the poor, and the malnourished. Women, in particular, were affected negatively by processes of structural adjustment because they represent a disproportionate share of the world's poor, are increasingly represented among low-wage workers, and are forced to balance wage work with subsistence and domestic production in meeting household needs. Using country-based studies, this text offers new perspectives on the consequences of economic crisis in terms of changing state practices and household and family organization, patterns of resource allocation, and women's work.

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.

We know more about cancer prevention, detection, and treatment than ever beforeâ€"yet not all segments of the U.S. population have benefited to the fullest extent possible from these advances. Some ethnic minorities experience more cancer than the majority population, and poor peopleâ€"no matter what their ethnicityâ€"often lack access to adequate cancer care. This book provides an authoritative view of cancer as it is experienced by ethnic minorities and the medically underserved. It offers conclusions and recommendations in these areas: Defining and understanding special populations, and improving the collection of cancer-related data. Setting appropriate priorities for and increasing the effectiveness of specific National Institutes of Health (NIH) research programs, to ensure that special populations are represented in clinical trials. Disseminating research results to health professionals serving these populations, with sensitivity to the issues of cancer survivorship. The book provides background data on the nation's struggle against cancer, activities and expenditures of the NIH, and other relevant topics.

'Punchily written ... He leaves the reader with a sense of the gross injustice of a world where health outcomes are so unevenly distributed' Times Literary Supplement 'Splendid and necessary' Henry Marsh, author of Do No Harm, New Statesman There are dramatic differences in health between countries and within countries. But this is not a simple matter of rich and poor. A poor man in Glasgow is rich compared to the average Indian, but the Glaswegian's life expectancy is 8 years shorter. The Indian is dying of infectious disease linked to his poverty; the Glaswegian of violent death, suicide, heart disease linked to a rich country's version of disadvantage. In all countries, people at relative social disadvantage suffer health disadvantage, dramatically so. Within countries, the higher the social status of individuals the better is their health. These health inequalities defy usual explanations. Conventional approaches to improving health have emphasised access to technical solutions – improved medical care, sanitation, and control of disease vectors; or behaviours – smoking, drinking – obesity, linked to diabetes, heart disease and cancer. These approaches only go so far. Creating the conditions for people to lead flourishing lives, and thus empowering individuals and communities, is key to reduction of health inequalities. In addition to the scale of material success, your position in the social hierarchy also directly affects your health, the higher you are on the social scale, the longer you will live and the better your health will be. As people change rank, so their health risk changes. What makes these health inequalities unjust is that evidence from round the world shows we know what to do to make them smaller. This new evidence is compelling. It has the potential to change radically the way we think about health, and indeed society.

Most public health students, academicians, and practitioners recognize the association between racial/ethnic minority status and the disproportionate burden of preventable disease in the United States. Much less attention has been directed, however, toward health disparities that affect gay and bisexual men. These disparities affect the lives of an estimated 5.3-7.4 million American men, and are an important concern for public health. Until very recently, the relative invisibility of this group and a paucity of empirical data have hampered attempts to identify health disparities experienced by gay and bisexual men. This book proposes to review and synthesize evidence of health disparities among gay and bisexual men, identify individual and community factors that contribute to these disparities, and articulate strategies for public health efforts to eliminate disparities. To date, these disparities have been largely discussed in isolation in the research literature in a manner that does not permit a comprehensive examination of these problems, their underlying causes, and potential solutions. Thus, a primary emphasis of the book will be to document health disparities among gay and bisexual men while also describing public health solutions to these challenges.

America’s higher education system is failing its students. In the space of a generation, we have gone from being the best-educated society in the world to one surpassed by eleven other nations in college graduation rates. Higher education is evolving into a caste system with separate and unequal tiers that take in students from different socio-economic backgrounds and leave them more unequal than when they first enrolled. Until the 1970s, the United States had a proud history of promoting higher education for its citizens. The Morrill Act, the G.I. Bill and Pell Grants enabled Americans from across the income spectrum to attend college and the nation led the world in the percentage of young adults with baccalaureate degrees. Yet since 1980, progress has stalled. Young adults from low to middle income families are not much more likely to graduate from college than four decades ago. When less advantaged students do attend, they are largely sequestered into inferior and often profit-driven institutions, from which many emerge without degrees—and shouldering crushing levels of debt. In Degrees of Inequality, acclaimed political scientist Suzanne Mettler explains why the system has gone so horribly wrong and why the American Dream is increasingly out of reach for so many. In her eye-opening account, she illuminates how political partisanship has overshadowed America’s commitment to equal access to higher education. As politicians capitulate to corporate interests, owners of for-profit colleges benefit, but for far too many students, higher education leaves them with little besides crippling student loan debt. Meanwhile, the nation’s public universities have shifted the burden of rising costs onto students. In an era when a college degree is more linked than ever before to individual—and societal—well-being, these pressures conspire to make it increasingly difficult for students to stay in school long enough to graduate. By abandoning their commitment to students, politicians are imperiling our highest ideals as a nation. Degrees of Inequality offers an impassioned call to reform a higher education system that has come to exacerbate, rather than mitigate, socioeconomic inequality in America.

Racial and ethnic disparities in health care are known to reflect access to care and other issues that arise from differing socioeconomic conditions. There is, however, increasing evidence that even after such differences are accounted for, race and ethnicity remain significant predictors of the quality of health care received. In Unequal Treatment, a panel of experts documents this evidence and explores how persons of color experience the health care environment. The book examines how disparities in treatment may arise in health care systems and looks at aspects of the clinical encounter that may contribute to such disparities. Patients' and providers' attitudes, expectations, and behavior are analyzed. How to intervene? Unequal Treatment offers recommendations for improvements in medical care financing, allocation of care, availability of language translation, community-based care, and other arenas. The committee highlights the potential of cross-cultural education to improve provider-patient communication and offers a detailed look at how to integrate cross-cultural learning within the health professions. The book concludes with recommendations for data collection and research initiatives. Unequal Treatment will be vitally important to health care policymakers, administrators, providers, educators, and students as well as advocates for people of color.

An Equal Burden is the first scholarly study of the Army Medical Services in the First World War to focus on the roles and experiences of the men of the Royal Army Medical Corps (RAMC). Though they were not professional medical caregivers, they were called upon to provide urgent medical care and, as non-combatants, were forbidden from carrying weapons. Their role in the war effort was quite unique and warranting of further study. Structured both chronologically and thematically, An Equal Burden examines the work that RAMC rankers undertook and its importance to the running of the chain of medical evacuation. It additionally explores the gendered status of these men within the medical, military, and cultural hierarchies of a society engaged in total war. Through close readings of official documents, personal papers, and cultural representations, Meyer argues that the ranks of the RAMC formed a space in which non-commissioned servicemen, through their many roles, defined and redefined medical caregiving as men's work in wartime.

How can we all work together to eliminate the avoidable injustices that plague our health care system and society? Health is determined by far more than a person's choices and behaviors. Social and political conditions, economic forces, physical environments, institutional policies, health care system features, social relationships, risk behaviors, and genetic predispositions all contribute to physical and mental well-being. In America and around the world, many of these factors are derived from a lingering history of unequal opportunities and unjust treatment for people of color and other vulnerable communities. But they aren't the only ones who suffer because of these disparities—everyone is impacted by the factors that degrade health for the least advantaged among us. In Why Are Health Disparities Everyone's Problem? Dr. Lisa Cooper shows how we can work together to eliminate the injustices that plague our health care system and society. The book follows Cooper's journey from her childhood in Liberia, West Africa, to her thirty-year career working first as a clinician and then as a health equity researcher at Johns Hopkins University. Drawing on her experiences, it explores how differences in communication and the quality of relationships affect health outcomes. Through her work as the founder and director of the Johns Hopkins Center for Health Equity, it details the actions and policies needed to reduce and eliminate the conditions that are harming us all. Cooper reveals with compelling detail how health disparities are crippling our health care system and society, driving up health care costs, leading to adverse health outcomes and ultimately an enormous burden of human suffering. Why Are Health Disparities Everyone's Problem? demonstrates the ways in which everyone's health is interconnected, both within communities and across the globe. Cooper calls for a new kind of herd immunity, when a sufficiently high proportion of people, across race and social class, become immune to harmful social conditions through "vaccination" with solidarity among groups and opportunities created by institutional and societal practices and policies. By acknowledging and acting upon that interconnectedness, she believes everyone can help to create a healthier world. Features • Raises readers' health care inequities literacy through an approachable narrative with specific examples • Introduces the concept of "herd immunity" as it applies to building communal awareness of systemic injustices • Features sections that underscore key takeaways • Includes contributions from the world's leading minds through their research findings and quotations • Guides readers on what can be done at an individual level as a patient, public health professional, and community member • Includes inspiring stories of effective health equity studies and practices around the world, from Ghana's ADHINCRA Project addressing hypertension control to Baltimore's BRIDGE Study for depression in African Americans and the Maryland and Pennsylvania–based RICH LIFE Project for hypertension, diabetes, and other medical conditions Johns Hopkins Wavelengths In classrooms, field stations, and laboratories in Baltimore and around the world, the Bloomberg Distinguished Professors of Johns Hopkins University are opening the boundaries of our understanding of many of the world's most complex challenges. The Johns Hopkins Wavelengths book series brings readers inside their stories, illustrating how their pioneering discoveries benefit people in their neighborhoods and across the globe in artificial intelligence, cancer research, food systems' environmental impacts, health equity, science diplomacy, and other critical arenas of study. Through these compelling narratives, their insights will spark conversations from dorm rooms to dining rooms to boardrooms.