Health Care Divided

David Barton Smith offers a complete chronicle of racial segregation and discrimination in health care in the United States using vivid firsthand accounts as well as a formal review of the current evidence of inequity in patterns of use and outcomes. Smith details the efforts through the courtsand federal regulation to address these disparities, discusses their persistence in more subtle forms, and offers possible strategies for ending them. Health Care Divided: Race and Healing a Nation tells the story from 1920 to the present by distilling a narrative from archival records and interviews with key participants. The book traces the decisive role race has played in shaping the development of American medicine and our system of medical care and goes on to explore the effect of this legacy on the organization of long-term care for the elderly and prenatal care for infants. Identified here are lessons largely overlooked by health services leaders, researchers, and policy analysts and examines how this divided health system persists, both exacerbating and distorting racial disparities. Smith asserts that in spite of federal efforts to end segregation, health care remains, at best, more than half the distance between a fully separate and an integrated system. This book will appeal to the general reader though will be of particular interest to those in or preparing for health related professions and to those interested in African American and recent American history, political science and organization behavior, public policy and race relations, and trends in health care in the absence of a national reform initiative. "Health Care Divided is a fascinating and often distressing history of our racially divided health care system." -- Ruth Roemer, J.D., UCLA School of Public Health, and Past President, American Public Health Association The research for this book was supported by a Robert Wood Johnson Health Policy Investigator Award.