Just Medicine: A Cure for Racial Inequality in American Health Care

by Dayna Bowen Matthew Narrated by Diana Blue

Overview

Health disparities have remained stubbornly entrenched in the American health care system-and in Just Medicine Dayna Bowen Matthew finds that they principally arise from unconscious racial and ethnic biases held by physicians, institutional providers, and their patients.



Implicit bias is the single most important determinant of health and health care disparities. Because we have missed this fact, the money we spend on training providers to become culturally competent, expanding wellness education programs and community health centers, and even expanding access to health insurance will have only a modest effect on reducing health disparities. We will continue to utterly fail in the effort to eradicate health disparities unless we enact strong, evidence-based legal remedies that accurately address implicit and unintentional forms of discrimination, to replace the weak, tepid, and largely irrelevant legal remedies currently available.



Our continued failure to fashion an effective response that purges the effects of implicit bias from American health care, Matthew argues, is unjust and morally untenable. In a time when the health of the entire nation is at risk, it is essential to confront the issues keeping the health care system from providing equal treatment to all.

Editorial Reviews

Health Affairs

"The book is highly engaging and worthwhile reading for health care providers, hospital administrators, insurers, medical students and educators, and those involved in civil rights law."

Political Science Quarterly

"Just Medicine is necessary reading for all who envision a society in which health equity is a moral imperative. I would place Matthew's contributions on the scale of Michelle Alexander's transformational book, The New Jim Crow. Matthew not only documents the problem of color-blind racism but also provides solution-oriented road maps for a way forward."

Angela Onwuachi-Willig

"Just Medicine is a must-read for everyone! Weaving together from insights from research in history, sociology, psychology, law, and more, Matthew crushes the argument that racial disparities in health and health care are due to factors like biology and bad behavior. Time and time again, Matthew exposes the role of racial bias and discrimination in disparate outcomes. More so, she offers meaningful and achievable suggestions for resolving these problems. Lets hope those with the most power to create these changes are paying attention to this important scholarly contribution!"

Michele Goodwin

"A powerful socio-legal reflection on the history of health disparities and how that terrible legacy now further impedes racial equality and results in death. . . . Masterfully written. The author provides a captivating narrative that is at once stark and grizzly (how many ways can people of color suffer at the hands of medicine) and yet so provocatively and artfully written that one cannot stop reading. Not since Harriet Washingtons page-turning (and award-winning) book,Medical Apartheid, has there been another that makes medical discourse so captivating."

Los Angeles Review of Books

"Her ambitious book lays out a case for a legal remedy for racial health inequality."

Osagie K. Obasogie

"A remarkably ambitious and provocative book on the ways that implicit bias exacerbates racial disparities in health. Matthew provides a critical analysis and call to action that should be taken seriously by all health care professionals, policymakers, and anyone interested in health equality."

Choice Connect

"This book will spark much debate."

From the Publisher

"Having presented a thorough picture of the problems facing minorities in the health care system, Matthew proposes a solution: reform of specific sections of the Civil Rights Act of 1964, which she claims would provide a legal and moral basis to hold liable those who unconsciously discriminate and would help to establish a new standard of care in medicine....[F]ood for thought here." -Kirkus Reviews

"A powerful socio-legal reflection on the history of health disparities and how that terrible legacy now further impedes racial equality and results in death. . . . Masterfully written. The author provides a captivating narrative that is at once stark and grizzly (how many ways can people of color suffer at the hands of medicine) and yet so provocatively and artfully written that one cannot stop reading. Not since Harriet Washington’s page-turning (and award-winning) book, Medical Apartheid, has there been another that makes medical discourse so captivating."-Michele Goodwin,Chancellor’s Professor of Law, University of California, Irvine

"A remarkably ambitious and provocative book on the ways that implicit bias exacerbates racial disparities in health. Matthew provides a critical analysis and call to action that should be taken seriously by all health care professionals, policymakers, and anyone interested in health equality."-Osagie K. Obasogie,UC Hastings

"Her ambitious book lays out a case for a legal remedy for racial health inequality."-Los Angeles Review of Books

"Just Medicine is a must-read for everyone! Weaving together from insights from research in history, sociology, psychology, law, and more, Matthew crushes the argument that racial disparities in health and health care are due to factors like biology and bad behavior. Time and time again, Matthew exposes the role of racial bias and discrimination in disparate outcomes. More so, she offers meaningful and achievable suggestions for resolving these problems. Let’s hope those with the most power to create these changes are paying attention to this important scholarly contribution!"-Angela Onwuachi-Willig,Charles M. and Marion J. Kierscht Professor of Law, University of Iowa College of Law

Kirkus Reviews

2015-10-04
A densely written proposal for reducing discrimination by white physicians, nurses, and other health care personnel against minorities seeking medical services. Matthew (Law/Univ. of Colorado) opens with a shocking statistic: according to one estimate, nearly 84,000 more minority patients die annually "due to health care disparities" and "inferior medical treatment" compared to "their white counterparts." Drawing on social science studies, many of which are cited here, the author gathers evidence of implicit bias before, during, and after the clinical encounter, and she argues forcefully that this can and must be changed. A co-founder of the Colorado Health Equity Project, a medical legal partnership, Matthew tackles this important issue in disconcertingly repetitive prose filled with the jargon of the social sciences. Matthew presents a "Biased Care Model" with clunky charts of "physician and patient communication mechanisms" depicting how "physician's stored clinical and social knowledge of a patient's group" leads to "racially/ethnically disparate health outcomes." Quotes from various health care providers and excerpts from interviews with patients reinforce her message and lighten the sociolegal passages at times, but too often her presentation becomes discouragingly challenging for casual readers. Having presented a thorough picture of the problems facing minorities in the health care system, Matthew proposes a solution: reform of specific sections of the Civil Rights Act of 1964, which she claims would provide a legal and moral basis to hold liable those who unconsciously discriminate and would help to establish a new standard of care in medicine. Health care providers, hospital administrators, insurers, and those involved in civil rights law will find food for thought here; general readers will be better served by Damon Tweedy's Black Man in a White Coat: A Doctor's Reflections on Race and Medicine (2015).

Product Details

BN ID:	2940177749662
Publisher:	Tantor Audio
Publication date:	11/17/2020
Edition description:	Unabridged

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