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The Death Gap: How Inequality Kills

von David A. Ansell MD

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We hear plenty about the widening income gap between the rich and the poor in America and about the expanding distance dividing the haves and the have-nots. But when detailing the many things that the poor have not, we often overlook the most critical their health. The poor die sooner. Blacks die sooner. And poor urban blacks die sooner than almost all other Americans. In nearly four decades as a doctor at hospitals serving some of the poorest communities in Chicago, David Ansell has witnessed the lives behind these devastating statistics firsthand. In 'The Death Gap', he gives a grim survey of these realities, drawn from observations and stories of his patients. While the contrasts and disparities in Chicago's communities are particularly stark, the death gap is truly a nationwide epidemic as Ansell shows, there is a thirty-five-year difference in life expectancy between the healthiest and wealthiest and the poorest and sickest American neighborhoods. It doesn't need to be this way; such divisions are not inevitable. Ansell calls out the social and cultural arguments that have been raised as ways of explaining or excusing these gaps, and he lays bare the structural violence the racism, economic exploitation, and discrimination that is really to blame. Inequality is a disease, Ansell argues, and we need to treat and eradicate it as we would any major illness. To do so, he outlines a vision that will provide the foundation for a healthier nation for all.… (mehr)
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A quick read for non-fiction, The Death Gap uses Chicago neighborhoods as case studies for the various ways inequity decreases health outcomes with dramatic life expectancy differences for neighborhoods along the same road. This is structural violence- redlining contributes to placement of facilities in certain neighborhoods, limiting access to care (all while the healthcare system is strangled by labyrinthine health insurance companies). Smaller hospitals might not be able to maintain much needed programs, thus forcing their constituents to travel farther for care (and increase the likelihood of death).

Dr. Ansell also advocates for single-payer healthcare, as current US systems are expensive with control in the hands of insurers for who is in-network, etc.

This book is from 2017, so I imagine healthcare disparities have only widened in the last five years, especially with the coronavirus pandemic exacerbating issues in an already broken system. ( )
  Daumari | Dec 28, 2023 |
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We all die.
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We hear plenty about the widening income gap between the rich and the poor in America and about the expanding distance dividing the haves and the have-nots. But when detailing the many things that the poor have not, we often overlook the most critical their health. The poor die sooner. Blacks die sooner. And poor urban blacks die sooner than almost all other Americans. In nearly four decades as a doctor at hospitals serving some of the poorest communities in Chicago, David Ansell has witnessed the lives behind these devastating statistics firsthand. In 'The Death Gap', he gives a grim survey of these realities, drawn from observations and stories of his patients. While the contrasts and disparities in Chicago's communities are particularly stark, the death gap is truly a nationwide epidemic as Ansell shows, there is a thirty-five-year difference in life expectancy between the healthiest and wealthiest and the poorest and sickest American neighborhoods. It doesn't need to be this way; such divisions are not inevitable. Ansell calls out the social and cultural arguments that have been raised as ways of explaining or excusing these gaps, and he lays bare the structural violence the racism, economic exploitation, and discrimination that is really to blame. Inequality is a disease, Ansell argues, and we need to treat and eradicate it as we would any major illness. To do so, he outlines a vision that will provide the foundation for a healthier nation for all.

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