The Safety-Net Health Care System: Health Care at the Margins

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Overview

"

A unique and authoritative guide to the US safety-net health care system, this book addresses how various populations and their difficult health and socio-economic issues are dealt with and impacted by the system. Drs. Gunnar Almgren and Taryn Lindhorst, experts in the fields of social work and public health, provide critical, much-needed insight into the safety-net system and how the recession, unemployment, and reform have accelerated its growth.

Ideal for graduate students and early professionals in the health professions, this textbook:

  • Includes narratives from patients and caregivers that will help readers understand and empathize with the poor, homeless, and other vulnerable populations affected by the safety-net system
  • Discusses various health issues, including: violence, chronic diseases, mental illness, victimization, and substance abuse/addiction
  • Examines overlaps in US public health, social work, nursing, and medical education
  • Analyzes the differences between the populations that depend on safety-net system providers and more advantaged populations that have access to the mainstream health care system
"
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Editorial Reviews

Doody's Review Service
Reviewer: Carole A. Kenner, PhD, RN, FAAN (Council of International Neonatal Nurses)
Description: This book makes the frightening observation that, in many health professions educational programs, vulnerable populations are presented as a problem, a burden, and people who are poorly understood. Using case studies to which readers can relate, this book aims to address all aspects of the safety net for healthcare in America and bring about an attitudinal change.
Purpose: The purpose is to bring to the forefront difficult discussions about addiction, homelessness, chronic illness, and health disparities within the context of the safety net that is supposed to help provide care to vulnerable populations. The book illustrates the gaps between the theory of the safety net and how it is operationalized in the community or acute care settings. This type of presentation is necessary if health professionals are to change their view of this problem.
Audience: The main audience includes graduate students in the health professions as well as practicing healthcare providers and educators.
Features: The book begins with a description of the social structural issues, such the origins of the safety net hospitals/community agencies, the definitions of poverty, homelessness, and associated stigma. There is an in-depth discussion of the differences in power, privilege, and disparities in care as well as the new movement towards patient engagement and personal involvement in care. The book highlights the contrast between the power and influence of health professionals in a hierarchical healthcare structure and that of patients of any race or ethnicity, then adds in the backdrop of poverty, homelessness, and mental health issues, for example, and demonstrates how they impact even further the power disparity that ultimately affects patient engagement.
Assessment: This is the only book currently available that fully addresses all aspects of the safety net for healthcare. The last few sections are particularly strong, emphasizing the discontent among patients and practitioners in terms of access to and use of healthcare services. The last chapter presents tips on how to survive the stress of healthcare in today's fast-paced world. This is an important contribution to the growing body of literature on America's healthcare system.
From The Critics
Reviewer: Carole Ann Kenner, PhD, MSN, BSN(Northeastern University Bouve College of Health Sciences)
Description: This book makes the frightening observation that, in many health professions educational programs, vulnerable populations are presented as a problem, a burden, and people who are poorly understood. Using case studies to which readers can relate, this book aims to address all aspects of the safety net for healthcare in America and bring about an attitudinal change.
Purpose: The purpose is to bring to the forefront difficult discussions about addiction, homelessness, chronic illness, and health disparities within the context of the safety net that is supposed to help provide care to vulnerable populations. The book illustrates the gaps between the theory of the safety net and how it is operationalized in the community or acute care settings. This type of presentation is necessary if health professionals are to change their view of this problem.
Audience: The main audience includes graduate students in the health professions as well as practicing healthcare providers and educators.
Features: The book begins with a description of the social structural issues, such the origins of the safety net hospitals/community agencies, the definitions of poverty, homelessness, and associated stigma. There is an in-depth discussion of the differences in power, privilege, and disparities in care as well as the new movement towards patient engagement and personal involvement in care. The book highlights the contrast between the power and influence of health professionals in a hierarchical healthcare structure and that of patients of any race or ethnicity, then adds in the backdrop of poverty, homelessness, and mental health issues, for example, and demonstrates how they impact even further the power disparity that ultimately affects patient engagement.
Assessment: This is the only book currently available that fully addresses all aspects of the safety net for healthcare. The last few sections are particularly strong, emphasizing the discontent among patients and practitioners in terms of access to and use of healthcare services. The last chapter presents tips on how to survive the stress of healthcare in today's fast-paced world. This is an important contribution to the growing body of literature on America's healthcare system.
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Product Details

  • ISBN-13: 9780826105714
  • Publisher: Springer Publishing Company, Incorporated
  • Publication date: 12/21/2011
  • Pages: 408
  • Product dimensions: 6.00 (w) x 9.00 (h) x 1.10 (d)

Meet the Author

Gunnar Almgren, PhD, is an Associate Professor in the School of Social Work at the University of Washington. He is also a Faculty Affiliate of the West Coast Poverty Center and a Faculty Research Associate at the Center for Studies in Demography and Ecology. His professional interests include health care policy and the social determinants of health. His research interests include the study of the effects of racial segregation and economic disadvantage on urban mortality trends, and the health care policy effects on the health care safety net.

Taryn Lindhorst is an Associate Professor at the University of Washington School of Social Work. Her professional interests include health practice and poverty and welfare reform.

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Table of Contents

Foreword

Preface

Acknowledgments

PART I: SYSTEMIC FOUNDATIONS OF SAFETY-NET HEALTH CARE

1. Origins and Defi nitions of the Safety-Net Health Care System

2. Poverty and Being Poor

3. Stratifi cation and Stigma

4. Differences, Power, Privilege, and Disparities in Care

PART II: POPULATIONS AND PROVIDERS

5. Homelessness as a Social Phenomenon and Being Homeless

6. Substance Abuse and Addiction

7. Violence, Victimization, and Trauma

8. Diffi cult Patients, Diffi cult Health Conditions

9. Adherence to Care

10. Thriving in Stressful Environments

Index

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