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Doody's Review ServiceReviewer: 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.