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“Quality of life means more than just consumption”: Two MIT economists urge that a smarter, more politically aware economics be brought to bear on social issues. As it is, the readers who are likely to come to this book-undergraduates, mostly, in survey courses-probably won’t question Dunbar-Ortiz’s inaccurate assertion that the military phrase “in country” derives from the military phrase “Indian country” or her insistence that all Spanish people in the New World were “gold-obsessed.” Furthermore, most readers won’t likely know that some Ancestral Pueblo (for whom Dunbar-Ortiz uses the long-abandoned term “Anasazi”) sites show evidence of cannibalism and torture, which in turn points to the inconvenient fact that North America wasn’t entirely an Eden before the arrival of Europe.Ī Churchill-ian view of native history-Ward, that is, not Winston-its facts filtered through a dense screen of ideology. For one thing, while “Indian” isn’t bad, since “ndigenous individuals and peoples in North America on the whole do not consider ‘Indian’ a slur,” “American” is due to the fact that it’s “blatantly imperialistic.” Just so, indigenous peoples were overwhelmed by a “colonialist settler-state” (the very language broadly applied to Israelis vis-à-vis the Palestinians today) and then “displaced to fragmented reservations and economically decimated”-after, that is, having been forced to live in “concentration camps.” Were he around today, Vine Deloria Jr., the always-indignant champion of bias-puncturing in defense of native history, would disavow such tidily packaged, ready-made, reflexive language. Indeed, the author says little that hasn’t been said before, but she packs a trove of ideological assumptions into nearly every page. Inducing guilt in non-native readers would seem to be the guiding idea behind Dunbar-Ortiz’s (Emerita, Ethnic Studies/California State Univ., Hayward Blood on the Border: A Memoir of the Contra War, 2005, etc.) survey, which is hardly a new strategy. And so, this book would seem to suggest, did every other native victim of colonialism. 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).Ĭuster died for your sins. 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. 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. 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.
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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 densely written proposal for reducing discrimination by white physicians, nurses, and other health care personnel against minorities seeking medical services.