David Barton Smith offers a complete chronicle of racial segregation and discrimination in health care in the United States using vivid first-hand accounts as well as current evidence of inequity in patterns of use and outcomes. Smith details judicial and federal efforts to address these disparities, discusses their persistence in more subtle forms, and offers possible strategies for ending them. Health Care Divided tells the story from 1920 to the present by distilling a narrative from archival records and interviews with key participants. The book traces the decisive role race has played in shaping our system of medical care and explores the effect of this legacy on long-term care for the elderly and prenatal care for infants. Identified here are lessons largely overlooked by health services leaders, researchers, and policy analysts. Smith examines how this divided health system persists, both exacerbating and distorting racial disparities. He asserts that in spite of federal efforts to end segregation, health care remains, at best, more than half the distance between a fully separate and an integrated system. Health Care Divided is a fascinating and often distressing history of our racially divided health care system. --Ruth Roemer, J.D., UCLA School of Public Health, and Past President, American Public Health Association David Barton Smith is Professor and Program Director of the Healthcare Management Program, the School of Business and Management, Temple University. The research for this book was supported by a Robert Wood Johnson Health Policy Investigator Award.
