Poor Families in America's Health Care Crisis

Poor Families in America's Health Care Crisis examines the implications of the fragmented and two-tiered health insurance system in the United States for the health care access of low-income families. For a large fraction of Americans their jobs do not provide health insurance or other benefits and although government programs are available for children, adults without private health care coverage have few options. Detailed ethnographic and survey data from selected low-income neighborhoods in Boston, Chicago, and San Antonio document the lapses in medical coverage that poor families experience and reveal the extent of untreated medical conditions, delayed treatment, medical indebtedness, and irregular health care that women and children suffer as a result. Extensive poverty, the increasing proportion of minority households, and the growing dependence on insecure service sector work all influence access to health care for families at the economic margin.

Table of Contents:
1. The unrealized hope of welfare reform: implications for health care; 2. The health care welfare state in America; 3. The tattered health care safety net for poor Americans; 4. State differences in health care policies and coverage; 5. Work and health insurance: a tenuous tie for the working poor; 6. Confronting the system: minority group identity and powerlessness; 7. The nonexistent safety net for parents; 8. Health care for all Americans.

About the Author :
Ronald J. Angel, Ph.D. is Professor of Sociology at the University of Texas, Austin. With his wife, Jacqueline Angel, he is author of Painful Inheritance: Health and the New Generation of Fatherless Families and Who Will Care for Us? Aging and Long-term Care in Multicultural America. Professor Angel served as Editor of the Journal of Health and Social Behavior from 1994 to 1997, and he has served on the editorial boards of numerous other journals. He has administered several large grants from NIA, NIMH, NICHD, and several private foundations. Laura Lein, Ph.D. is Professor in the School of Social Work and the Department of Anthropology at the University of Texas at Austin. She received her doctorate in social anthropology from Harvard University in 1973. She is the author, with Kathryn Edin, of Making Ends Meet: How Single Mothers Survive Welfare and Low-Wage Work. She has published numerous articles, most recently in Community, Work and Family, Violence Against Women, and Journal of Adolescent Research. Jane Henrici, Ph.D., an Assistant Professor of Anthropology at the University of Memphis, earned her doctorate from the University of Texas at Austin. Henrici has published articles and chapters on development programs and their interaction with ethnicity and gender in Peru, and on social programs and their effects on poorer women in the U.S. With respect to the latter, she edited as well as contributed to a volume contracted by the University of Arizona Press tentatively titled Going it Alone: U.S. Women in the Age of Welfare Reform. She is also the recipient of a Fulbright fellowship.

Review :
"This book provides evidence in rich and specific detail of the 'human experience of dealing with serious adversity'. An important message of this book is the consequences for health of uncertainty in the structural conditions and personal lives of the working poor -- "physical and social environments that seem to attack and undermine an impoverished family's every effort to get ahead." Rich qualitative data give these findings the context and specificity of personal experiences and stories." -Thomas S. Weisner, University of California, Los Angeles "Poor Families in America's Health Care Crisis is an important and timely book. Ronald J. Angel, Laura Lein, and Jane Henrici have analyzed rich data collected in selected neighborhoods in Boston, Chicago, and San Antonio to provide a compelling account of the health of poor families and their untreated medical conditions. The information in this book is disturbing, but it is a must read for those concerned about the lack of health insurance and access to health care for millions of American families." -William Julius Wilson, Harvard University 'Women and children first' has come to mean that, when poor, they are the first to suffer the gaps, delays, disrespect and lack of care endemic to the United States' two tiered health care system. Poor Families in America's Health Care Crisis makes these stories vivid and specific as the book's analysis is anchored to real people's experiences. The book should fuel our determination and equip us to fix this cruel situation." -Wendy Chavkin, Columbia University