The hidden health care system: Mediating structures and medicine - Softcover

Levin, Lowell S

Softcover

ISBN 10: 0884108228 ISBN 13: 9780884108221

Publisher: Ballinger Pub. Co, 1981

Synopsis

Health care policy traditionally views lay people as health care consumers. This groundbreaking book offers evidence of a new perspective: lay people are the primary providers of health care. The family, organized religion, voluntary associations, neighborhoods, and ethnic and racial groups act as a buffer between the individual and the large institutions of modern society. These small social groups or "mediating structures" comprise the hidden non-professional health care system which is Cost Effective, Integral, and Enduring.

About this title

About the Author:

LOWELL S. LEVIN is Emeritus Professor of Public Health at Yale University. His research and work as a consultant throughout the world have often challenged established public health beliefs and practices. Committed to health promotion, in the 1960s he pioneered the citizen participation movement, focusing on health communication and the social and behavioral factors affecting health (Self-Care: Lay Initiatives in Health, 1976). In the 1970s and early 1980s, with the first publication of The Hidden Health Care System and other works, Professor Levin brought to public health s attention the role of non-professional resources in strengthening personal capacity for health and well being, primarily self-care. In the 1980s, Professor Levin pressed for improvement in the quality of medical care, notably as a co-author of Medicine on Trial (1988). As an advisor for over thirty-five years to the World Health Organization s European Region, as well as to various non-governmental organizations in Europe, Latin America, the British Commonwealth Caribbean and the United States, Professor Levin has worked to develop cross-departmental collaborations, particularly at the national level in European countries, to improve the impact on health of diverse public policies in such areas as agriculture, education, environment, employment, communications and tourism. During his career as professor, researcher, and advisor, Professor Levin has developed innovative educational programs, including founding the global health division at Yale s School of Public Health, always aiming to enhance the ability of health practitioners and policy makers to effectively work across sectors as public health advocates. Throughout his career, Professor Levin has published extensively, led numerous international seminars, served on editorial boards of many scholarly journals, and spoken to a wide range of audiences emphasizing health in the global context of economic and social development. Clarifying the links between poverty, social inequity and health, he has increased policy makers awareness of the need to make healthy public policies through intersectoral action designed to optimize the benefits of collaborative health interventions in effective and sustainable ways. Professor Levin lives in New Haven, CT with his wife, Joanna G. Stuart, an anthropologist, and has three daughters, one step-daughter, and five grandchildren. ELLEN L. IDLER, PhD is Director of the Religion and Public Health Collaborative of Emory University and Professor in the Department of Sociology and Rollins School of Public Health. Ellen Idler is a Fellow of the Gerontological Society of America. In her academic career since first publishing The Hidden Health Care System, she earned her PhD in Sociology with training in Epidemiology from Yale University. From 1985 to 2009 she taught at Rutgers, The State University of New Jersey, where she also served as Chair of the Department of Sociology and Acting Dean of Social and Behavioral Sciences for the School of Arts and Sciences, and was a member of the Institute for Health, Health Care Policy and Aging Research, where she retains an affiliation. She studies the influence of attitudes, beliefs, and social connections on health, including the effect of self-ratings of health on mortality and disability and the impact of religious participation on health and the timing of death among the elderly. Her current projects include studies of the impact of religion on end-of-life decision-making and quality of life in the last year before death, the effect of marital status on outcomes from cardiac surgery, patterns in physician and patient global ratings of health, and age-related trends in suicide rates. Her research has been supported by funding from the National Institutiion Aging including a FIRST Award, and the Fetzer Institute. She has

Review:

The re-publication of this remarkable book could not be more timely. As America considers strategies to follow in health development, The Hidden Health Care System reminds us that achieving and maintaining health calls for strengthening the often unrecognized resource in health care -- non-professional resources that people depend on. These "mediating structures" are complementary to the formal system of medical care. They are a vital component of the health care system. A must-read for health professionals and policy makers, this book will change the way US health care is planned and implemented. Nora Ellen Groce, PhD, Leonard Cheshire Chair Department of Epidemiology and Public Health University College London --Nora Ellen Groce, PhD, Leonard Cheshire Chair Department of Epidemiology and Public Health University College London

Einstein's definition of great scholarship is meant to invoke imagination. Levin and Idler do precisely that. Hence their pioneering work strongly merits reissue, given the continuing urgency of the same topic. Every field of science has a natural history phase. Considering that the first issue of The Hidden Health Care System was published in 1981, this reissue documents how ahead of the times and how pioneering this work was! Levin and Idler's work fits the evolving social model of health. Today's model of health is deeply committed to a social model without betraying the fundaments of biology, and looks to advances in medical care to take a broader systems view. Enrico Fermi (1953) urged us to think of nature in terms of complex math. Levin and Idler remind us that our health care model is likewise complex, and hidden, though self-evident. Berton H. Kaplan, PhD.. ABMR Department of Epidemiology UNC School of Public Health --Berton H. Kaplan, PhD.. ABMR Department of Epidemiology UNC School of Public Health

Levin and Idler s, The Hidden Health Care System is in many ways even more important for academics, policymakers, healthcare providers and communities to understand today than it was when first written in 1981. Its re-release is timely in the face of all that prefaced the focus and passage of a healthcare reform bill almost 30 years later. Healthcare costs, gaps in access, and unsustainable state run programs have reached zeniths heretofore never conceived. This reality when coupled with empirical data pointing to healthcare as representing but a fraction of what can be attributable to one s health, should guide how policymakers attack these runaway problems. Perhaps more time, money and effort should be paid to the non-healthcare aspects of health. Understanding and optimizing hidden mediating structures of health may be where proportional efforts should lie. The book explains through the use of classic studies what is meant by the mediating structure , and why medical science can only take us so far. The authors chose a few such structures to discuss in more detail. Families, religion and communities are mediating structures used as exemplars in the book to illustrate the construct. A new preface acknowledges the boom in technology not widely in play when the book was first written. However, the ideas hold and may be important in the new socialization that virtual networks provide. The authors offer that mediating structures must be instrumental as well as expressive in order to help the person in ill health in any meaningful way. In other words, the family, religion or community must move from admiring the problem of the individual to actually assisting in achieving the improved outcome. It is explained that while the former task is oriented to the individual the latter is moreso to the larger society . The book illustrates how this connection of structure and society has been lost over the last centuries, leaving our healthcare in the hands of strangers. Indigenous societies are used to show how connection is important in the total or holistic health of the person, the community and beyond. The authors noted that the terms, Health and Medical care were confused decades ago. These terms remain at the root of a current debate for example, whether the Healthcare Home or Medical Home is more appropriate. They offer some health policy tips on what should be taken into consideration regarding non-professional, lay, and informal health provision-i.e. the bulk of all provision of healthcare. And, the importance of these structures has become more significant as we move more towards a nation of chronic diseases as our primary health concern. Margaret P. Moss, PhD, JD, RN, FAAN 2008-2009 RWJF (Robert Wood Johnson Foundation) Health Policy Fellow --Margaret P. Moss, PhD, JD, RN, FAAN 2008-2009 RWJF (Robert Wood Johnson Foundation) Health Policy Fellow

About this edition

• Publisher: Ballinger Pub. Co
• Publication date: 1981
• ISBN 10: 0884108228
• ISBN 13: 9780884108221
• Binding: Perfect Paperback
• Number of pages: 272