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Book Reviews   |    
Health Care in the Black Community: Empowerment, Knowledge, Skills, and Collectivism
Reviewed by Irma J. Bland, M.D.
Psychiatric Services 2002; doi: 10.1176/appi.ps.53.8.1038
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edited by Sadye L. Logan, D.S.W., and Edith M. Freeman, Ph.D.; New York, Haworth Press, 2000, 276 pages, $69.95 hardcover, $34.95 softcover

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As health care professionals, physicians have finally come to realize that the administering of our knowledge, the practice of our skills, and the prescribing of our medications often fall far short of our goals. This is particularly true when our practice of medicine fails to recognize the specific social issues and cultural realities that affect our patients' lives.

Research continues to bear out this reality, as reflected in the health statistics of African Americans and other ethnic minority populations. As the authors of Health Care in the Black Community point out, African Americans continue to suffer disproportionately from a number of diseases that result in chronic disability and cause premature death. In spite of the advances in medical science and the development of more effective treatments and innovations in health care delivery, substantial disparities remain between African Americans and the general population in physical and mental health and in the delivery of health care services. This book proposes a comprehensive approach to bridge this gap.

The volume editors are eminently qualified professors of social work who have focused much of their scholarly work on the health and welfare of families in the interface of culture and community. For this book they brought together a distinguished and diverse group of academic scholars, researchers, and clinicians representing the fields of social work, psychology, and medicine. From the perspective of their disciplines, research, or clinical practices, the authors provide an overview of the most serious and persistent health problems affecting African Americans, identify and examine current issues that affect their health care, and offer solutions to these issues. They identify areas of knowledge, skills, and forms of collectivism that have traditionally supported the survival of blacks and illustrate how building on these strengths, values, and cultural traditions can foster more effective health education and enhance prevention and early intervention.

How can we increase utilization, enhance medical compliance, promote health and wellness, and improve the health status of African Americans? The authors offer a number of innovative models. They illustrate the effectiveness of partnerships with the black church to provide health education and social support such as weight reduction programs and drug abuse prevention programs; use of mutual assistance groups to augment health care for people with chronic illnesses; other community-centered initiatives; and educational and behavioral strategies targeting health care utilization, medical compliance, and the promotion of wellness.

Of particular interest to mental health professionals are models that focus on strengthening families and building social competence and emotional skills. These include competence development models to enhance the family's capacity to build competence and self-esteem in their children and frameworks that assist families in examining relationships and understanding, alleviating, and preventing violence as a means of coping with stress.

This book should be of interest to clinicians, faculty, and students in the social service and health care professions, persons involved in the delivery of health services to African Americans and other racially or ethnically diverse populations, and anyone interested in a multisystems approach to health care delivery.

It is time for physicians to partner more effectively with colleagues from social work, psychology, and other health professions. In the empowerment framework of this book, the authors put forth innovative models that are culturally sensitive, that have been shown by research to be effective, and that can support and enhance all individuals, families, and communities in efforts to improve utilization, medical compliance, and physical and mental health.

Dr. Bland is clinical professor of psychiatry at the Louisiana State University Health Sciences Center and regional administrator and chief executive officer of the Office of Mental Health, Region-1, in New Orleans.




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