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Book Reviews   |    
Disability and the Black Community
Reviewed by Altha J. Stewart, M.D.
Psychiatric Services 2005; doi: 10.1176/appi.ps.56.2.227
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by Sheila D. Miller; New York, Haworth Press, 2002, 239 pages, $24.95 softcover

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Although the literature related to the complex and diverse disability concerns and needs of the black community has increased in the past two decades, there are still gaps and inconsistencies in translating theory and knowledge into practice. An already marginalized population, black persons with disabilities are further disenfranchised by the stigma and discrimination related to their disability. Disability and the Black Community is relevant to all health and human service professionals, because it expands the focus beyond treatment and intervention to include other important cultural and socioeconomic stressors that influence disabilities and those adapting to disability in the black community. Sheila D. Miller and her contributors have diverse perspectives on the needs of black individuals with disabilities. As the national debate on reducing health care disparities continues, the topics discussed in this book are timely and relevant.

The aim of the book is to motivate, influence, and empower communities, including providers and policy makers. Disability and the Black Community goes beyond a traditional review of health care services and reforms, with several authors providing an overview of the history of the development of current service delivery systems and the systemic deficiencies that account for the inadequate treatment of black people. The inclusion of such background and historical information makes the book useful for both beginning and veteran practitioners. Mental health and social service professionals at all levels should find this book helpful.

Several authors describe the variables to be taken into account to ensure appropriate inclusion of a cultural perspective in dealing with black persons with disabilities and highlight the need to shift from crisis-oriented and reactive responses in the current system to a more proactive, fully integrated approach. In addition, several authors confront assumptions and stereotypes about blacks and the roles such biases play in response to disability by individuals, their communities, and the service delivery system. Several contributors offer specific, culturally appropriate strategies for effective interventions designed to improve quality of life for these individuals.

Topics of importance to black individuals, such as mental health services for children, chronic medical illnesses (sickle cell anemia, arthritis, HIV infection and AIDS, and end-stage renal disease), domestic violence, foster care, housing, education and workforce training, and the cultural resiliency required to overcome the challenges they present are discussed. Adolescent males, a high-risk group, are the subject of three articles. One article describing the quality of life of black hemodialysis patients is especially thought provoking as we learn more about the metabolic and possible end-organ effects of newer psychotropic medications.

No matter what their professional orientation, those who work with black persons with disabilities will find that Disability and the Black Community offers useful information to support the belief that culture, instead of being viewed as an "add-on," should be viewed as improving care for all those we serve.

Dr. Stewart is president of the American Psychiatric Foundation and leads a minority health care firm based in Memphis, Tennessee, that provides consultative services to nonprofit health and behavioral health systems, governmental agencies, and private corporations.

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