Across the contiguous 48 states, populations in states with more activist civic cultures have lower mortality than states that do not follow this model. Several different factors can be pointed to as causes for this discrepancy - net income, class inequality, and the history of settlement in each of the different states and regions. These observations are true of Non-Hispanic Whites and African Americans but not of American Indians, and Hispanics, neither of which is fully integrated into the state political culture and economy in which it resides. In Regional Cultures and Mortality in America, the struggles these various populations face in regard to their health are explored in terms of where they reside.
- Emphasizes regional and state histories as the root of the existence of different state cultures
- Examines how state political cultures and civic activism influence the health of said state's citizens
- Shows how some populations are at a disadvantage due to state political culture and civic activism, which are irrelevant as they are not fully integrated into the life of their states, leading to increased rates of mortality
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Reviews & endorsements
'This is a masterly and important study from one of the leading and most historically knowledgeable analysts of diverse health trends. The deep knowledge that Dr Kunitz draws from his highly productive career enables him to combine a coherent synoptic vision with illuminating case studies that explore the distinct health fortunes of indigenous and Hispanic populations. This is history that policy makers urgently need to know and to reflect on.' Simon Szreter, St John's College, Cambridge
'Understanding what determines differences in health between populations is a central preoccupation of public health. Stephen Kunitz tackles the heterogeneity of mortality experience across individual states in the United States. In a scholarly and thought-provoking manner, he draws on a broad literature to argue that historically informed differences in state culture, running back centuries, influence health via the manner in which communities mobilize state and private institutions to advance the public good. This book is an important contribution to the study of determinants of population health, challenging as it does simplistic one-dimensional explanations. Its scope and intelligence will engage anyone interested in these big and difficult questions.' David Leon, London School of Hygiene and Tropical Medicine
'Stephen Kunitz has given us an inspiring book of extraordinary importance. He engages historical perspectives, regional cultures, national institutions and social traumas in the study of mortality. His approach might be of interest to scientists in many fields, and to humanists in many disciplines, as an example of how we might learn from one another.' David Hackett Fischer, Earl Warren Professor of History, Brandeis University, Massachusetts
'… provides a much-needed explanation for a long-standing and well-documented problem: regional and social inequality in mortality in the United States … Kunitz's investigation into the social determinants of health and mortality in the United States takes a broad structural perspective that is refreshing to readers of the population health literature.' Andrew Fenelon, Population and Development Review
'Regional Cultures and Mortality in America presents a novel approach that may challenge the traditional way policymakers, public health practitioners, and many other disciplines develop one-size-fits-all programs designed to change risk behavior at the individual level. Kunitz makes a thorough and compelling argument that we must take a broader look at a state's culture, policies and institutions, while mindful of differences in mortality among subpopulations.' Jillian Jacobellis, New Mexico Historical Review
'Stephen Kunitz has presented a thought-provoking book that engages history, public health, and economics … Scholars will certainly continue to think about the ways in which regional variation informs how people die, and therefore with an eye for helping people live.' Richard M. Mizelle, Jr, Bulletin of the History of Medicine
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Product details
- Date Published: March 2015
- format: Hardback
- isbn: 9781107079632
- length: 265 pages
- dimensions: 240 x 160 x 20 mm
- weight: 0.53kg
- contains: 73 b/w illus. 1 map 50 tables
- availability: Available
Table of Contents
Part I. The National Perspective:
1. Institutions, income, and mortality in the United States
2. Institutions and the mortality of African Americans, Hispanics, and American Indians
3. Regional patterns of urban African American mortality
Part II. Local Studies:
4. Extremes of mortality in the poorest states
5. Regional differences in American Indian mortality
6. Hispanic mortality in New Mexico
7. Conclusion.
Look Inside
Author
Stephen J. Kunitz, University of Rochester, New York
Stephen J. Kunitz is Professor Emeritus at the University of Rochester School of Medicine. Much of his past research has been focused on the Navajos in the American Southwest. He is the author of Disease Change and the Role of Medicine: The Navajo Experience (1983); as well as co-author, with J. E. Levy, of Indian Drinking: Navajo Practices and Anglo-American Theories (1974); Navajo Aging: The Transition from Family to Institutional Support (1991); Drinking Careers: A Twenty-Five Year Follow-Up of Three Navajo Populations (1994); and Drinking, Conduct Disorder, and Social Change: Navajo Experiences (2000). He is also the author of Disease and Social Diversity (1994) and The Health of Populations (2007). He held a Robert Wood Johnson Foundation Health Policy Investigator Award in 2002–6 and is the recipient of two Fulbright awards.