Paper $18.00 ISBN: 9780226641669 Published March 2019 For sale in North America and the British Commonwealth only
Cloth $26.00 ISBN: 9780226428154 Published April 2017 For sale in North America and the British Commonwealth only
E-book $18.00 About E-books ISBN: 9780226428291 Published April 2017 Also Available From
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The Death Gap

How Inequality Kills

David A. Ansell, MD

The Death Gap

David A. Ansell, MD

240 pages | 23 halftones | 6 x 9 | © 2017
Paper $18.00 ISBN: 9780226641669 Published March 2019 For sale in North America and the British Commonwealth only
Cloth $26.00 ISBN: 9780226428154 Published April 2017 For sale in North America and the British Commonwealth only
E-book $18.00 About E-books ISBN: 9780226428291 Published April 2017
We hear plenty about the widening income gap between the rich and the poor in America and about the expanding distance separating the haves and the have-nots. But when detailing the many things that the poor have not, we often overlook the most critical—their health. The poor die sooner. Blacks die sooner. And poor urban blacks die sooner than almost all other Americans. In nearly four decades as a doctor at hospitals serving some of the poorest communities in Chicago, David A. Ansell, MD,  has witnessed firsthand the lives behind these devastating statistics. In The Death Gap, he gives a grim survey of these realities, drawn from observations and stories of his patients.

While the contrasts and disparities among Chicago’s communities are particularly stark, the death gap is truly a nationwide epidemic—as Ansell shows, there is a thirty-five-year difference in life expectancy between the healthiest and wealthiest and the poorest and sickest American neighborhoods. If you are poor, where you live in America can dictate when you die. It doesn’t need to be this way; such divisions are not inevitable. Ansell calls out the social and cultural arguments that have been raised as ways of explaining or excusing these gaps, and he lays bare the structural violence—the racism, economic exploitation, and discrimination—that is really to blame. Inequality is a disease, Ansell argues, and we need to treat and eradicate it as we would any major illness. To do so, he outlines a vision that will provide the foundation for a healthier nation—for all.

Inequality is all around us, and often the distance between high and low life expectancy can be a matter of just a few blocks. But geography need not be destiny, urges  Ansell. In The Death Gap he shows us how we can face this national health crisis head-on and take action against the circumstances that rob people of their dignity and their lives.
Preface: One Street, Two Worlds

Part 1: American Roulette

Chapter 1: American Roulette
Chapter 2: Structural Violence and the Death Gap
Chapter 3: Location, Location, Location
Chapter 4: Perception Is Reality
Chapter 5: The Three Bs: Beliefs, Behavior, Biology

Part 2: Trapped by Inequity

Chapter 6: Fire and Rain: Life and Death in Natural Disasters
Chapter 7: Mass Incarceration, Premature Death, and Community Health
Chapter 8: Immigration Status and Health Inequality: The Case of Transplant

Part 3: Health Care Inequality

Chapter 9: The US Health Care System: Separate and Unequal
Chapter 10: The Poison Pill: Health Insurance in America

Part 4: The Cure

Chapter 11: Community Efficacy and the Death Gap
Chapter 12: Community Activism against Structural Violence
Chapter 13: Observe, Judge, Act

Review Quotes
Christian Century
"Compelling. . . . Without providing easy answers, Ansell challenges readers to be aware of health disparities and to work toward equality."
Clare Bambra | Times Higher Education
"This passionate polemic uses powerful patient stories to highlight the importance of neighbourhood conditions, healthcare inequalities and poverty in explaining the health gap between black and white Americans. Drawing on detailed case studies of racial inequalities in breast cancer mortality, the health consequences of mass imprisonment, immigration status and access to healthcare, the Chicago heatwave and Hurricane Katrina, Ansell vividly unpicks a spider’s web of causality. . . . This is a wide-ranging and very important book. Easy to read and engaging, it makes the social determinants come alive."
Beryl Satter, author of Family Properties: How the Struggle over Race and Real Estate Transformed Chicago and Urban America
“Ansell does a magnificent job of uncovering the myriad ways in which structural racism — in housing, employment, education, and health care, for a start — creates unacceptable ‘death gaps’ or disparities in life expectancy that are preventable and therefore morally unacceptable.  This moving study delivers the harsh truth about the ways that racism infects our nation’s health care system, and it does so with passion and eloquence.  One comes away from Death Gap feeling inspired to act, and that’s a rare and wonderful accomplishment.”
Harold Pollack, University of Chicago
 “The Death Gap describes critical health inequalities in the United States, which are drawn from Ansell’s  gripping first-person experiences as a leading practitioner operating in Chicago’s medical safety net. He reveals the profound inequalities, particularly racial inequalities, that generate tremendous differences in lifespan and well-being across neighborhoods, and he provides powerful patient anecdotes that provide a human face to otherwise abstract challenges.”

Eve Ottenberg | Truthout
"How race and class affect health is demonstrated by a single statistic: Black women are 40 percent more likely to die from breast cancer than white women, though they develop it at the same rate... The Death Gap cites the three B’s – beliefs, behavior and biology – as the wrong explanations for health and life expectancy differences."
Association of Professional Chaplains
"...a valuable and challenging book for any audience."
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