Skip to main content

Mama Might Be Better Off Dead

The Failure of Health Care in Urban America

With a New Foreword by David A. Ansell, MD
North Lawndale, a neighborhood that lies in the shadows of Chicago’s Loop, is surrounded by some of the city’s finest medical facilities, Yet, it is one of the sickest, most medically underserved communities in the country.

Mama Might Be Better Off Dead immerses readers in the lives of four generations of a poor, African-American family in the neighborhood, who are beset with the devastating illnesses that are all too common in America’s inner-cities. Headed by Jackie Banes, who oversees the care of a diabetic grandmother, a husband on kidney dialysis, an ailing father, and three children, the Banes family contends with countless medical crises. From visits to emergency rooms and dialysis units, to trials with home care, to struggles for Medicaid eligibility, Laurie Kaye Abraham chronicles their access—or more often, lack thereof—to medical care. Told sympathetically but without sentimentality, their story reveals an inadequate health care system that is further undermined by the direct and indirect effects of poverty.

Both disturbing and illuminating, Mama Might Be Better Off Dead is an unsettling, profound look at the human face of health care in America. Published to great acclaim in 1993, the book in this new edition includes an incisive foreword by David Ansell, a physician who worked at Mt. Sinai Hospital, where much of the Banes family’s narrative unfolds.


Read the introduction. An audiobook version is available.

304 pages | 6 x 9 | © 1994

Anthropology: Cultural and Social Anthropology

Chicago and Illinois

Economics and Business: Health Economics

Political Science: Public Policy, Race and Politics, Urban Politics

Social Work

Sociology: Medical Sociology, Urban and Rural Sociology


“A provocative examination of our health care delivery for the poor. . . . Such an honest and candid account is essential if we are to seriously explore a restructuring of the health care system.”

Alex Kotlowitz, author of There Are No Children Here

“Goes to the heart of today’s problem in just a few words: ‘Health care is treated as a commodity available to those who can afford it, rather than a public good.’ . . . Powerful . . . deeply searching.”

Victor Cohn | Washington Post

“Abraham has done prodigious research, and her grasp of the [Banes] family’s dizzying ride is formidable. . . . A powerful indictment of the big business of medicine.”

Los Angeles Times

“Abraham doesn’t pretend to have the answers—but she illuminates the problems with passion and skill.”

Kirkus Reviews

“This personally observed, lucid chronicle and call for reform of our ailing health system covers all levels of responsibility in the medical establishment, and deserves scrutiny by our administration’s health service planners.”

Publishers Weekly

Table of Contents

1: "Where crowded humanity suffers and sickens": The Banes family and their
2: The rigors of kidney dialysis for Robert Banes
3: Gaps in government insurance for Mrs. Jackson
4: Fitful primary care fails Mrs. Jackson
5: Mrs. Jackson’s melancholy
6: The inner-city emergency room
7: One hospital’s story: How treating the poor is "bad" for business
8: Who’s responsible for Tommy Markhams’s health?
9: Jackie Banes’s "patient"
10: Empty promises: Preventive care for the Banes children
11: Robert Banes plays the transplant game
12: The Banes family and white doctors
13: Life-sustaining technology
14: Amazing grace

Be the first to know

Get the latest updates on new releases, special offers, and media highlights when you subscribe to our email lists!

Sign up here for updates about the Press