Health Affairs Book Review: Bridging The Death Gap

By: Damon Tweedy, Health Affairs

Headlines portray Chicago, Illinois, as the epicenter of urban gun violence. But most premature deaths among Chicago’s black residents are caused by heart disease, diabetes, and cancer. In his new book, The Death Gap, David Ansell, senior vice president and associate provost for community health equity and a professor of medicine at Chicago’s Rush University Medical Center, asserts that structural violence is the true cause of the dramatic racial differences in death rates and life expectancy across Chicago neighborhoods. According to Ansell, this form of violence—rooted in past and present social, economic, and racial inequality—saps the lives of residents in poor neighborhoods and results in the death gap. Chicago, in this narrative, is a microcosm of America.

Ansell is a well-known advocate on the subject. In recent years he has published a memoir (County: Life, Death, and Politics at Chicago’s Public Hospital) and an essay in the New England Journal of Medicine that examine the adverse impact of bias (within health care institutions and among physicians) on black-white health differences. In this new book, he takes a larger view, focusing on how factors outside of the health care system—neighborhood segregation, in particular—affect health.

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