Book Reviews

Braithwaite, Ronald L., & Taylor, Sandra E. (Eds.) (2001). Health Issues in the Black Community (2nd ed.). San Francisco: Jossey-Bass. 528 pp., $55.00. ISBN: 0-7879-5236-2.

Editors Ronald Braithwaite and Sandra Taylor, with a foreword from Rev. Jesse Jackson, offer a comprehensive view of health issues and problems impacting health in the African American community. They observe that the health status gap between disenfranchised and affluent citizens continues to widen. This edition addresses contemporary health challenges confronting African Americans and discusses relevant strategies and policy implications for government agencies and community organizations. The editors present information on the most salient health concerns of this population as evidenced by morbidity and mortality indicators. A common theme transcending the various chapters is the "need for demonstrative change if the Black community is to achieve significantly improved health in the new millennium."

The book is divided into five parts. The first part takes a life span perspective in considering the health status of African American children and adolescents, men, women, and the elderly. The second section addresses social, mental and environmental challenges, with particular attention to mental disorders, disproportionate rates of homicide and violence, the role of Black faith communities in fostering health, and culturally sensitive issues of organ and tissue donation and transplantation. Part three reports on the status of several chronic diseases that unevenly affect African Americans, such as hypertension, cancer, diabetes, sickle cell anemia, and new to this edition, asthma. Part four, "Lifestyle Behaviors," draws attention to several self-defeating health behaviors that negatively affect health status, including sexual behaviors related to HIV/AIDS, smoking, abuse of alcohol and drugs, and nutrition and exercise. The final section highlights ethical, political, and ecological issues that are critical to consider when taking a wider contextual perspective on improving the health and quality of life in African American communities.

The various chapters are full of statistics and figures that document and portray the disparities between African Americans and the majority culture. In varying degrees, chapter authors assume an activist stance, calling for needed changes to right previous injustices. A cultural distrust of health care researchers and reluctance to be involved in research—resulting in part from the unethical Tuskegee syphilis study —was mentioned by several authors as a barrier to more complete understanding of African American health issues. The authors offer practical ideas, describe model programs, suggest interventions, and list pertinent resources. I found these to be especially helpful and hope-inducing antidotes to what could be seen as overwhelming and discouraging difficulties.

I recently saw a brief news report indicating that mortality rates for African Americans with cancer were much higher than for whites with comparable disease states, but when Blacks had access to and received similar treatments as whites, the rates were virtually even. This dense, information-packed edited text helped to shed light upon how and why such disparities exist. More importantly, this book offers solutions and suggestions to health inequities such as these that will likely continue to be serious challenges as costs for health care and health insurance steadily increase.

Cohen, Donna & Eisdorfer, Carl (2002). The Loss of Self: A Family Resource for the Care of Alzheimer's Disease and Related Disorders. New York; Norton. 461 pp., $16.95. ISBN: 0-3933-2333-1.

The Loss of Self: A Family Resource for the Care of Alzheimer's Disease and Related Disorders is a welcome revised edition of the same book first written in 1986. For families who are dealing with the challenges of Alzheimer's disease, there are few references that deliver as much information. For professionals, this book serves as a good introduction to the concepts of Alzheimer's and related dementias. While some chapters explain how the diagnosis of Alzheimer's is made, others describe what to expect after diagnosis. This book covers a wide range of information, including delicate topics that caregivers may encounter but be afraid to inquire about such as sexuality, patient assaultiveness, and death and dying. Chapters for the caregiver also provide information on self care and depression so that caregivers may become informed and aware of the signs and symptoms that they might be experiencing.

I recommend this book to both the layperson and the professional. The authors, with great sensitivity, weave anecdotes throughout the book that patients and their family members have experienced in dealing with this devastating disease, effectively conveying to the reader what it means to have dementia as a diagnosis. Communicating on a very human level yet informing at the same time, Cohen and Eisdorfer allow those of us who have no experience with Alzheimer's the ability to peek into the worlds of those who do. A powerful message of hope and compassion is extended to the reader throughout this family resource book.