An Unfinished Revolution: Women and Health Care in America
Emily Friedman, editor
United Hospital Fund of New York, New York City
1994, 304 pp., $20 (paperback)
In 1990 the United Hospital Fund of New York, the century-old research and philanthropic organization dedicated to improving healthcare in New York City and across the nation, believed it impossible to understand the future of healthcare without considering questions of gender. In response, the fund sponsored a one-day conference, "Taking Care: The Impact of Women on Health Care." So enthusiastic was the response to the conference that the organization undertook to publish a book that draws on and develops the ideas presented at the conference.
The book's strongest draw is its editor, health policy writer and analyst Emily Friedman. Friedman is an exceptionally insightful observer of all aspects of our nation's healthcare system and an even better writer when it comes to explaining complex realities. I have read and relished everything she has written. I would have been delighted if Friedman had been the author of the entire book rather than editor for 19 other authors. She wrote the introductory article and, as is her style, completely summed up the entire book. When she finished, there was little left to say other than the statistics to back up the conclusions.
Three to six writers cover each of the book's four sections:
- "Women as Users of Health Services"
- "Women and Informal Caregiving"
- "Women as Health Care Providers"
- "Women as Health Care Leaders"
In "Women as Users of Health Services," the authors express a clear prejudice that a woman should have full autonomy over her body and that abortion should be safe and legal. Some Catholic readers will find such a view offensive, and some will not read beyond this section.
In the book's other sections, the information presented is pretty predictable but there are a lot of statistics to back up the claims. Most people in healthcare know that women do more care giving than men; that women have dominated nursing but have had a lesser role in medicine and administration; and that women will have a more active future role as healthcare leaders.
The overall message of the book is best captured in a quote from Friedman's introductory article (p. 11):
Women and health care are inextricably intertwined, like a bramble and a rose. The good and the bad come with the territory. Health care has both used women and benefitted them. It has largely excluded them from professions where they could do much good, yet it gave them, in nursing, one of the most beloved professions in American society. It has often been paternalistic toward their diseases and concerns, yet it has also largely eliminated some of the horrible scourges that claimed the lives of women over the centuries. It has been extraordinarily dependent on women workers, and has succeeded because of them, but has often relegated them to positions of powerlessness.
An Unfinished Revolution: Women and Health Care in America is intended for a wide readership — presumably any woman and man in healthcare. I doubt the readership will be that broad. I believe policymakers and academicians are going to be most interested in the statistics and technical information presented here. They will benefit most from the material presented.
Jane E. Poe
Vice President, Mission Services and Member Relations
Catholic Health Corporation
Omaha