Mama Might Be Better Off Dead Analysis

In this paper, I examine the ways in which living in poverty negatively impacts the health of African-Americans, based on the ethnographic family history and study of health care policy recounted by Laurie Kaye Abraham in Mama Might Be Better Off Dead: The Failure of Health Care in Urban America. I will focus first on the barriers that poverty creates to health care on a structural and personal level. I will then discuss how the unique stresses of poverty construct specific behavioral and emotional patterns which reinforce systemic problems to exacerbate poor health outcomes. The central factor that Abraham identifies with regards to health disparities for impoverished people is the lack of access to primary care which manifests in two

When pressed about the tendency of her family to fall ill, Jackie bursts out that it just happens, not ascribing it to any outside force. This passivity manifests itself in other ways, most notably in Jackie’s refusal to learn to perform a number of home health functions in order to provide more specialized care for her grandmother. Mrs. Jackson herself struggled also to feel control over her life, especially after her first amputation confined her to the house, cutting her off from the church community that provided her with a weekly excursion, social engagement, and a sense of fulfillment. The conditions of poverty and illness combined can even preclude the possibility of self-efficacy, as demonstrated by the struggle of dialysis patients to gain or keep employment. Dialysis requires a regular time commitment and saps a great deal of energy from the people who undergo it, but dialysis centers still attempt to coax and prod patients towards the workforce. Abraham illuminates how in many cases, to do so would mean giving up the disability checks that patients rely on in favor of an uncertain job that can just as easily be lost if their health worsens, leaving them in an even more precarious situation than before. The inferior living conditions of poverty also work as a strong deterrent for any patients considering home dialysis, which requires a fair amount of medical know-how, the willingness to take charge of one’s own care, and a sterile environment, but may boost independence by giving the patient control over their schedule. For many patients, the sterile environment is impossible and they are unwilling or unable to consider taking charge of such a vital procedure. The requirements of illness and the need for governmental assistance often outweigh the ability to direct one’s own