Citation

Fleming MD, Shim JK, Yen I, Van Natta M, Hanssmann C, Burke NJ. Med. Anthropol. Q. 2019; 33(2): 173-190.

Affiliation

Department of Anthropology, History and Social Medicine, University of California, San Francisco.

Copyright

(Copyright © 2019, American Anthropological Association, Publisher John Wiley and Sons)

DOI

10.1111/maq.12481

PMID

30291726

Abstract

Hospitals throughout the United States are implementing new forms of care delivery meant to address social needs for structurally vulnerable patients as a strategy to prevent emergency department visits and hospitalizations and to thereby reduce costs. This article examines how the deployment of social assistance within a neoliberal institutional logic involves the negotiation and alignment of economistic values with ethics of care. We focus on care practices meant to stabilize the socioeconomic conditions of the most expensive patients in the health care system-the "super-utilizers"-through the provisioning of basic resources such as housing, food, transportation, and social support. These patients typically suffer from multiple chronic illnesses accompanied by conditions of poverty, housing and food insecurity, exposure to violence and trauma, and associated substance use and mental health problems. We offer an account of how practices of social assistance are being forged within contexts defined by neoliberal governance. [super-utilizers, cost effectiveness, neoliberalism, justice, social determinants of health] This article is protected by copyright. All rights reserved.

This article is protected by copyright. All rights reserved.

Language: en