Poor Families in America's Health Care Crisis examines the implications of the fragmented and two-tiered health insurance system in the United States for the health care access of low-income families. For a large fraction of Americans their jobs do not provide health insurance or other benefits and although government programs are available for children, adults without private health care coverage have few options. Detailed ethnographic and survey data from selected low-income neighborhoods in Boston, Chicago, and San Antonio document the lapses in medical coverage that poor families experience and reveal the extent of untreated medical conditions, delayed treatment, medical indebtedness, and irregular health care that women and children suffer as a result. Extensive poverty, the increasing proportion of minority households, and the growing dependence on insecure service sector work all influence access to health care for families at the economic margin.

"This book provides evidence in rich and specific detail of the 'human experience of dealing with serious adversity'. An important message of this book is the consequences for health of uncertainty in the structural conditions and personal lives of the working poor — "physical and social environments that seem to attack and undermine an impoverished family's every effort to get ahead." Rich qualitative data give these findings the context and specificity of personal experiences and stories." -Thomas S. Weisner, University of California, Los Angeles"Poor Families in America's Health Care Crisis is an important and timely book. Ronald J. Angel, Laura Lein, and Jane Henrici have analyzed rich data collected in selected neighborhoods in Boston, Chicago, and San Antonio to provide a compelling account of the health of poor families and their untreated medical conditions. The information in this book is disturbing, but it is a must read for those concerned about the lack of health insurance and access to health care for millions of American families." -William Julius Wilson, Harvard University“'Women and children first' has come to mean that, when poor, they are the first to suffer the gaps, delays, disrespect and lack of care endemic to the United States' two tiered health care system. Poor Families in America's Health Care Crisis makes these stories vivid and specific as the book's analysis is anchored to real people's experiences. The book should fuel our determination and equip us to fix this cruel situation." -Wendy Chavkin, Columbia University

For a large fraction of Americans their jobs do not provide health insurance or other benefits and although government programs are available for children, adults without private health care coverage have few options. Detailed ethnographic and survey data reveal a number of untreated medical conditions among this population, as well as serious medical indebtedness, job loss due to illness, and delayed health care. Poverty, the increasing proportion of minority households, and the dependence on insecure service sector work all influence access to health care for families at the economic margin.

This documents the holes in the health care safety net for poor and minority Americans.

1. The unrealized hope of welfare reform: implications for health care; 2. The health care welfare state in America; 3. The tattered health care safety net for poor Americans; 4. State differences in health care policies and coverage; 5. Work and health insurance: a tenuous tie for the working poor; 6. Confronting the system: minority group identity and powerlessness; 7. The nonexistent safety net for parents; 8. Health care for all Americans.