This essay summarizes key insights across the essays in the Hastings Center Report's special report “Time to Rebuild: Essays on Trust in Health Care and Science.” These insights concern trust and trustworthiness as distinct concepts, competence as a necessary but not sufficient input to trust, trust as a reciprocal good, trust as an interpersonal as well as structural phenomena, the ethical impermissibility of seeking to win trust without being trustworthy, building and borrowing trust as distinct strategies, and challenges to trustworthiness (...) posed by the contingent nature of science. Together, these insights stand to advance an area of research that we believe has been historically stymied by conceptual confusion and a long‐standing insistence on treating trust as a purely instrumental good. (shrink)

Many health care organizations made public commitments to become antiracist in the wake of George Floyd's murder. These actions raise questions about the appropriateness of health care's engagement in racial justice and social justice movements generally. We argue that health care organizations can be usefully thought of as having two roles: a functional role to care for the sick and a meta‐role as an organizational citizen. Fulfilling the role of citizen may require participating in the pursuit of social justice, including (...) efforts to achieve racial equity. The demands of these two roles will need to be balanced, but the role of organizational citizen has been largely ignored and merits serious attention. (shrink)

P-adic logarithms are used to translate localization sequences, involving multiplicative groups of units, to simpler additive descriptions of [italic]D([double-struck]Z[italic]G) and [bold]Wh′([italic]G) for the [italic]p-group [italic]G. The goal of this paper is to work out a procedure for using logarithms to translate the localization sequences in to sequences involving additive groups.

The health policy community has a growing interest in the impact of nonmedical determinants of health, such as housing, nutrition, and social supports, on both health outcomes and costs. This interest has been spurred by the Affordable Care Act’s emphasis on prevention, Robert Wood Johnson’s grant‐making focus on a Culture of Health, and an uptick of research demonstrating the potential returns to health care from investments in social services. Much of this policy‐making, grant making, and research has focused on older (...) Americans.The direct policy implications of this strategy can be elusive. It has become clear that more than medicine will be necessary to improve older Americans’ health status. Real improvement likely requires the development of additional social service offerings, including housing that is accessible to people with disabilities, Meals on Wheels‐type nutrition supports, and transportation. But who should bear the costs and control the finances associated with these programs? In this essay, I explore the question of how policy‐makers should consider financing nonmedical investments in older Americans’ health. As the reader will recognize, I stop short of arguing for what will work. Rather, I identify the strands of an emerging strategy—namely, for health care dollars to be diverted into social service programming—and offer several cautions. It may be that policy‐makers still wish to continue down this path, but my hope is that this essay will allow them to so with greater attention to the risks and unintended consequences of that strategy. (shrink)

In 2013, one year after the enactment of the landmark Mental Health Act, a small team of psychiatrists, psychologists, and statisticians from the University of Ghana Medical School began a controversial field-based randomized-control trial entitled "Joining Forces" at the Mount Horeb prayer camp. Located about 45 minutes outside of Accra, Mt. Horeb is one of the largest and best known prayer camps in Ghana. It is an Evangelical Pentecostal organization whose mission is to "set free those held captive by Satan (...) through a ministry of fasting and prayer". Mount Horeb had a well-documented track record of human... (shrink)

Since early 2014, i have studied what life is like for staff in a mental health sanatorium at a Ghanaian prayer camp. I have traveled to the camp on six occasions to observe its rhythms and routines and interview staff about their work. What follows is an informal reflection on the role of prayer camps as a source of mental health care in Ghana. The text is based on my experience conducting the research at the camp, rather than a formal (...) reporting of results. As such, I make minimal references to theoretical frameworks and previous literature and instead have relied on my own field notes and recreated conversations I had with one staff member in particular.Despite longstanding records of human rights abuses, many... (shrink)

For global health academics and practitioners, it can feel as though we are living in a tyranny of partnerships. The primary trappings of professional success in global health—funding and publications—increasingly rely on the presence or absence of institutional partnerships. Funders often require letters of support from collaborators, and the literature routinely lauds partnerships as the "secret sauce" necessary to solve intractable problems. Commonly, the term describes relationships between entities in the Global North and the Global South, serving as a euphemism (...) for relationships that, at their core, are premised on a transfer of resources from the former to the latter. Many partnerships... (shrink)

David Dranove and Lawton Burn’s new collaboration Big Med: Megaproviders and the High Cost of Health Care in America provides readers with a comprehensive tutorial on consolidation in United States healthcare markets over the past 40 years. Although the book is most explicitly aimed at those who look around and wonder how we arrived at a healthcare landscape dominated by giants, anyone with a serious interest in the prices of U.S. healthcare will want to have this rigorous and timely treatment (...) on their bookshelf. (shrink)