Dying And Living
In The Neighborhood

A Street-Level View Of America's Healthcare Promise

A path-breaking book sure to redirect inquiry in the United States on how to repair our broken health care system. While economists and politicians have suggested countless ways to tinker with the overpriced and underperforming system, Singh offers a much deeper, nuanced, and humane diagnosis of the problems. This book will stir major new thinking and creative approaches towards a more effective and decent U.S. health care system.
— Jeffrey D. Sachs, Director, The Earth Institute, Columbia University

Prabhjot Singh’s “aha” moment came in 2011 when he attended the funeral for Ray, a patient who had died in his care. Ray was a veteran of the U.S. military who had struggled for years to find work, lived with un-diagnosed diabetes and a host of chronic illnesses, and had become increasingly reclusive even as the streets of his East Harlem neighborhood became less dangerous. As he sat in the pew at Ray’s funeral, Singh—whose relationship to Ray had been typical to that of a doctor and patient and who had come to know the facts of Ray’s life through medical charts and test results—was able to understand for the first time Ray’s death in the context of his life.  He witnessed the strength of the community around Ray, heard about his unique history as a military veteran, his family’s speculation that he perhaps had been illiterate, and learned more about the environmental factors that led to his declining health. Singh realized that Ray’s death had been the result of the collective failure of many systems—education, mental health, neighborhood safety, job placement, veteran support— well before Ray had been admitted to his care.

Dr. Singh had a clear understanding then that a functioning healthcare system must look beyond the walls of hospitals and clinics and into the neighborhoods— schools, offices, places of worship, parks, and homes—where the health of communities is actually determined.  In his landmark book DYING AND LIVING IN THE NEIGHBORHOOD: A Street Level View of America’s Healthcare Promise, Singh urges:  We must discard a “one-size-fits-all” healthcare system and instead reimagine a system in which healthcare is tailored to the needs of a community and is fully integrated and embedded in our neighborhoods.  

Instead of viewing healthcare as a complicated, expensive, political quagmire designed in Washington DC and orchestrated in the halls of hospitals, what if we thought of healthcare as a collaboration between schools, places of worship, city planners, community leaders, nutritionists, fitness centers, mental health experts, and doctors? What if we utilized the latest cutting edge technologies to connect these various community institutions, provide more efficient care, and give a patient more control and accountability over their own health?

In DYING AND LIVNG IN THE NEIGHBORHOOD, Singh draws on his experience in rural sub-Saharan Africa, his research in sociology and economics, and training as a physician in East Harlem to provide a blueprint that connects the dots between communities and healthcare and introduces nationally-recognized trailblazers—doctors, administrators, community institutions, and even coders—around the country who are already successfully embedding health care in neighborhood institutions.  

DYING AND LIVING IN THE NEIGHBORHOOD is a galvanizing, innovative, and grounded call to action, one that  has the power to disrupt the healthcare industry as we know it and transform the health of our nation.

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Singh’s novel and compelling look at what really causes disease is a must-read for new physicians looking to understand sources of power and ways to leverage it in today’s paradoxical health care system.
— Elizabeth H. Bradley, President, Vassar College & coauthor of The American Healthcare Paradox: Why Spending More Is Getting Us Less
A remarkable book that bridges public health and healthcare, bringing lessons of global health to the streets of New York City. Singh is the scholar we need: data-driven, practical, but ultimately impatient. He is changing healthcare one clinic, one hospital, one neighborhood, and one city at a time.
— Ashish K. Jha, Director, Harvard Global Health Institute
At this time of health care transformation, Dr. Singh champions an innovative vision for a more integrated, community-centered approach to wellness. Drawing on real-world cases and experiences, he weaves a thought-provoking narrative of how the power of collaboration across multiple spheres can build a healthier America for everyone.
— Olympia Snowe, former Senator from Maine
This brilliant and sweeping book is a rich source of insights. Prabhjot Singh draws on extensive travel, interviews and research to rightly argue that policies and business models need to be adjusted to empower neighborhoods as partners for better community health. He is one of that small, but growing, band of physicians and policymakers who recognize that better health is much more than healthcare.
— Stuart M. Butler, Senior Fellow, The Brookings Institution
Dr. Singh weaves stories of history, policy, and economics, into a rich tapestry that provides both an incisive commentary on the challenges of health economics and public policy and a poignant glimpse of the impact on the lives of real people. An important read for anyone working to transform health care and create healthy communities.
— Don Berwick, former Administrator of the Centers for Medicare and Medicaid Services
In many nations with few resources, models linking health services to communities are well developed. Except for scattered examples, the US system is largely disconnected from neighborhoods and their problems. With penetrating analysis and compelling storytelling, Prabhjot Singh calls for connecting our system to people and their neighborhoods, almost quite literally turning it on its head.
— Drew Altman, CEO, The Henry J. Kaiser Family Foundation
As a physician and resident of Harlem, Prabhjot Singh understands that good health has more to do with what happens in neighborhoods than in health care institutions. In Dying and Living in the Neighborhood, Dr. Singh exposes the realities and explores the solutions in an engaging, scholarly, and personal narrative.
— Risa Lavizzo-Mourey, former President and CEO, Robert Wood Johnson Foundation