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Brotherton, S. P. (2010). Review Essay of Social Relations and the Cuban Health Miracle, by Elizabeth Kath. Contemporary Sociology: A Journal of Reviews 40 (4), 459-460

Social Relations and the Cuban Health Miracle is Elizabeth Kath’s attempt to explain the seeming paradox of Cuba’s health care system: How has a small developing country with scarce resources, experiencing a fiscal crisis, managed to achieve laudable health outcomes? To answer this question, Kath moves beyond a facile analysis of Cuba’s vital health statistics to examine the institutional and personal dynamics that constitute Cuba’s “health miracle.” The author’s main point is that “non-material factors,” such as the collaborative relationships among a diverse group of actors, including health workers, the state and different institutions, have proven influential in helping Cuba achieve its national health goals. These factors are effective for health policy implementation, she notes. Nevertheless, as she further argues, the state-centered, top-down approach in the design of Cuba’s health policies provides no opportunities for popular participation or cooperation. This has led to some adverse consequences for quality of health care delivery in the country.

The general conclusions this study draws are not remarkable in and of themselves, as most of these observations have been well documented in the health policy literature. The original contribution of this book, however, is the alternative theoretical framing the author presents in Chapter Two to analyze the Cuban case study. Marshalling a somewhat overwrought …


Brotherton, Sean P.

Brotherton’s research and teaching interests include the critical study of health, medicine, the state, subjectivity, and the body. His theoretical references draw on contemporary social theory and postcolonial studies. His ethnographic research is carried out in the Caribbean, particularly...

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