Our public health system is primarily concerned with the promotion of health and the prevention of disease. But while everyone may agree with these goals in principle, in practice public health is a highly contentious policy arena. that is inevitably entangled with sensitive issues ranging from occupational safety and environmental hazards to health education, immunization, and treatment of addiction and sexually transmitted disease. Today however, concern for protecting the population against bio-terrorism and new epidemics such as SARS is tipping the balance back toward increased support for public health. This book focuses on the politics, policies, and methodologies of public health and the twenty-first century challenges to the public health system of the United States. It explores the system's relatively weak position in the American political culture, medical establishment, and legal system; scientific and privacy issues in public health; and the challenges posed by ecological risk and the looming threat of bio-terrorist attack. Each chapter includes study questions. The volume also includes a chronology of major laws and events in public health policy along with an extensive bibliography.

Health is political. It entails fierce battles over the allocation of resources, arguments over the imposition of regulations, and the mediation of dueling public sentiments—all conflicts that are often narrated from a national, top-down view. In All Health Politics Is Local, Merlin Chowkwanyun shifts our focus, taking us to four very different places—New York City, Los Angeles, Cleveland, and Central Appalachia—to experience a national story through a regional lens. He shows how racial uprisings in the 1960s catalyzed the creation of new medical infrastructure for those long denied it, what local authorities did to curb air pollution so toxic that it made residents choke and cry, how community health activists and bureaucrats fought over who'd control facilities long run by insular elites, and what a national coal boom did to community ecology and health. All Health Politics Is Local shatters the notion of a single national health agenda. Health is and has always been political, shaped both by formal policy at the highest levels and by grassroots community battles far below.

An insightful chronicle of the changing public health demands in New York City. The first permanent Board of Health in the United States was created in response to a cholera outbreak in New York City in 1866. By the mid-twentieth century, thanks to landmark achievements in vaccinations, medical data collection, and community health, the NYC Department of Health had become the nation's gold standard for public health. However, as the city's population grew in number and diversity, the department struggled to balance its efforts between the treatment of diseases—such as AIDS, tuberculosis, and West Nile Virus—and the prevention of illness-causing factors like lead paint, heroin addiction, homelessness, smoking, and unhealthy foods. In Epidemic City, historian of public health James Colgrove chronicles the challenges faced by the health department since New York City's mid-twentieth-century "peak" in public health provision. This insightful volume draws on archival research and oral histories to examine how the provision of public health has adapted to the competing demands of diverse public needs, public perceptions, and political pressure. Epidemic City analyzes the perspectives and efforts of the people responsible for the city's public health from the 1960s to the present—a time that brought new challenges, such as budget and staffing shortages, and new threats like bioterrorism. Faced with controversies such as needle exchange programs and AIDS reporting, the health department struggled to maintain a delicate balance between its primary focus on illness prevention and the need to ensure public and political support for its activities. In the past decade, after the 9/11 attacks and bioterrorism scares partially diverted public health efforts from illness prevention to threat response, Mayor Michael Bloomberg and Health Commissioner Thomas Frieden were still able to pass New York's Clean Indoor Air Act restricting smoking and significant regulations on trans-fats used by restaurants. This legislation—preventative in nature much like the department's original sanitary code—reflects a return to the nineteenth century roots of public health, when public health measures were often overtly paternalistic. The assertive laws conceived by Frieden and executed by Bloomberg demonstrate how far the mandate of public health can extend when backed by committed government officials. Epidemic City provides a compelling historical analysis of the individuals and groups tasked with negotiating the fine line between public health and political considerations. By examining the department's successes and failures during the ambitious social programs of the 1960s, the fiscal crisis of the 1970s, the struggles with poverty and homelessness in the 1980s and 1990s, and in the post-9/11 era, Epidemic City shows how the NYC Department of Health has defined the role and scope of public health services for the entire nation.

By the time William Penn was planning the colony that would come to be called Pennsylvania, with Philadelphia at its heart, Europeans on both sides of the ocean had long experience with the hazards of city life, disease the most terrifying among them. Drawing from those experiences, colonists hoped to create new urban forms that combined the commercial advantages of a seaport with the health benefits of the country. The Contagious City details how early Americans struggled to preserve their collective health against both the strange new perils of the colonial environment and the familiar dangers of the traditional city, through a period of profound transformation in both politics and medicine. Philadelphia was the paramount example of this reforming tendency. Tracing the city's history from its founding on the banks of the Delaware River in 1682 to the yellow fever outbreak of 1793, Simon Finger emphasizes the importance of public health and population control in decisions made by the city's planners and leaders. He also shows that key figures in the city's history, including Benjamin Franklin and Benjamin Rush, brought their keen interest in science and medicine into the political sphere. Throughout his account, Finger makes clear that medicine and politics were inextricably linked, and that both undergirded the debates over such crucial concerns as the city's location, its urban plan, its immigration policy, and its creation of institutions of public safety. In framing the history of Philadelphia through the imperatives of public health, The Contagious City offers a bold new vision of the urban history of colonial America.

Barely a day goes by without news of the latest public health threat from the American media. Some of us are told we live in a ""cancer cluster""-an area with a disproportionate number of cancer deaths. During the summer months, those who live in or near urban areas are bombarded with daily smog measurements and air pollution alerts. City water supplies are frequently called health hazards. At times, it seems as though virtually everything we eat and drink is denounced as bad for us by some ""public health expert."" Our cars burn too much gasoline; we own too many firearms; we are too fat; some of us are too skinny. Americans today are living longer than they ever have before. Why the almost daily announcements of new public health threats and proclamations of impending crises? Bennett and DiLorenzo address this question and others here. They begin by examining the large public health bureaucracy, its preoccupation with expanding governmental programs, and its concern with political issues that too often have little to do with improving public health. Then they trace the evolution of the American public health movement from its founding after the Civil War to the 1950s. They describe the transformation of public health's focus from the eradication of disease to social policy as a by-product of the 1960s. Bennett and DiLorenzo catalogue the ""radicalization"" of the public health movement by discussing its numerous political initiatives. They include case studies of the politicization of the public health movement in America. The authors reveal various methods of statistical manipulation that certain public health researchers use to ""cook the data"" in order to achieve politically correct results. A final chapter discusses the implications of the transformation of public health from pathology to politics. This vigorously argued analysis sees the public health movement as claiming expertise on virtually every social issue, from poverty to human rights. Students of public pol

A thought-provoking and evocative account that considers both the policies we think of as "health policyand those that we don't, The Political Determinants of Health provides a novel, multidisciplinary framework for addressing the systemic barriers preventing the United States from becoming the healthiest nation in the world.

The anthrax incidents following the 9/11 terrorist attacks put the spotlight on the nation's public health agencies, placing it under an unprecedented scrutiny that added new dimensions to the complex issues considered in this report. The Future of the Public's Health in the 21st Century reaffirms the vision of Healthy People 2010, and outlines a systems approach to assuring the nation's health in practice, research, and policy. This approach focuses on joining the unique resources and perspectives of diverse sectors and entities and challenges these groups to work in a concerted, strategic way to promote and protect the public's health. Focusing on diverse partnerships as the framework for public health, the book discusses: The need for a shift from an individual to a population-based approach in practice, research, policy, and community engagement. The status of the governmental public health infrastructure and what needs to be improved, including its interface with the health care delivery system. The roles nongovernment actors, such as academia, business, local communities and the media can play in creating a healthy nation. Providing an accessible analysis, this book will be important to public health policy-makers and practitioners, business and community leaders, health advocates, educators and journalists.