Population health has recently grown from a series of loosely connected critiques of twentieth-century public health and medicine into a theoretical framework with a corresponding field of research—population health science. Its approach is to promote the public’s health through improving everyday human life: affordable nutritious food, clean air, safe places where children can play, living wages, etc. It recognizes that addressing contemporary health challenges such as the prevalence of type 2 diabetes will take (...) much more than good hospitals and public health departments. -/- Blending philosophy of science/medicine, public health ethics and history, this book offers a framework that explains, analyses and largely endorses the features that define this relatively new field. Presenting a philosophical perspective, Valles helps to clarify what these features are and why they matter, including: searching for health’s “upstream” causes in social life, embracing a professional commitment to studying and ameliorating the staggering health inequities in and between populations; and reforming scientific practices to foster humility and respect among the many scientists and non- scientists who must work collaboratively to promote health. -/- Featuring illustrative case studies from around the globe at the end of all main chapters, this radical monograph is written to be accessible to all scholars and advanced students who have an interest in health—from public health students to professional philosophers. (shrink)

Throughout history Christians have responded to the need for direct care for the sick in imitation of the healing ministry of Jesus and in the creation of hospitals as signs of God’s love. The COVID-19 pandemic has created a global, unprecedented modern experience of vulnerability. It has resulted in moral distress for doctors and health care workers in overwhelmed facilities. It has also revealed profound inequity in access to health care, the tragic consequences of the neglect of (...) public health and its focus on communities, and the effects of poverty and marginalization on the risk of illness and death. This paper proposes insights from Catholic social teaching that can guide a renewal of public health by rebalancing duties to individuals and communities, and renewing medicine as a public trust. These insights can assist in reducing moral distress in scarcity. (shrink)

ABSTRACT The history of Latin America, the history of disease, medicine, and public health, and global history are deeply intertwined, but the intersection of these three fields has not yet attracted sustained attention from historians. Recent developments in the historiography of disease, medicine, and public health in Latin America suggest, however, that a distinctive, global approach to the topic is beginning to emerge. This essay identifies the distinguishing characteristic of this approach as an (...) attentiveness to transfers of contagions, cures, and medical knowledge from Latin America to the rest of the world and then summarizes a few episodes that demonstrate its promise. While national as well as colonial and neocolonial histories of Latin America have made important contributions to our understanding, works taking the global approach have the potential to contribute more directly to the decentering of the global history of disease, medicine, and public health. (shrink)

There exists in the United States a popular account of the historical roots of environmental philosophy which is worth noting not simply as a matter of historical interest, but also as a source book for some of the key ideas that lend shape to contemporary North American environmental philosophy. However, this folk wisdom about the historical beginnings of North American environmental thinking is incomplete. The wilderness-based history commonly used by environmental philosophers should be supplemented with the neglected story of (...) garbage and sanitation in North American urban areas during the nineteenth century. This supplemented history changes the conceptual territory over which North American environmental philosophy roams. This new territory is better suited to a number of important local and international environmental challenges. (shrink)

Public health ethics in the future will be distinguished from public health ethics in the past by this new subfield being labeled as such, acknowledged, and called upon for service. Ethical dilemmas have been present throughout the history of public health. The question of whether to force Henning Jacobson to be immunized in 1905 in accordance with the 1902 Massachusetts smallpox vaccination law was one of ethics as well as law. How Thomas Parran, (...) Surgeon General in 1936, chose to respond to a raging syphilis epidemic in the United States in the early part of the 2W century raised considerable moral debate in determining the appropriate public health response for a government? More recently, questions have arisen concerning the appropriate reach of government in controlling HIV banning smoking, or promoting healthy lifestyles. Debates over government infringement, morality, and justice recur throughout the history of public health. (shrink)

The suggestion that crime be treated as a public health problem instead of being treated retributively provokes unease for two reasons. Firstly, it is thought to foster impersonal treatment, which is “objectifying” or “dehumanizing.” I argue that practices are problematically impersonal when they bypass or undermine an agent’s ability to take responsibility. However, there is a difference between taken responsibility and retributive responsibility. Skepticism about the latter does not entail skepticism about the former. Skeptics about retributive desert still (...) have strong moral reasons to condemn practices that undermine taken responsibility, so it need not have these dehumanizing implications. Secondly, the association of medicine and crime has a dark history. While this is true, this is largely because medicine has a dark history. Instead of striving to limit things that fall within the boundaries of public health, I argue that the solution is to take a more ethical approach to public health. (shrink)

Public health nurses (PHN) have had a long history of working with new mothers in the community. Their practice includes collaboration, building therapeutic relationships, mutual goal setting, establishing trust, supporting clients’ strengths, empowerment and social justice. The wealth of information that new mothers receive both solicited and unsolicited may come from many different sources such as medicine, midwifery and those created personally by families. Although much of the information on mothering is presented with the intent of helping, (...) it can also be hegemonic and oppressive depending on different discourses, stereotypes and myths of mothering and therefore may cause confusion, guilt and uncertainty. Public health nurses often address conflicting social, cultural and personal discourses about mothering practices in order to support an empowering mothering experience. The term ‘social mediator’ was purposefully created in an attempt to describe the unique work of PHNs that this author has witnessed through her own research and practice as a PHN. This paper will present a discussion of the author's own work and research findings that will suggest how feminist poststructuralist theory may be used to guide and understand information exchange between PHNs and mothers as they mediate different social, cultural and personal discourses on mothering. (shrink)

Diphtheria is an acute toxin-mediated superficial infection of the respiratory tract or skin caused by the aerobic gram-positive bacillus Corynebacterium diphtheriae. The epidemiology of infection and clinical manifestations of the disease vary in different parts of the world. Historical accounts of diphtheria epidemics have been described in many parts of the world since antiquity. Developed in the late 19th century, the diphtheria antitoxin played a pivotal role in the history of public health and vaccinology prior to the (...) advent of the diphtheria-tetanus toxoids and acellular pertussis vaccine. One of the most significant demonstrations of the importance of DAT was its use in the 1925 diphtheria epidemic of Nome, Alaska. Coordinated emergency delivery of this life-saving antitoxin by dog-sled relay in the harshest of conditions has left a profound legacy in the annals of vaccinology and public health. Lead dogs Balto and Togo, and the dog-led antitoxin run of 1925 represent a dynamic illustration of the contribution made by non-human species towards mass immunization in the history of vaccinology. This unique example of cooperative interspecies fellowship and collaboration highlights the importance of the human-animal bond in the one-health initiative. (shrink)

Since the establishment of the modern prison system in the early nineteenth century, prisons and prisoners have been construed as sites of moral, social, and biological contagion. Historic and contemporary studies show that most prisoners experience severe health inequalities, higher rates of addiction and mental health issues, and lower life expectancy than the rest of the population. They also come from deprived social strata. Yet, these aspects of Irish penal history have been largely neglected in academia and (...) popular histories. Our article discusses two public history projects—an art installation, _The Trial_, and a museum exhibition, _Living Inside_—that engaged different publics with the long history of health and welfare in Irish prisons. Developed by the research team on the Wellcome Trust Investigator Award “Prisoners, Medical Care and Entitlement to Health in England and Ireland, 1850-2000,” based at University College Dublin, the projects adopted different methodologies to engage their audiences and explore the experience and management of health and welfare in nineteenth- and twentieth-century Irish prisons. We further examine the different methodological approaches of each project, their varied aims and audiences, and the impacts reported by audiences and participants. The article also considers some of the challenges of doing this kind of public history, both in terms of working with marginalized communities and presenting research about difficult subjects to various audiences. (shrink)

Kaci Hickox was a nurse who worked with persons who were infected with Ebola in West Africa. When she returned to the United States, the governors of New Jersey and Maine intervened to confine her to inpatient quarantine despite the fact that she was asymptomatic and had no serological evidence of infection. She defied the quarantine which resulted in enormous public attention and discussion of quarantine and public fear. This article summarizes the case discussing the history of (...) the case, the government actions, and the final legal rulings. (shrink)

U.S. immigration law has excluded noncitizens likely to become a “public charge” since 1882. When the Trump administration proposed a new Rule expanding the interpretation of that exclusion in 2018, over 55,000 people wrote public comments. These comments, overwhelmingly opposed to the change, are the subject of Rachel Fabi and Lauren Zahn’s insightful article in this issue of The Journal of Law, Medicine, and Ethics. The themes they identify resonate with the history of the public charge (...) exclusion, which has always reflected a tension between two aims of American governance — to provide for those in need of assistance, and to shape the nation’s citizenry according to ideals of self-sufficiency. (shrink)

Virtue ethics has a rich history; yet, its application in health ethics has been minimal compared to other major ethical frameworks. Even more, its application to health policy and population-level questions has been almost nonexistent. A new concept in moral theology, structures of virtue, provides impetus for ethicists to consider how virtue ethics can be a valuable addition to existing frameworks in public health ethics. This article offers a basic overview of virtue ethics and its (...) value for analysis of social structures in public health. It does so by explaining how virtue can be seen not only in the process of public health—the promotion of habituated behavior—but also in the content of public health—values such as temperance, fortitude and prudence. It concludes with two extended applications of virtue ethics: vaccination policy and healthy eating. (shrink)

The paper uses two historical examples, public health (1840-1880) and town planning (1945-1975) in Britain, to analyse the challenges faced by goal-driven research, an increasingly important trend in science policy, as exemplified by the prominence of calls for addressing Grand Challenges. Two key points are argued. (1) Given that the aim of research addressing social or global problems is to contribute to improving things, this research should include all the steps necessary to bring science and technology to fruition. (...) This need is captured by the idea of practical integration, which brings this type of research under the umbrella of collective practical reason rather than under the aegis of science. Achieving practical integration is difficult for many reasons: the complexity of social needs, the plurality of values at stake, the limitation of our knowledge, the elusive nature of the skills needed to deal with uncertainty, incomplete information and asymmetries of power. Nevertheless, drawing from the lessons of the case studies, it is argued that (2) practical integration needs a proper balance between values, institutions and knowledge: i.e. a combination of mutual support and mutual limitation. Pursuing such a balance provides a flexible strategy for approximating practical integration. (shrink)

Faden, R. & Shebaya, S, Public Health Ethics. The Stanford Encyclopedia of Philosophy (Summer 2010 Edition), Edward N. Zalta (ed.). Available from: htt : lato.stanford.edu archives sum2010 entries ublichealth-ethics (accessed ...

This work resulted from a conference held in 2003 that was jointly sponsored by the Rockefeller Archive Center and Quinnipiac University. Drawing upon perspectives from history, philosophy, and the social sciences, as well as public health and medicine, the authors in this volume examine and critique the role of Foundations, most prominently the Rockefeller Foundation, in promoting and expanding the development of Western medicine around the world during the 20th century. The first half of the book examines (...) the historical involvement of philanthropic foundations in public heath, basic medical research, and related social and political issues. These studies range from an examination of the Rockefeller's Foundation's anti-malaria campaigns to the involvement of Foundations in promoting eugenic ideology and population control. The second half of the book considers current situations in which philanthropic foundations are active in promoting public health and westernized medicine, including consideration of the fight against AIDS in Africa, the resurgence of tuberculosis as a major public health threat, and the ongoing war against malaria. Finally, the book concludes with thoughts on the future of health, disease, and public health by Peter C. Goldmark, Jr., a former president of the Rockefeller Foundation. By considering issues of public health and health policy from a wide range of perspectives, this book seeks to contribute both to our understanding of the past successes and failures of growing dominance of Westernized medicine over global health, and to consider present and future possibilities for improving the delivery of health services to the population of the world. (shrink)

Based on event history analysis, this study examined the survival distribution of the duration of online public opinions related to major health emergencies and its influencing factors. We analyzed the data of such emergencies that took place in China during a period of 10 years. The results of the Kaplan-Meier method and Cox proportional hazards regression analysis showed that the average duration of online public opinions regarding health emergencies is 43 days, and the median is (...) 19 days, which dispels the myth of the “Seven-day Law of Propagation.” Furthermore, the duration of online public opinions can be divided into three stages: the rapid decline stage, the slowdown stage, and the disappearing stage. In addition, the type of event, and the volume of both social media discussion and traditional media coverage all had significant impacts on the duration. Our findings provide practical implications for the carrying out of targeted and stage-based governance of public opinions. (shrink)

Public health emergencies have occurred throughout history, encompassing such events as plagues and famines arising from natural causes, disease pandemics interrelated with wars, and industrial accidents such as the 1986 Chernobyl disaster, among others. Law and legal tools have played an important role in addressing such emergencies. Three prime U.S. examples are Congressional authorization of quarantine as early as 1796, legally mandated smallpox vaccination upheld in a landmark 1905 U.S. Supreme Court ruling, and the President's 2003 executive (...) order adding SARS to the federal government's list of “quarantinable communicable diseases.”The public health emergencies of the present — both actual and potential — pose equally serious threats but do so in the context of greatly magnified expectations that stem directly from the attacks of September 11, 2001, and the immediately following anthrax attacks. (shrink)

The BiDil affair brought once again to the fore questions of race and medicine. As discussed in other essays in this collection, the emergence of BiDil as the first medication approved and marketed for treating specific racial groups raises important questions for medicine and society: How are race and ethnicity framing our understanding of health and illness? Should treatment decisions be based on the race and ethnicity of patients? Should we encourage the development of race-specific medical treatments in order (...) to reduce health disparities? Or is this approach dangerous, and can it lead to unwanted consequences including racial stigmatization? These questions are not new, and since the introduction of race as a scientific construct in the late-19th century, race has played an important part in the history of medicine, most notoriously during World War II and the Holocaust. Yet the identification of race medicine with Nazi science tends to obscure the vast use of race as a medical construct by a wide range of medical scientists and practitioners across the political spectrum. In many instances, racial minorities were preoccupied with race medicine in order to promote the health of their own communities. One such group was that of Jewish physicians. (shrink)

The practice of law has changed greatly since the days when judges based decisions on the maxim salus populi suprema lex, and Oliver Wendell Holmes disagreed, noting that “experience” has been the “life of the law.” In the intervening years, the profession has followed Holmes and the legal realists in recognizing that the law does not exist in a vacuum. It is a human endeavor, molded by experiences and filled with human consequences. Today, lawyers, jurists, and legal scholars everywhere on (...) the political spectrum recognize the importance of social context, history, and a variety of non-legal disciplines, and non-legal insights to the intelligent practice of the law Unfortunately, in rejecting the old maxims, the legal profession also lost sight of the fundamental truth of salus populi suprema lex, Latin for “the health of the people is the highest law” - namely, it has lost sight of the truth that a population’s health is a critical part of law’s social context. One of the consequences of this is that the profession has failed to include public health - the study of the causes and prevention of disease, disability, and death in populations - among the non-legal disciplines regularly incorporated into legal analysis and routinely taught to all would-be lawyers. It is time to correct this oversight. (shrink)

Perhaps nothing symbolizes the current polarized political climate in the United States more than the world of public health. Public health schools and health departments are full of “true believers,” people willing to crusade for any program designed to reduce morbidity and mortality. But in the “real world,” proven programs and strategies—such as gun-control measures, universal vaccination, and improved traffic safety—are routinely thwarted. Why do critics oppose efforts to improve the public's health? (...) class='Hi'>History can provide some answers. (shrink)

This essay revisits the scholarly production around three major pandemics in the region: (a) the Third Plague Pandemic; (b) HIV/AIDS in the 1980s; and (c) COVID-19. The essay aims to provide a comprehensive set of resources (both printed and digital) in four languages (Portuguese, Spanish, English, and French) to examine how scholars have approached these phenomena and how their scope and interpretations have changed over time. Historians of health paid particular attention to sociocultural aspects of the disease, which enabled (...) them to consider usually-neglected actors, such as patients of Indigenous and African descent with their own medical traditions. This added more complexity to our understanding of how these pandemics were fought and received. In addition, the essay suggests that COVID-19 prompted the emergence of historians of health as public scholars. They actively used social networks and other digital tools not only to communicate about the long history of diseases and pandemics in the region, but also to provide an authorized or informed perspective amid misinformation and fake news. In addition, the internet was crucial to the development of helpful databases and virtual conferences beyond academic campuses and paywalls. (shrink)

ArgumentThis article examines how antimicrobial resistance (AMR) came to be constituted as a matter of public concern in Sweden in conjunction with the development of an inter-professional organization called Strama, founded to promote rational prescription of antibiotics. An outbreak of penicillin-resistant pneumococci in the mid-1990s was crucial for this development, because it brought attention to AMR as an urgent public threat. This outbreak fuelled the constitution of AMR as caused by consumption of antibiotics and as a matter of (...) disease control. As a consequence, Strama was able to mobilize the Swedish health officers responsible for disease control. The outbreak is conceptualized as a “transformative event” – an event that makes an issue and its associated risks concrete and urgent. Transformative events play the crucial role of expediting the transformation of issues into matters of public concern. (shrink)

Repeating history? Public and community health nursing in AustraliaDespite the long history in Australia of public and community health nursing, it has never been regarded as important as hospital‐based nursing. Notwithstanding the establishment of nursing organisations in the very early years of the 20th century and subsequent efforts to develop the nursing workforce, public and community health nursing has been neglected in terms of policy, research into public health nursing practice (...) and workforce development. Even in the present day, public and community health nurses are marginalised from mainstream nursing interests and there is a lack of conceptualisation about the value of nursing’s contribution to the primary health sector. This sector is experiencing a new wave of reforms driven by a combination of managerialism and systems change for improved responses to address health inequalities. Because there is not a strong institutionalised professional policy and support base for public and community health nurses, they are vulnerable in these reforms to increased domination and appropriation of their practice by stronger professional interests. There is an urgent need for professionally organised support from mainstream nursing to ensure that public and community health nurses are positioned as a unified force in efforts to advance the health of the community. (shrink)

By the mid-1960s, nonhuman primates had become key experimental organisms for vaccine development and testing, and was seen by many scientists as important for the future success of this field as well as other biomedical undertakings. A major hindrance to expanding the use of nonhuman primates was the dependency on wild-captured animals. In addition to unreliable access and poor animal health, procurement of wild primates involved the circulation of infectious diseases and thus also public health hazards. This (...) paper traces how the World Health Organization (WHO) became involved in the issue of primate supply, and shows how by the late 1960s concerns for vaccine development and the conservation of wildlife began to converge. How did the WHO navigate public health and animal health? What characterized the response and with what implications for humans and animals? The paper explores how technical standards of care were central to managing the conflicting concerns of animal and human health, biological standardization, and conservation. While the WHO’s main aim was to prevent public health risks, I argue that imposing new standards of care implied establishing new hierarchies of humans and animals, and cultures of care. (shrink)

The social and cultural history of medicine and health is a growing field of research in Sweden, stimulated by the present political, economic and social concern about health and health care. Since there have never been any chairs in the history of medicine within the medical faculty, the topic has mostly been approached by historians of science and ideas, social historians and anthropologists and sociologists interested in long-term developments. Psychiatry and psychiatric care is one of (...) the most popular subjects. Other fields are professional history and social policy, cultural and local studies on different aspects, epidemics and public health and socio-demographic studies of mortality and morbidity. This report presents some major Swedish contributions and gives a short summary of some of the results. There has, during the recent years, been a trend towards interdisciplinary exchange, for instance through Swedish and Scandinavian networks, and towards an international orientation that has led to comparative studies and exchange of results, a trend that can also be observed in many other countries. (shrink)

These essays, first presented at a conference, “Coping with Sickness,” held in Italy in 1997, address ethical and regulatory medical issues within a historical context. Many of the essays, while addressing interesting topics, combine policy analysis and critical cultural theory. Critical cultural theory can be intellectually engaging at times but is generally irrelevant to public officials concerned with specific policy issues.Coping with Sickness is the third and final volume derived from a series of conferences cosponsored by the European Science (...) Foundation and the Euroconferences Activity of the European Union. The eight essays are organized chronologically and cover a range of disparate topics: medical practitioners and the Spanish Inquisition , the history of autopsy legislation in German since 1800 , the history of “sadism” as a medical term in the nineteenth century , folk medicine in Holland in the late nineteenth century , abortion in Weimar Germany , drug testing in Africa in the early twentieth century , comparative policies toward STDs , and the debate over brain death in Germany . As might be expected in an anthology of this sort, the quality varies considerably. Nonetheless, the subjects addressed in this volume are engaging—much to the credit of the editors.Two pieces in particular represent the range of these collected essays. In “Vacher the Ripper and the Construction of the Nineteenth‐Century Sadist,” Angus McLaren, one of the best historians writing on the history of sexuality today, explores the “discovery” of sadism in the late nineteenth century by focusing on the dramatic trial of Joseph Vacher, who was charged in 1895 for the brutal sexual murder of a woman in Champuis. He later confessed to the murder and the sexual violation of another seven females and four males. Vacher had a long history of mental illness; indeed, he had been institutionalized in July 1893 following a failed attempt at suicide that left a bullet lodged in his head. At the trial the criminologist Alexandre Lacassagne was brought in as an expert witness to testify that Vacher was not insane but an antisocial sadist, as revealed by his dabbling in anarchism, vagabondism, and homosexuality. As a consequence, Vacher was found guilty and given a death sentence.McLaren finds in this trial an example of the social construction of a new medical concept, “sadism.” The emergence of the concept of sadism, he argues, reflected a “gendered notion” of defining appropriate male and female behavior; physicians at the turn of the century believed that “civilized men were most threatened, not by excess passion, but by the enervation spawned by urban life” . The concept of sadism was also employed by doctors to enhance their own authority and to alert the public to the dangers of a male manifesting “feminine traits” and to “beat back” homosexuality.There is much interesting conjecture to McLaren's study, but what policy lessons should be drawn from this remains unclear. If every concept is actually a social construction, reflecting the social anxieties of the age, then is the fashionable concept of social construction itself socially constructed to enhance the authority of the medical historian?More interesting methodologically is Claudia Wiesemann's absorbing essay on the historical debate in Germany over “brain death.” Relying on Ulrich Beck's social theory of simple and reflexive modernization, she shows that, when confronted with complex scientific questions, the public has to decide between competing plausible scientific claims; as a result, political groups make use of scientific expertise and counterexpertise to push their favorite practical and legal solutions. (shrink)

ArgumentThis article analyzes for the first time the earliest western maps of diseases in China spanning fifty years from the late 1870s to the end of the 1920s. The 24 featured disease maps present a visual history of the major transformations in modern medicine from medical geography to laboratory medicine wrought on Chinese soil. These medical transformations occurred within new political formations from the Qing dynasty (1644–1911) to colonialism in East Asia (Hong Kong, Taiwan, Manchuria, Korea) and hypercolonialism within (...) China (Tianjin, Shanghai, Amoy) as well as the new Republican Chinese nation state (1912–49). As a subgenre of persuasive graphics, physicians marshaled disease maps for various rhetorical functions within these different political contexts. Disease maps in China changed from being mostly analytical tools to functioning as tools of empire, national sovereignty, and public health propaganda legitimating new medical concepts, public health interventions, and political structures governing over human and non-human populations. (shrink)

Today, “scientism“ is a concept with a negative connotation in every language. Although many definitions are circulating, they have the assessment in common that scientism implicates a blind faith in science, which is wrong, simple-minded and even dangerous. However, the question is, who actually is defending that kind of position? Is scientism not just a ghost, a projection, an intellectual scarecrow in order to use many people’s fear of science in order to bash rationalistic opinions? This article develops the argument (...) that scientism is a real historical current which can be analyzed in a concrete way. It starts by outlining the history of the French word “scientisme” and the debates around it and discovers that the word is not at all of recent invention, but goes back to the 1840s and received its negative emphasis in the late nineteenth century when “scientific spiritism” on the one hand and Catholicism on the other were struggling against the “exaggerated” claims of natural science. A polemical counter-concept was therefore needed. Soon afterward some scientists and philosophers emerge, like Félix Le Dantec, Abel Rey or Marcel Boll, who turn around the invective in order to describe their own optimistic and rationalistic conception of science. In conclusion the article argues that scientism has to be understood as an intellectual project and as an optimistic thought-style in science that does not at all correspond to the prejudices of the amoral scientist or the power-hungry technocrat, but is represented mostly by outsiders and nonconformists. (shrink)

This paper uses the example of the COVID-19 pandemic to analyse the danger associated with insufficient epistemic pluralism in evidence-based public health policy. Drawing on certain elements in Paul Feyerabend’s political philosophy of science, it discusses reasons for implementing more pluralism as well as challenges to be tackled on the way forward.

In 2005, President George Bush read John Barry’s The Great Influenza: The Story of the Deadliest Pandemic in History. After his experiences of 9/11 and Hurricane Katrina, Bush began the first White...

Amidst the climate of crisis surrounding the rise in opioid-related overdose in the USA, early in 2019, Google and Deloitte launched ‘Opioid360’. Here came a platform combining browser histories, credit, insurance, social media, and traditional survey data to sell the service of risk calculation in population health. Opioid360's approach to automating risk calculation not only promised to identify persons ‘at risk’ of opioid dependence, but also paved the way for broader applications anticipating common chronic diseases and coordinating logistical operations (...) involved in pandemic response. Beginning with this experimental platform, this paper develops an analysis of the Big Data mode of risk calculation - an epistemological and political shift that involves technology companies, investors, insurers, governments, and public health institutions. The analysis focuses on the re-emergence of ‘social determinants of health’ in the rhetoric accompanying novel analytic platforms that estimate, calculate, and compute individual health risks. While the treatment of SDOH has always been a site of political contestation within the discipline of public health, powerful interests are crystallising around the concept and instrumentalising it in platforms that sell algorithmic prediction. Silicon Valley's breed of asset-oriented technoscience appears not only to be amplifying the behaviouralist elements of public health. Among the stakes of the Big Data mode is the paradoxical retreat from changing social conditions that contribute to the prevalence of health and illness in populations; and instead, the promotion of an apparatus for pricing and exchanging individual risk or excluding from services those who bear risk most acutely. (shrink)

Participatory and collaborative approaches in sustainability science and public health research contribute to co-producing evidence that can support interventions by involving diverse societal actors that range from individual citizens to entire communities. However, existing philosophical accounts of evidence are not adequate to deal with the kind of evidence generated and used in such approaches. In this paper, we present an account of evidence as clues for action through participatory and collaborative research inspired by philosopher Susan Haack’s theory of (...) evidence. Differently from most accounts of evidence for use in policies and interventions, our account combines action-oriented (the how) and actors-oriented (the who) considerations. We build on Haack’s theory and on the analysis of examples of participatory and collaborative research in sustainability science and public health research to flesh out six procedural criteria for the generation and mobilization of evidence in and from participatory research. Action-oriented criteria invite to look at evidence from a (a) foundherentist, (b) gradational and (c) quasi-holistic perspective. Actors-oriented criteria point out that evidence generation and utilization are (d) social, (e) personal, and (f) embedded. We suggest that these criteria may reinforce participatory and collaborative approaches to evidence co-production when addressing complex problems in sustainability science and public health allowing for the generation of a kind of practical objectivity. (shrink)

There are five ways in which shame might negatively impact upon our attempts to combat and treat HIV. Shame can prevent an individual from disclosing all the relevant facts about their sexual history to the clinician. Shame can be a motivational factor in people living with HIV not engaging with or being retained in care. Shame can prevent individuals from presenting at clinics for STI and HIV testing. Shame can prevent an individual from disclosing their HIV status to new (...) sexual partners. Shame can serve to psychologically imprison people, it makes the task of living with HIV a far more negative experience than it should, or needs to, be. Drawing on recent philosophical work on shame, and more broadly on work in the philosophy and psychology of emotion, we propose a framework for understanding how shame operates upon those who experience the emotion, propose a strategy for combatting the negative role shame plays in the fight against HIV, and suggest further study so as to identify the tactics that might be employed in pursuing the strategy here proposed. (shrink)

In the early 1920s, the Rockefeller Foundation's International Health Board was presenting itself as the watchtower of public health for the world at large. Yet Soviet Russia was never included in any of the International Health Board's programs, despite the efforts of the Russians to reach out to the Board. This paper examines the exclusion of Russia as a function of the conceptual and structural lenses through which the International Health Board 'saw' post-revolutionary Soviet (...) class='Hi'>public health. It also speculates about the ways in which those who spoke on behalf of Soviet public health contributed to the perceptions of the Board. (shrink)

ABSTRACT:Much has been written about the deplorable state of American health care, but rarely with the wealth of historical and political information packed into Peter Swenson’s Disorder: A History of Reform, Reaction, and Money in American Medicine (2021). In this meticulously researched and comprehensive study of the role of organized medicine, particularly the American Medical Association (AMA) and affiliated state and county medical societies, Swenson provides detailed insight into the AMA’s political evolution from a force advocating progressive reforms (...) to a protective guild backed by powerful economic and ideological interests. Swenson addresses the conflicts leading to and arising from these movements, always with an eye on the profession’s failure over the last century to fulfill its implicit social contract. Swenson describes the American medical disorder without fear or favor, including a public health system in disarray, defective government regulation of drugs, unchecked and concealed commercial influence on medical research, publications, and clinical guidelines. Swenson’s hope is clear: that a progressively reformed AMA—combined with a broad coalition of concerned citizens and legislators—will lead the medical profession back to its rightful mission. (shrink)