Robert A. Aronowitz, M.D.Expertise:
Health Risks; Public and Population Health; Public Health Strategies | The Construction of Health Risk and the Demand for Disease Prevention, 1945-2000
Award Year: 2000 Show AbstractWhile many newly defined health risks have elicited major societal and biomedical responses such as screening tests and risk-reducing drugs, others have not. Dr. Aronowitz examines how values and interests of various stakeholders influence how we recognize, name, define, and respond to health risks. His project traces the history of these risks in the U.S. since World War II and seeks to explain how they have been discovered, promoted, and made the object of prevention practices. Case studies on cancer cluster investigations, in situ cancers, Lyme disease vaccines, lung cancer screening, and the association between homocysteine and coronary heart disease will be compiled. Findings should inform and provoke societal debate over new ways to better manage research on health risks as well as the demand for interventions to reduce them. |
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Peter Baldwin, Ph.D.Expertise:
AIDS; Public Health Strategies | The Influence of History and Tradition on Public Health Strategies: A Nationally Comparative Approach to the AIDS Epidemic
Award Year: 2000Show Abstract This project explores why the public health response to the AIDS epidemic has varied so greatly in industrialized nations. By setting the approach to the AIDS epidemic in a broader historical context, Dr. Baldwin analyzes the factors that have determined AIDS responses in five countries - the U.S., France, Germany, Britain and Sweden. The study considers: local political traditions, social composition (ethnic and class), mutual interactions and inflections of other policies with public health measures, the nature of the state imposing the preventive response, the social policy infrastructure, as well as the power and political influence of the various interest groups most directly affected by the epidemic. The results should shed light on the determinants of public health policy and their broader political implications. |
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Ronald Bayer, Ph.D.Expertise:
AIDS; Civil Rights; Public Health Strategies; Technology | Privacy and Surveillance: The History and Politics of Public Health Reporting
with Amy L. Fairchild, Ph.D., M.P.H.
Award Year: 2001Show Abstract Although surveillance has long been a feature of public health practice, there has been no systematic and comprehensive analysis that meaningfully relates the history of surveillance to current public health policy and practice. Drs. Bayer and Fairchild will address the broad question of how shifting understandings of privacy, confidentiality and individual rights - as reflected in constitutional, ethical, and social norms - have affected our understanding and acceptance of public health surveillance. Through historical and contemporary analysis, the project will shed light on the core ethical and policy challenges posed by surveillance and provide key information for advancing public policy discussions. Case studies with both state and federal components - including infectious disease reporting, vaccine, cancer and birth defect registries, and occupational health reporting - as well as study of the Model State Public Health Privacy Act - will contribute to the development of public policy that is sensitive to privacy and confidentiality and the demands of research and public health. |
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Amy L. Fairchild, Ph.D., M.P.H.Expertise:
Public Health Strategies; Technology | Privacy and Surveillance: The History and Politics of Public Health Reporting
with Ronald Bayer, Ph.D.
Award Year: 2001Show Abstract Although surveillance has long been a feature of public health practice, there has been no systematic and comprehensive analysis that meaningfully relates the history of surveillance to current public health policy and practice. Drs. Bayer and Fairchild will address the broad question of how shifting understandings of privacy, confidentiality and individual rights - as reflected in constitutional, ethical, and social norms - have affected our understanding and acceptance of public health surveillance. Through historical and contemporary analysis, the project will shed light on the core ethical and policy challenges posed by surveillance and provide key information for advancing public policy discussions. Case studies with both state and federal components - including infectious disease reporting, vaccine, cancer and birth defect registries, and occupational health reporting - as well as study of the Model State Public Health Privacy Act - will contribute to the development of public policy that is sensitive to privacy and confidentiality and the demands of research and public health. |
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David Hemenway, Ph.D.Expertise:
Health Risks; Public Health Strategies; Violence | Firearms and Public Health
Award Year: 1997Show Abstract Firearms are the second leading cause of injury-related death in the U.S. While attention to the problem has increased, the amount of research on the topic lags behind. This project provides new information about gun carrying, storage, brandishing, injuries, the use of guns in self-defense, and the connection between guns and suicide. It also synthesizes new public health literature relevant to firearms policy and analyzes private firearm surveys from college students and adults. Adopting a general public health framework, Dr. Hemenway develops beneficial and feasible firearm policy recommendations, seeking to alter the current social norm which accepts high levels of lethal violence as a part of American life. Findings will provide public health-oriented policy options for gun safety, firearm product oversight, collecting gun injury information, and the roles of the medical community and general public in firearm safety. |
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Lisa I. Iezzoni, M.D., M.Sc.Expertise:
Health Outcomes; Health Risks; Health Services Research; Mobility Impairment; Public Health Strategies | When Walking Fails
Award Year: 1996Show Abstract When walking fails, people lose easy movement essential to daily life as well as a fundamental sense of value. Available evidence suggests that about one-quarter of Americans age 55 and older have trouble walking, and almost 10 percent are unable to walk even a few blocks due to such chronic conditions as heart disease, osteoporosis, diabetes, and arthritis. The American health care system does little to identify or address the problem, although feasible ways exist to aid mobility and improve lives. Dr. Iezzoni's research focuses on three areas: 1) the epidemiology of walking impairments among adult Americans due to chronic illness; 2) the views of persons whose walking has failed, primarily concerning perceived barriers to mobility assistance and experiences with the health care system; and 3) the attitudes of health professionals and payers concerning services to assist mobility for chronically ill persons. Her results describe barriers experienced by those with walking impairments and policy options for overcoming them. |
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Peter D. Jacobson, J.D., M.P.H.Expertise:
Managed Care; Politics and Policymaking; Public Health Strategies | The Role of the Courts in Shaping Health Policy
Award Year: 1995Show Abstract Dr. Jacobson looks at the role judicial decision-making plays in shaping health policy and how courts can best resolve policy and value conflicts emerging in the shift to managed care. Judicial doctrine dealing with medical necessity, utilization management, anti-trust issues, and ERISA are analyzed. This leads to increased understanding of the impact of the courts on medical practice and health policy goals such as access to health care services, cost containment, technology diffusion and innovation, quality of care, and physician and patient autonomy. The project includes: a case content analysis of trends in health care litigation, a synthesis of the legal and health services literature, and interviews with judges and health law scholars. A conceptual framework, to assist judges in appraising the health policy conflicts and trade-offs they are likely to confront, is developed. This offers a useful rationale and organizing principles for deciding individual cases and guiding the evolution of consistent judicial doctrine in resolving health care disputes. |
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Edward W. Maibach, Ph.D., M.P.H.Expertise:
Climate Change; Health Communication; Media and Health; Public Health Strategies; Public Opinion | Mobilizing Citizen Support for Climate Stabilization and Adaptation Policies
with Matthew C. Nisbet, Ph.D.
Award Year: 2008Show Abstract Climate change poses a potentially significant threat to the public's health, and addressing it is among President Obama's top priorities. Co-PIs Edward W. Maibach, Ph.D., M.P.H. and Matthew C. Nisbet, Ph.D. believe that citizens and stakeholders need to play an active role in formulating effective public policies and investments in greenhouse gas reduction. Their project, Mobilizing Citizen Support for Climate Stabilization and Adaptation Policies, investigates how best to engage Americans on climate control issues and analyzes the extent to which a health perspective can enlist community interest and participation. Through surveys and interviews, Drs. Maibach and Nisbet explore people's beliefs and motivations and test their reactions to various policy proposals and messages about climate change and its health implications. Their research findings could help galvanize the public health community and provide policy experts, government agencies, journalists, and other stakeholders with practical guidance on how best to increase public understanding of the implications of climate change. |
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Constance A. Nathanson, Ph.D.Expertise:
Public Health Strategies; Women's Health | Disease Prevention as Social Change: A Comparative Study of Public Health Policymaking in the U.S., Canada, Great Britain, and France
Award Year: 1994Show Abstract This project explores social and political factors, which foster or impede effective public health policymaking, and the development of a sociological theory of change in parameters of health and disease. Historical and demographic research indicates that public health policies play a significant role in mortality decline and that these policies are the outcome of identifiable social and political processes. Dr. Nathanson examines: the roles of state characteristics, grass-roots social and/or political movements, and issue-specific social characteristics in public health policy adoption and implementation. These variables and their relative importance are investigated through comparative analysis of infant health, tuberculosis, sexually transmitted diseases/HIV infection, and smoking as they have evolved from the late nineteenth century to the present in the U.S., Canada, Great Britain, and France. Drawing from case studies, she clarifies the unique aspects of the U.S. experience in public health policymaking, highlighting its limits and possibilities. |
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Victor G. Rodwin, Ph.D., M.P.H.Expertise:
Public Health Strategies; Urban Health | Health and Megacities: A Neglected Dimension of U.S. Health Policy
Award Year: 1999Show Abstract This project undertakes a comparative analysis of public health infrastructure, health care delivery systems, and health in the four principal mega-cities of the industrially advanced world. Dr. Rodwin examines how: the use of the city as a unit of analysis can advance the comparative study of health care systems, inter-city comparisons of health outcomes can provide a better understanding of similarities and differences, and intra-city comparisons of health information can be used to help set health priorities and assess public health programs. A conceptual framework is developed and indicators selected for comparing public health infrastructure, health systems, and health in New York, London, Paris, and Tokyo. Based on the results of his review of the literature, data analyses, and interviews with local officials and experts, Dr. Rodwin compares health outcomes and system performance and identifies best practices and other opportunities for cross-national learning that have the potential for improving U.S. health policy. |
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Kenneth E. Warner, Ph.D.Expertise:
Health Risks; Public Health Strategies | The Nature, Evolution, and Implications of Tobacco Policy in the United States
Award Year: 1994Show Abstract Dr. Warner produces a detailed history of the rise and fall of cigarette smoking in the U.S. in the 20th century both as a social phenomenon and as a major determinant of trends in health and health care. Special attention is devoted to the roles of tobacco-control research and policy. Synthesizing the leading work in this field, he provides a comprehensive analysis of the nature, origins, and consequences of tobacco policy in the U.S. Lessons are drawn relevant to tobacco-control activists, policymakers, and the broader health promotion community as to what matters in health promotion policy and what affects its emergence in social discourse. The role of tobacco-control policy, its origins and uses, and the integration of policy research findings into policy advocacy, are also examined. The project makes a valuable contribution as interpretive social history and to understanding the development and analysis of health policy in the domain of self-affecting health behaviors. |
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