Modern psychological and political theory meet head-on in this powerful re-evaluation of America's contradictory and sometimes dangerous addiction to individualism. Best-selling author Gaylin and co-author Jennings investigate the contentious intersections of interdependence and autonomy, rights and public responsibility. They examine the painful abrasion occurring between America's tradition of personal freedom and privacy, as it rubs against the still valuable if almost vanishing ideals of sacrifice and social order.

Our current culture of autonomy—championed by both liberals on the left and libertarians on the right—is based on the idea of rationality as the motivation for human conduct. But, as the authors remind us, people are not simply rational creatures—appeals to emotions are always far more effective than logical argument in changing our behavior.

This timely edition includes a new preface; updated examples and illustrations throughout; and new coverage of contemporary social critics and their work since the publication of the first edition. Two essential new chapters, one on the movement to forgo life-sustaining treatment and the other on physician-assisted suicide, particularly clarify the authors' arguments. Drawing on these and numerous other illustrations—with significant emphasis on the state of American health care—Gaylin and Jennings demonstrate that society has not just the right but the duty to occasionally invoke fear, shame, and guilt in order to motivate humane behavior.

As cases of AIDS are once again on the upswing, as the dangerously mentally ill are allowed to wander free and untreated, as starvation and poverty still hold too many in its grip in the richest nation on the planet, this controversial book, considerably revised and expanded, is needed more than ever. If we are to indeed preserve and nurture a genuinely free—and liberal—society, the authors suggest that these "coercions" may be essential for the health and the maturity of a nation where we all too often avert our eyes, not seeing that our neighbor is in pain or trouble and needs our help.

Between 1990 and 1993, breast cancer activism became a significant political movement. The issue began to receive extensive media attention, and federal funding for breast cancer research jumped dramatically. Describing the origins of this surge in interest, Maureen Hogan Casamayou attributes it to the emergence of politically potent activism among breast cancer survivors and their supporters. Exploring the creation and development of the National Breast Cancer Coalition (NBCC), she shows how many of its key leaders were mobilized by their own traumatic experiences with the disease and its treatments.

Casamayou details the NBCC’s meteoric rise and impressive lobbying efforts, explaining how—in contrast to grassroots movements founded by dedicated individuals—the coalition grew from the simultaneous efforts of a network of women who invested their time, energy, money, and professional skills in the fight for increased funding for breast cancer research. This multiple leadership—or collective entrepreneurialism, says Casamayou—was crucial to the NBCC’s success framing the issue in the minds of the public and policymakers alike.

The government, the media, HMOs, and individual Americans have all embraced programs to promote disease prevention. Yet obesity is up, exercise is down, teenagers continue to smoke, and sexually transmitted disease is rampant. Why? These intriguing essays examine the ethical and social problems that create subtle obstacles to changing Americans' unhealthy behavior.

The contributors raise profound questions about the role of the state or employers in trying to change health-related behavior, about the actual health and economic benefits of even trying, and about the freedom and responsibility of those of us who, as citizens, will be the target of such efforts. They ask, for instance, whether we are all equally free to live healthy lives or whether social and economic conditions make a difference. Do disease prevention programs actually save money, as is commonly argued? What is the moral legitimacy of using economic and other incentives to change people's behavior, especially when (as with HMOs) the goal is to control costs?

One key issue explored throughout the book is the fundamental ambivalence of traditionally libertarian Americans about health promotion programs: we like the idea of good health, but we do not want government or others posing threats to our personal lifestyle choices. The contributors argue that such programs will continue to prove less than wholly successful without a fuller examination of their place in our national values.

From two leading experts, a revolutionary new way to think about and measure aging.

Aging is a complex phenomenon. We usually think of chronological age as a benchmark, but it is actually a backward way of defining lifespan. It tells us how long we’ve lived so far, but what about the rest of our lives?

In this pathbreaking book, Warren C. Sanderson and Sergei Scherbov provide a new way to measure individual and population aging. Instead of counting how many years we’ve lived, we should think about the number of years we have left, our “prospective age.” Two people who share the same chronological age probably have different prospective ages, because one will outlive the other. Combining their forward-thinking measure of our remaining years with other health metrics, Sanderson and Scherbov show how we can generate better demographic estimates, which inform better policies. Measuring prospective age helps make sense of observed patterns of survival, reorients understanding of health in old age, and clarifies the burden of old-age dependency. The metric also brings valuable data to debates over equitable intergenerational pensions.

Sanderson and Scherbov’s pioneering model has already been adopted by the United Nations. Prospective Longevity offers us all an opportunity to rethink aging, so that we can make the right choices for our societal and economic health.

Public Health and the State constitutes both a fine piece of social history and an ideal model for evaluating our current definition of public health. In this thought-provoking account, Ms. Rosenkrantz perceptively traces the development of the Massachusetts State Board of Health--established in 1869 as the first state institution in the United States responsible for preventing unnecessary mortality and promoting all aspects of public health.

This study describes the areas in which state responsibility for deterring disease assumed increased authority after the Civil War. It begins at a time when the definition of health' implied that it could be achieved, supported by the perfectionist belief that a healthy populace--obedient to the laws of nature--guaranteed a sound society. As rapid urban and industrial growth began to sweep the country, however, there was an expressed concern that this expansion threatened the health and morals of the people. During this period, when the etiology of disease was ascribed to a variety of environmental and behavioral factors, the Massachusetts Board developed a comprehensive program of investigation and advice on such diverse issues as housing, water supplies, slaughterhouse conditions, and the use of alcohol.

Later, as specific medical prophylaxis and therapy came to characterize public health policy, the relationship between sanitary science and social reform was redefined by both professional standards and public expectation. The State Board depended less and less upon its ability to influence individual conduct. Laboratory scientists, chemists, and physicians, who tended to describe disease in biological terms, directed public health toward science.

In view of pressing public health problems posed by such hazards as drug abuse and environmental pollution, Ms. Rosenkrantz warns us that it is as important to identify the origins of the social and scientific assumptions regarding public health as it is to discover the biological etiology of disease. The last chapter of Public Health and the State suggests that the goal of perfect health, based upon the ideal concepts of the past, may no longer be a viable objective. For these reasons she views the development of the Massachusetts State Board of Health as "the story of a successful endeavor that can never be re-enacted."