Law plays a crucial role in protecting the health of populations. Whether the public health threat is bioterrorism, pandemic influenza, obesity, or lung cancer, law is an essential tool for addressing the problem. Yet for many decades, courts and lawyers have frequently overlooked law’s critical importance to public health. Populations, Public Health, and the Law seeks to remedy that omission. The book demonstrates why public health protection is a vital objective for the law and presents a new population-based approach to legal analysis that can help law achieve its public health mission while remaining true to its own core values.

By looking at a diverse range of topics, including food safety, death and dying, and pandemic preparedness, Wendy E. Parmet shows how a population-based legal analysis that recalls the importance of populations and uses the tools of public health can enhance legal decision making while protecting both public health and the rights and liberties of individuals and their communities.

This volume brings together feminist social and biomedical scholars from the Southern and Northern hemispheres to examine the aggregate forces that affect reproductive choice. Drawing on numerous case studies, this book examines the range of social, economic, and scientific policies which collectively impact on reproductive well being. Power and Decision offers an analysis of how disparate policies, seemingly unrelated to reproduction, are implicitly “pro-natalist” or “anti-natalist.” Moreover, these policies are imbued with gender, race, and class biases. The authors examine the reproductive impact of welfare and parental leave legislation, health services, adoption policies, biomedical research, the global transfer and regulation of reproductive technologies, and international family planning programs.

Offering a rare global feminist critique of social policy, this volume makes explicit the direction of current legislative, economic, and scientific trends, providing a basis for discussion, debate, and possible redress.

Rapid development of sophisticated new techniques has vastly increased physicians' ability to detect congenital disorders before birth. Yet advances in treatment, before or after birth, have been very modest. This discrepancy leads to ethical and social problems that require serious attention by professionals and patients alike. This innovative book tackles such problems in the case of prenatal screening for neural tube defects. Afflicting about 7,000 newborn babies each year in the United States, neural tube defects are serious abnormalities in the development of the brain and spinal cord that have grave consequences for the child and family.

The editors, Elena O. Nightingale, a geneticist, physician, and expert in health policy, and Susan B. Meister, a specialist in parent-child nursing, social and developmental psychology, and quantitative methods, led a multidisciplinary effort by distinguished Harvard faculty, including economist Richard Zeckhauser and clinical decision analyst Barbara J. McNeil. Other contributors include Donald S. Shepard, Mary L. Kiely, and Stephen G. Pauker. The book examines the impact of technology assessment, cost effectiveness analysis, and decision analysis on reaching decisions about prenatal screening. The book includes a discussion of the results of formal analyses against a backdrop of our basic ethical and societal values, as well as the analyses themselves. Health care workers, policymakers, and concerned individuals will find this volume informative and thought provoking.

Like other dangerous but pleasurable activities, such as downhill skiing and mountain climbing, engaging in unprotected sex implicitly involves the weighing of costs and benefits. Recognizing that the transmission of the AIDS virus is a consequence of private choices—rational and often informed—to engage in risky conduct, the authors employ tools of economic analysis to reassess the orthodox approach to AIDS by the public health community.

Standard predictions of the spread of AIDS, the authors argue, are questionable because they ignore rational behavioral response to the risk of infection. For the same reason, customary recommended public health measures, such as extensive testing for the AIDS virus, not only may be ineffective in controlling the spread of the disease but may actually cause it to spread more rapidly. The authors examine regulatory measures and proposals such as mandatory testing, criminal punishments, and immigration controls, as well as the subsidization of AIDS education and medical research, the social and fiscal costs of AIDS, the political economy of the government's response, and the interrelation of AIDS and fertility risk.

Neither liberal nor conservative, yet on the whole skeptical about governmental involvement in the epidemic, this book is certain to be controversial, but its injection of hard-headed economic thinking into the AIDS debate is long overdue. Although Private Choices and Public Health is accessible to the interested general reader, it will also capture the attention of economists—especially those involved in health issues—epidemiologists, public health workers, lawyers, and specialists in sexual behavior and drug addiction.

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."

In this book, based almost exclusively on original source material, Dr. Blake takes a detailed look at the public health history of the town of Boston. Historically, the author tells us, public health may be viewed as the science and art of preventing disease and promoting health through organized community activity. A significant part of this study is the insight it offers into the early attitudes toward disease and death as well as other basic political, social, and economic questions.

Dr. Blake outlines the development of public health practice from occasional emergency measures to a continuing program for the prevention and control of certain epidemic diseases. The introduction and increasing use of smallpox inoculation and later of vaccination are described and their importance evaluated. The book also discusses the further developments in the 1790s and the following two decades that resulted from a series of yellow-fever epidemics in northern seaports, including the establishment of a board of health and its efforts to prevent recurrence of this disease. The prevention of other endemic infectious diseases, though far more important in their effect on the community’s health, was largely neglected. Nevertheless, the principles of notification, isolation, and quarantine had been established and the need for governmental activity to protect the public health, for special public health officials, and for expenditure of tax money for public health purposes had been recognized.

This study, restricted in time to the period before Boston became a city (1630–1822), deals with the early years of the public health movement, a period that has been largely neglected. In comparing Boston’s experience with that of other colonies and England, Dr. Blake presents the European background in both the theory and practice of epidemiology and public health. The colonies themselves, whose differences caused many contemporaries to despair of their ever becoming a single nation, were yet bound by an essential homogeneity. “By and large they had the same language, the same religion, the same inheritance of British social and political ideals. And by and large they had the same diseases. Thus the history of public health in Boston becomes significant for the whole American experience.”