From mad-cow disease and E. coli-tainted spinach in the food supply to anthrax scares and fears of a bird flu pandemic, national health threats are a perennial fact of American life. Yet not all crises receive the level of attention they seem to merit. The marked contrast between the U.S. government's rapid response to the anthrax outbreak of 2001 and years of federal inaction on the spread of AIDS among gay men and intravenous drug users underscores the influence of politics and public attitudes in shaping the nation's response to health threats. In Disease Prevention as Social Change, sociologist Constance Nathanson argues that public health is inherently political, and explores the social struggles behind public health interventions by the governments of four industrialized democracies. Nathanson shows how public health policies emerge out of battles over power and ideology, in which social reformers clash with powerful interests, from dairy farmers to tobacco lobbyists to the Catholic Church. Comparing the history of four public health dilemmas—tuberculosis and infant mortality at the turn of the last century, and more recently smoking and AIDS—in the United States, France, Britain, and Canada, Nathanson examines the cultural and institutional factors that shaped reform movements and led each government to respond differently to the same health challenges. She finds that concentrated political power is no guarantee of government intervention in the public health domain. France, an archetypical strong state, has consistently been decades behind other industrialized countries in implementing public health measures, in part because political centralization has afforded little opportunity for the development of grassroots health reform movements. In contrast, less government centralization in America has led to unusually active citizen-based social movements that campaigned effectively to reduce infant mortality and restrict smoking. Public perceptions of health risks are also shaped by politics, not just science. Infant mortality crusades took off in the late nineteenth century not because of any sudden rise in infant mortality rates, but because of elite anxieties about the quantity and quality of working-class populations. Disease Prevention as Social Change also documents how culture and hierarchies of race, class, and gender have affected governmental action—and inaction—against particular diseases. Informed by extensive historical research and contemporary fieldwork, Disease Prevention as Social Change weaves compelling narratives of the political and social movements behind modern public health policies. By comparing the vastly different outcomes of these movements in different historical and cultural contexts, this path-breaking book advances our knowledge of the conditions in which social activists can succeed in battles over public health.

In this first English-language study of popular and scientific responses to tuberculosis in nineteenth-century France, David Barnes provides a much-needed historical perspective on a disease that is making an alarming comeback in the United States and Europe. Barnes argues that French perceptions of the disease—ranging from the early romantic image of a consumptive woman to the later view of a scourge spread by the poor—owed more to the power structures of nineteenth-century society than to medical science. By 1900, the war against tuberculosis had become a war against the dirty habits of the working class. Lucid and original, Barnes's study broadens our understanding of how and why societies assign moral meanings to deadly diseases.

This 1998 book contains historical essays about how diseases change their meaning.

Historically, AIDS is just one of a series of dreaded diseases that have aroused both great fear and irrational actions. The previous diseases, including bubonic plague, syphilis, tuberculosis, leprosy and cancer, have evoked such a sense of dread that rational moves to halt the disease have become compromised.; This text examines the deep sense of fear that AIDS evokes, stigmatizing those who suffer from the disease, as well as their families and caregivers. Until AIDS can be seen for what it actually is - a life-threatening disease - policies providing for humane treatment will not evolve. The book also emphasizes that diseases are more than biological phenomena or individual catastrophes - they are profoundly social events. The ways in which diseases are spread and treated are strongly influenced by larger sociological considerations, and they may have the capacity to change social institutions or society Itself. Rooting Aids In The History Of Diseases, The First Part Of The book reviews the nature, history and responses of earlier dreaded diseases. The next section examines AIDS itself, proposed as the archetypal dreaded disease. Already creating a sense of panic, AIDS is also shown to be a social disease, likely to have significant effects on the social order. Thus, only by containing the epidemic of fear and controlling the resulting irrationality, can the AIDS epidemic be halted.

"The Nation has lost sight of its public health goals and has allowed the system of public health to fall into 'disarray'," from The Future of Public Health. This startling book contains proposals for ensuring that public health service programs are efficient and effective enough to deal not only with the topics of today, but also with those of tomorrow. In addition, the authors make recommendations for core functions in public health assessment, policy development, and service assurances, and identify the level of government--federal, state, and local--at which these functions would best be handled.

Collection of author's essays previously published individually

Originally published in 1987 this textbook is a comprehensive introduction to the rapidly developing field of medical geography. It illustrates the ideas, methods and debates that inform contemporary approaches to the subject, demonstrating the potential of a social and environmental approach to illness and health. The central theme is the need to reject an exclusively biological approach to health. The authors examine both the geography of health care and outline a selection of health service planning initiatives in both North America and Europe.