Cover

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Title Page, Copyright, Dedication

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Contents

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pp. vii-viii

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About the Author

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p. ix

Constance A. Nathanson is a sociologist and professor of clinical sociomedical sciences in the Columbia University Mailman School of Public Health.

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Acknowledgments

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pp. xi-xiv

This book is the outcome of a project not only ambitious—too ambitious, it often seemed—but also very long in the time it took to accomplish. Neither the research nor the writing would have been possible without the financial support—reflecting a belief in the project’s ...

PART I. Setting the Stage

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p. 1

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Chapter 1. Introduction

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pp. 3-24

Stories of public health are stories about how individuals, communities, and states recognize and respond to the threat of disease. These stories have a dramatic form. Actors—experts, officials, aroused citizens—emerge on the public stage in the first scene, sounding the alarm ...

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Chapter 2. The Nineteenth Century:From Miasmas to Microbes

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pp. 25-46

Public health as an enterprise distinct from curative medicine is a product of the nineteenth century, as are—not coincidentally— nation-states and social movements as we know them today. Through complex and mutually reinforcing processes, industrial and geographic expansion ...

PART II. The Turn of the Nineteenth Century

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p. 47

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Chapter 3. Infant Mortality

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pp. 49-79

Infant mortality—the number of babies who die in the first year of life—had been identified by the middle of the nineteenth century as a “particularly sensitive index of community health and well-being and of the effectiveness of existing public health measures” (Meckel 1990, 5). John Simon, then medical officer of ...

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Chapter 4. Tuberculosis

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pp. 80-105

In 1815, an English physician, Thomas Young, wrote, “of all hectic affections, by far the most important is pulmonary consumption, a disease so frequent as to carry off prematurely about one-fourth part of the inhabitants of Europe, and so fatal as often to deter the practitioner ...

PART III. The Late Twentieth Century

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p. 107

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Chapter 5. Smoking

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pp. 109-159

The connection between smoking and lung cancer was established, to all intents and purposes, simultaneously by British and American investigators following virtually identical scientific pathways. An “alarming” rise in death rates attributed to cancer of the lung was ...

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Chapter 6. HIV/AIDS in Injection Drug Users

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pp. 160-200

THE FIRST five cases of what later came to be known as Acquired Immune Deficiency Syndrome (AIDS) were reported in the Morbidity and Mortality Weekly Report (MMWR) on June 5, 1981, under the enigmatic title, “Pneumocystis pneumonia—Los Angeles.” On June 12, 1981, the ...

PART IV. Structures, Movements, and Ideologies in the Making of Public Health Policy

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p. 201

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Chapter 7. Engines of Policy Change:The State and Civil Society

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pp. 203-220

I now turn from data—the sixteen stories of public health I have recounted—to analysis and interpretation organized around the three broad determinants of public health action proposed in chapter 1: states, collective actions, and constructions of risk. The goals of this analysis are to

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Chapter 8. Experts and Zealots

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pp. 221-232

At a symposium on the history of smoking and tobacco control, the medical historian Roy Porter commented on the difference between Britain and the United States in patterns of mobilization against smoking. “My suspicion [is that] relatively speaking . . . the medical profession has actually ...

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Chapter 9. Political Cultures and Constructions of Risk

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pp. 233-246

Public recognition of dangers to health and judgments concerning if, when and how to respond are the outcome of social processes, as I observed in chapter 1. Among the major sources of variation in recognition and response were the political cultures of nation-states. States’ political practices and the ideologies associated ...

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Chapter 10. Conclusion

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pp. 247-257

Public health originated as much from fear of social change—the revolutionary potential of the desperate poor huddled together in the teeming cities of the nineteenth century—as from the desire for social reform. Public health was conceived as a means to public order. Yet the social changes initiated ...

Notes

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pp. 259-287

References

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pp. 289-316

Index

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pp. 317-328