Public health policy is political.
ABSTRACT In his article,(1) Goldberg provides a very cohesive critique of why concern over politicization of public health policy as a justification for preferring a narrow to a broad model of public health is a nebulous argument. To achieve its mission of assurance, public health is obligated to engage broadly with the spectrum of factors that impact health outcomes, most importantly the social and environmental determinants. Avoiding the political implications of these factors has never been possible. Even the "basic 6" services defined under the narrow model of public health(2) have never been free of politics. Several recent and ongoing controversies illustrate this point. Firstly, recent H5N1 research,(3,4) with clear implications for controlling communicable disease and epidemic preparedness, became controversial largely as a result of US national security concerns, a political matter. Secondly, the ongoing challenges regarding abortion rights in multiple state legislatures and the recent debate regarding coverage of contraception in the Affordable Care Act, both of which clearly fall within the purview of maternal health, remain a political quagmire. Lastly, sexual education, an important health education issue, has always been highly political. Thus, even issues within the "basic 6" have always been of a political nature. As a result, the "narrow model" not only fails to carry any less risk of politicization, it also fails to address some of the most critical public health issues. (Am J Public Health. Published online ahead of print May 17, 2012: e1. doi:10.2105/AJPH.2012.300801).
- SourceAvailable from: David Rosner[show abstract] [hide abstract]
ABSTRACT: We trace the shifting definitions of the American public health profession's mission as a social reform and science-based endeavor. Its authority coalesced in the late nineteenth and early twentieth centuries as public health identified itself with housing, sanitation, and labor reform efforts. The field ceded that authority to medicine and other professions as it jettisoned its social mission in favor of a science-based identity. Understanding the potential for achieving progressive social change as it moves forward will require careful consideration of the industrial, structural, and intellectual forces that oppose radical reform and the identification of constituencies with which professionals can align to bring science to bear on the most pressing challenges of the day.American Journal of Public Health 11/2009; 100(1):54-63. · 3.93 Impact Factor
- [show abstract] [hide abstract]
ABSTRACT: I criticize the concern over the politicization of public health policy as a justification for preferring a narrow to a broad model of public health. My critique proceeds along 2 lines. First, the fact that administrative structures and actors are primary sources of public health policy demonstrates its inescapably political and politicized nature. Second, historical evidence shows that public health in Great Britain and the United States has from its very inception been political and politicized. I conclude by noting legitimate ethical concerns regarding the political nature of public health policy and argue that open deliberation in a democratic social order is best served by acknowledging the constraints of the inescapably politicized process of public health policymaking.American Journal of Public Health 11/2011; 102(1):44-9. · 3.93 Impact Factor