In a stirring and radical new treatise from one of America's most respected voices in health and medicine, Well examines the subtle factors that determine who gets to be healthy in the United States. Physician Sandro Galea reckons with our country's many fraught relationships--with history, money, pain, and pleasure, which are in turn augmented by factors like luck, compassion, and values--in terms of how they determine the health of those in the world's richest country. Well represents a radical new approach to Americans' ingrained understanding of health. It examines the forces that are not typically part of the health discussion--but should be--and is a clarion call for where the country goes from here"--
A provocative chronicle of how US public health has strayed from its liberal roots. The Covid-19 response was a crucible of politics and public health—a volatile combination that produced predictably bad results. As scientific expertise became entangled with political motivations, the public-health establishment found itself mired in political encampment. It was, as Sandro Galea argues, a crisis of liberalism: a retreat from the principles of free speech, open debate, and the pursuit of knowledge through reasoned inquiry that should inform the work of public health. Across fifty essays, Within Reason chronicles how public health became enmeshed in the insidious social trends that accelerated under Covid-19. Galea challenges this intellectual drift towards intolerance and absolutism while showing how similar regressions from reason undermined social progress during earlier eras. Within Reason builds an incisive case for a return to critical, open inquiry as a guiding principle for the future public health we want—and a future we must work to protect.
A better and healthier time to be alive than ever -- An unhealthy country -- An unhealthy world -- Who we are, the foundational forces -- Where we live, work, and play -- Politics, power, and money -- Compassion -- Social, racial, and economic justice -- Health as a public good -- Understanding what matters most -- Working in complexity and doubt -- Humility and informing the public conversation.
Fifty essays on the state of population health from a vanguard voice in the field Public health can rightly claim its share of victories: healthier cities, widespread sanitation, broader availability of nutrient-rich food, and reductions in violence and injury. But for all these gains, today we face a new set of challenges, ones complicated by political and professional shifts that threaten to fundamentally change the health of populations. Healthier is both an affirmation and an essential summary of the current challenges and opportunities for those working in and around the improvement of population health. The essays contained here champion an approach to health that is consequentialist and rooted in social justice -- an expansion of traditional, quantitatively motivated public health that will both inform and inspire any reader from student to seasoned practitioner. Galea's cogent, incisive arguments guarantee that his perspective, currently at the forefront of public health, will soon become conventional wisdom.
A deeply affecting work from one of the important and innovative voices in American health and medicine." -- Arianna Huffington In Well, physician Sandro Galea examines what Americans miss when they fixate on healthcare: health. Americans spend more money on health than people anywhere else in the world. And what do they get for it? Statistically, not much. Americans today live shorter, less healthy lives than citizens of other rich countries, and these trends show no signs of letting up. The problem, Sandro Galea argues, is that Americans focus on the wrong things when they think about health. Our national understanding of what constitutes "being well" is centered on medicine -- the lifestyles we adopt to stay healthy, and the insurance plans and prescriptions we fall back on when we're not. While all these things are important, they've not proven to be the difference between healthy and unhealthy on the large scale. Well is a radical examination of the subtle and not-so-subtle factors that determine who gets to be healthy in America. Galea shows how the country's failing health is a product of American history and character -- and how refocusing on our national health can usher enlightenment across American life and politics.
The COVID-19 response was a collision of politics and public health-a volatile combination that produced predictably bad results. As public-health expertise became a tool for serving political ends, it did more than just prolong a crisis; it left the public-health establishment, like the country, mired in polarization. It was, Sandro Galea argues, a crisis of liberalism: a retreat from the spirit of enlightenment and its reliance on evidence-informed reason above all else. In Within Reason, Galea offers a critical appraisal of public health's capture by the lesser angels of today's society. Across 50 spirited essays, he shows that this is a story much larger than COVID or Trump. The diminishing of US public health is symptomatic of the same insidious social trends that were accelerated under COVID and now pervade the administration of public good everywhere: an intolerance for incrementalism, an intolerance of tradeoffs, an expectation of absolutism and moral purity. Galea challenges this recent intellectual drift while articulating how it has undermined much of the progress of earlier eras. With his trademark incision, he makes a case for a return to critical, unbeholden inquiry as a guiding principle for the future we want-and will have to work in order to achieve"--
Featuring Engaging Podcasts Highlighting Major Public Health Case Studies in all 15 Chapters! Public Health: An Introduction to the Science and Practice of Population Health is a foundational textbook designed for students who are launching their public health studies and preparing for professions in the field. Our health is generated throughout our lives and by the world around us—by where we live, where we work, and who we interact with on a daily basis. This book, therefore, takes a unique approach to teach public health. It combines an eco-social framework with a life course perspective on population health to help the student understand how our experiences and context shape our health and how this informs the practice of public health. Written by leading public health educators, the textbook begins with the foundations—a history of public health and a discussion of the core values of health equity and disease prevention. An engaging survey of the eco-social framework and life course factors affecting health follows. The book concludes with a section dedicated to population health methods, implementation science, community engagement, advocacy, and health promotion. The book is illustrated throughout by cases that cross disciplines, that engage the student with issues of contemporary concern that are the remit of public health, and that offer systematic analyses that point toward solutions. With a focused approach to public health that guides the student through the causes of health—across levels and across stages in the life course—this groundbreaking, first-of-its-kind textbook integrates the core components of the field in clear and lucid language. Timely and relevant case studies, practical learning objectives, discussion questions in all chapters, numerous tables and illustrations throughout, chapter-based podcasts, and more make Public Health an innovative and lively platform for understanding the science of population health and the practice of public health. Key Features: A modern approach to the field that grounds the study of public health in life course and eco-social frameworks to better organize the science of population health and the practice of public health Explains the central role that prevention and health equity play in improving population health Features case studies that discuss contemporary issues affecting population health, including heart disease, Ebola, environmental exposures, gun violence, the opioid epidemic, health policy, and many more High volume of figures and tables to illustrate key points Includes a robust Instructor ancillary package with PowerPoints, an Instructor’s Manual, test banks, discussion questions, and conversion guide
Fifty essays on the state of population health from a vanguard voice in the field Public health can rightly claim its share of victories: healthier cities, widespread sanitation, broader availability of nutrient-rich food, and reductions in violence and injury. But for all these gains, today we face a new set of challenges, ones complicated by political and professional shifts that threaten to fundamentally change the health of populations. Healthier is both an affirmation and an essential summary of the current challenges and opportunities for those working in and around the improvement of population health. The essays contained here champion an approach to health that is consequentialist and rooted in social justice -- an expansion of traditional, quantitatively motivated public health that will both inform and inspire any reader from student to seasoned practitioner. Galea's cogent, incisive arguments guarantee that his perspective, currently at the forefront of public health, will soon become conventional wisdom.
POPULATION HEALTH SCIENCE formalizes an emerging discipline at the crossroads of social and medical sciences, demography, and economics--an emerging approach to population studies that represents a seismic shift in how traditional health sciences measure and observe health events. Bringing together theories and methods from diverse fields, this text provides grounding in the factors that shape population health. The overall approach is one of consequentialist science: designing creative studies that identify causal factors in health with multidisciplinary rigor. Distilled into nine foundational principles, this book guides readers through population science studies that strategically incorporate: · macrosocial factors · multilevel, lifecourse, and systems theories · prevention science fundamentals · return on investment · equity and efficiency Harnessing the power of scientific inquiry and codifying the knowledge base for a burgeoning field, POPULATION HEALTH SCIENCE arms readers with tools to shift the curve of population health.
Epidemiology Matters offers a new approach to understanding and identifying the causes of disease -- and with it, how to prevent disease and improve human health. Utilizing visual explanations and examples, this text provides an accessible, step-by-step introduction to the fundamentals of epidemiologic study, from design to analysis. Across fourteen chapters, Epidemiology Matters teaches the individual competencies that underlie the conduct of an epidemiologic study: identifying populations; measuring exposures and health indicators; taking a sample; estimating associations between exposures and health indicators; assessing evidence for causes working together; assessing internal and external validity of results. With its consequentialist approach -- designing epidemiologic studies that aim to inform our understanding, and therefore improve public health -- Epidemiology Matters is an introductory text for the next generation of students in medicine and public health.
The Causes and Behavioral Consequences of Disasters brings a public health perspective to the literature, reflecting the increasing importance of the field in both disaster preparedness and disaster response. Arguing that a disaster is not only the event but its aftermath as well, the authors apply salient local content to the study of scenarios ranging from the Cuzco, Peru, earthquake of 1950 to the Columbine school shooting, the Oklahoma City bombing, and 9/11. These case studies form the basis for models of vulnerabilities to disasters and population behavior following disasters, illustrating how careful pre-event planning and coordinated post-event response strategies can minimize the initial damage and negative aftereffects. The Causes and Behavioral Consequences of Disasters will further professional discussion and understanding among a wide range of professionals and students across public health, mental health, education, health administration and policy, social work, and the social sciences.
A better and healthier time to be alive than ever -- An unhealthy country -- An unhealthy world -- Who we are, the foundational forces -- Where we live, work, and play -- Politics, power, and money -- Compassion -- Social, racial, and economic justice -- Health as a public good -- Understanding what matters most -- Working in complexity and doubt -- Humility and informing the public conversation.
A POLITICAL PROVOCATION FROM A PAIR OF PHYSICIANS WRITING OUTSIDE THEIR LANE Americans care about their health. Americans pay lots of money in hopes of maintaining their health. So why are Americans so unhealthy? The reason is simple: as a country, the United States overinvests in medical care at the expense of the social, economic, and cultural forces that produce health. The rise of medicine as a cornerstone of American life and culture has coincided with a social and political devaluation of factors demonstrated to mean more to our vitality than anything else -- influences like where we live, work, and play; livable wages that create opportunity for healthy living; and gender and racial equity. In Pained, physicians Michael Stein and Sandro Galea push the conversation around American health where it belongs: toward matters of class, money, and culture. Across more than 50 essays and data illustrations, Pained casts a light on how the structural components of everyday life -- like school, housing, police, even cell phones -- ultimately determine who gets to be healthy in today's America. In doing so, it makes a case for reframing our political discourse in less myopic, more effectual terms. Accessible and surprising, political but not partisan, Pained is the urgent, uncomfortable conversation that American needs in this challenging moment. It will delight and infuriate readers of all political stripes.
POPULATION HEALTH SCIENCE formalizes an emerging discipline at the crossroads of social and medical sciences, demography, and economics--an emerging approach to population studies that represents a seismic shift in how traditional health sciences measure and observe health events. Bringing together theories and methods from diverse fields, this text provides grounding in the factors that shape population health. The overall approach is one of consequentialist science: designing creative studies that identify causal factors in health with multidisciplinary rigor. Distilled into nine foundational principles, this book guides readers through population science studies that strategically incorporate: - macrosocial factors - multilevel, lifecourse, and systems theories - prevention science fundamentals - return on investment - equity and efficiency Harnessing the power of scientific inquiry and codifying the knowledge base for a burgeoning field, POPULATION HEALTH SCIENCE arms readers with tools to shift the curve of population health.
This book begins the process of unraveling some of the most 'wicked' problems in public health." - Tony Iton, MD, JD, MPH-The California Endowment Growing evidence indicates that no single factor-but a system of intertwined causes-explains why America's health is poorer than the health of other wealthy countries and why health inequities persist despite our efforts. Teasing apart the relationships between these many causes to find solutions has proven extraordinarily difficult. But now researchers are uncovering groundbreaking insights using computer-based systems science tools to simulate how these determinants come together to produce levels of population health and disparities and test new solutions. The culmination of over five years of work by experts from a more than a dozen disciplines, this book represents a bold step forward in identifying why some populations are healthy and others are not. Describing a series of studies that apply the techniques of systems science, it shows how these tools can be used to increase our understanding of the individual, group, and institutional factors that generate a wide range of health and social problems. Most importantly, it demonstrates the utility and power of these techniques to both wisely guide our understanding and help policy makers know what works. ... an intellectually courageous undertaking. It faces up to the reality of complexity in the social determinants of health. Its achievements and its documentation of difficulties will serve as a valuable foundation for the next generation of scientists and scholars who aim to understand the determinants of health and of health disparities." - Harvey V. Fineberg, MD, PhD, President, Gordon and Betty Moore Foundation and Former President, the Institute of Medicine ...goes beyond the search for a simplistic answer to health disparities and instead embraces the complexity. This is exactly what is needed if we are to improve population health and eliminate disparities." - Thomas A. LaVeist, PhD, Chairman, Department of Health Policy & Management, Milken Institute School of Public Health, George Washington University It is increasingly likely that in the non-distant future that population health policy will be fully informed by a coherent computational decision-support system that integrates data, analytics, systems modeling, forecasting, and cost-effectiveness. This book marks a serious movement toward that future." - Donald S. Burke, MD, Associate Vice Chancellor for Global Health, Dean, Graduate School of Public Health UPMC, Jonas Salk Professor of Global Health, Graduate School of Public Health, University of Pittsburgh Recent review of Growing Inequality by Interdisciplinary Association of Population Health Science (IAPHS): https: //iaphs.org/book-review-complex-systems-population-health-insights-network-inequality-complexity-health/
Epidemiology Matters offers a new approach to understanding and identifying the causes of disease -- and with it, how to prevent disease and improve human health. Utilizing visual explanations and examples, this text provides an accessible, step-by-step introduction to the fundamentals of epidemiologic study, from design to analysis. Across fourteen chapters, Epidemiology Matters teaches the individual competencies that underlie the conduct of an epidemiologic study: identifying populations; measuring exposures and health indicators; taking a sample; estimating associations between exposures and health indicators; assessing evidence for causes working together; assessing internal and external validity of results. With its consequentialist approach -- designing epidemiologic studies that aim to inform our understanding, and therefore improve public health -- Epidemiology Matters is an introductory text for the next generation of students in medicine and public health.
The Causes and Behavioral Consequences of Disasters brings a public health perspective to the literature, reflecting the increasing importance of the field in both disaster preparedness and disaster response. Arguing that a disaster is not only the event but its aftermath as well, the authors apply salient local content to the study of scenarios ranging from the Cuzco, Peru, earthquake of 1950 to the Columbine school shooting, the Oklahoma City bombing, and 9/11. These case studies form the basis for models of vulnerabilities to disasters and population behavior following disasters, illustrating how careful pre-event planning and coordinated post-event response strategies can minimize the initial damage and negative aftereffects. The Causes and Behavioral Consequences of Disasters will further professional discussion and understanding among a wide range of professionals and students across public health, mental health, education, health administration and policy, social work, and the social sciences.
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