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Investigator Details: Select an Investigator-----Aber, J. LawrenceAiken, LindaAndrews, LoriArmstrong, ElizabethArno, PeterAronowitz, RobertAshton, CarolAwerbuch, TamaraBaldwin, PeterBauman, LaurieBayer, RonaldBazzoli, GloriaBearman, PeterBloche, M. GreggBlumenthal, DavidBosk, CharlesBrown, JeffreyBrown, LawrenceBrown, PhilBrückner, HannahBurns, LawtonBurris, ScottCampbell, Andrea LouiseCarpenter, DanielCasalino, LawrenceCaulkins, JonathanChristakis, NicholasCohen, CathyCohen, MichaelConley, DaltonCook, PhilipCook-Deegan, RobertCooper, RichardCorburn, JasonCosta, DoraCroghan, ThomasDaniels, NormanDavey Smith, GeorgeDeclercq, EugeneDeyo, RichardDiMatteo, M. RobinDudley, R. AdamsDuleep, HarrietEpstein, StevenEscarce, JoséFaden, RuthFagan, JeffreyFairchild, AmyFairman, JulieFinkelstein, AmyFins, JosephFoster, JamesFrank, RichardFrosch, DominickFullilove, MindyGaba, DavidGalea, SandroGallagher, ThomasGamble, VanessaGarber, AlanGaynor, MartinGelijns, AnnetineGeronimus, ArlineGlied, SherryGortmaker, StevenGray, BradfordGray, VirginiaGreenberg, DanielGrob, RachelGrogan, ColleenHaas-Wilson, DeborahHall, MarkHall, RichardHalpern, SydneyHammer, PeterHanoch, YanivHemenway, DavidHoffman, BeatrixHouse, JamesHowell, JoelHuskamp, HaidenIezzoni, LisaJackson, Pamela BraboyJacobs, LawrenceJacobson, PeterJohnson, KayJones, DavidKane, RosalieKaplan, GeorgeKaufman, JayKawachi, IchiroKennedy, BruceKlein, RudolfKlinenberg, EricKronick, RichardKunitz, StephenLantos, JohnLauderdale, DianeLazzarini, ZitaLeape, LucianLee, Shoou-Yih DanielLennon, Mary ClareLerner, BarronLevins, RichardLevy, FrankLink, BruceLowery, DavidLuft, HaroldLynch, JohnLynch, JuliaMarcus, Amy DockserMarkel, HowardMarkowitz, GeraldMarmor, TheodoreMcBride, DavidMcGuire, ThomasMechanic, DavidMello, MichelleMeltzer, DavidMillenson, MichaelMor, VincentMorales, LeoMorgan, KimberlyMorone, JamesMoscovice, IraNathanson, ConstanceNeedleman, JackNeighbors, HaroldOliver, ThomasPagán, JoséPatrick, DonaldPauly, MarkPerrin, JamesPescosolido, BernicePeterson, MarkPhelan, JoPortes, AlejandroPowers, G. MadisonQuadagno, JillRice, ThomasRoberts, DorothyRobinson, JamesRodwin, MarcRodwin, VictorRosenbaum, SaraRosner, DavidRothman, Barbara KatzRothman, DavidRothman, SheilaSage, WilliamSampat, BhavenSampson, RobertSanchez-Jankowski, MartinSardell, AliceScanlon, DennisSchlesinger, MarkSchneider, CarlScott, W. RichardSilvers, J.B.Skinner, JonathanSkocpol, ThedaSloan, FrankSmith, David B.Sparer, MichaelStein, RuthStern, Alexandra MinnaStevens, RosemaryStone, DeborahSuchman, MarkTeitelbaum, JoelThompson, FrankTomes, NancyUbel, PeterWailoo, KeithWallace, RodrickWarner, KennethWeiner, BryanWeir, MargaretWeisbrod, BurtonWeisman, CarolWestmoreland, TimothyWilliams, DavidWray, NeldaWright, GeorgeYoung, GaryZinn, Jacqueline
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Investigator Awards in Health Policy Research55 Commercial Ave.Third FloorNew Brunswick, NJ 08901-1340
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Investigator Awards in Health Policy Research, a national program of the Robert Wood Johnson Foundation (RWJF), supports researchers whose crosscutting and innovative ideas promise to contribute meaningfully to improving health and health care policy. The program provides one of the few funding opportunities in the United States for investigator-initiated projects that are broad in scope, innovative in approach, and have national policy relevance. Located at the Institute for Health, Health Care Policy, and Aging Research at Rutgers, The State University of New Jersey, the program is directed by David Mechanic, Ph.D.
What's New:Please note: Our web site address has changed to www.investigatorawards.org. Be sure to update or add our new address to your Favorites List.Friday, September 05, 2008 Hot Off the Press! The Contested Boundaries of American Public HealthEdited by James Colgrove, David Rosner (2001 Awardee), and Gerald Markowitz (2001 Awardee), The Boundaries of American Public Health is a collection of essays by 10 of the program's investigators and other scholars that probe what are, and what should be, the field of public health's chief goals and activities. Drawing on examples that include September 11th, Hurricane Katrina, the anthrax scare, and more, contributors examine the historical evolution of the profession and show how public health is changing in the context of natural and human-made disasters and the politics that surround them.Source: National Program OfficeFriday, September 05, 2008Hot Off the Press by Deborah Stone (1999 Awardee)!A new book by Deborah Stone, PhD (1999 Awardee), Research Professor of Government at Dartmouth, was recently published by Nation Books. The Samaritan's Dilemma: Should Government Help Your Neighbor explores how altruism can be harnessed for the common good, revive democracy, and mobilize people into politics.Source: National Program OfficeFriday, August 15, 2008JAMA Publishes Research Findings on Outcomes Following StentingOn June 25, 2008, JAMA published a paper by Jonathan Skinner, PhD (2005 Awardee) and colleagues at Dartmouth on "Outcomes Following Coronary Stenting in the Ear of Bare Metal vs. the Era of Drug-Eluting Stents." The research results were covered in a Wall Street Journal article on June 25, 2008 titled, "Study Might Ease Stent Fears."Source: National Program OfficeThursday, June 26, 2008JAMA and NEJM Review Medical Malpractice by Frank Sloan (2003 Awardee) and Lindsey ChepkeMedical Malpractice was reviewed in the July 16, 2008 issue of JAMAand the June 26, 2008 issue of NEJM. Authored by Frank Sloan, 2003 Awardee, and Lindsey Chepke, the book, published in 2008 by MIT Press, provides a comprehensive analysis of medical malpractice from legal, medical, economic, and insurance perspectives that considers why past efforts at reform have not worked and offers recommendations for realistic, achievable policy changes. According to the New England Journal review, Medical Malpractice "is a scholarly masterpiece and is easily the definitive work on its subject." For more information about the book, scroll down to the Featured Books section of this web page.Source: National Program OfficeThursday, June 26, 2008JAMA Reviews Science for Sale by Dan Greenberg, 2002 AwardeeScience for Sale: The The Perils, Rewards, and Delusions of Campus Capitalism was reviewed in the June 18, 2008 issue of JAMA. Authored by Daniel Greenberg, 2002 Awardee, the book, published in 2007 by University of Chicago Press, reveals that campus capitalism is more complicated—and less profitable—than media reports would suggest. According to the review, "Greenberg has done an outstanding job of detailing the problems and successes of academic entrepreneurship and has provided an excellent analysis of the current state of university science." For more information about the book, scroll down to the Featured Books section of this web page.Source: National Program OfficeMonday, May 19, 2008New Investigators Announced!Fifteen scholars affiliated with major universities across the country are starting new projects this year with suppport from the Robert Wood Johnson Foundation Investigator Awards in Health Policy Research program. The winning researchers will explore many challenging issues facing America today, as well as wide-ranging concerns about the nation's health and health care system. More information about the award recipients and their projects can be found in Research in Profile, Issue 23.Source: National Program OfficeView Archived AnnouncementsOnline Book » Policy Challenges in Modern Health Care:Go to Policy Challenges Special Feature Policy Challenges in Modern Health CareMechanic, D., Rogut, L., Colby, D., Knickman, J., editorsPublished: 2005Rutgers University PressA composite look at some of the striking contemporary challenges we face in health and health care by some of the nation's leading thinkers.Show summaryPraise for Policy Challenges in Modern Health Care
"A marvelous collection of ideas and insights by first-rate scholars. This book lays a foundation for more creative and effective policy-making." - Stephen M. Shortell, Dean and Blue Cross of California Professor of Health Policy and Management, University of California, Berkeley
Health care delivery in the United States is an enormously complex enterprise, and its $1.6 trillion annual expenditures involve a host of competing interests. While arguably the nation offers among the most technologically advanced medical care in the world, the American system consistently under performs relative to its resources. Gaps in financing and service delivery pose major barriers to improving health, reducing disparities, achieving universal insurance coverage, enhancing quality, controlling costs, and meeting the needs of patients and families.
Bringing together twenty-five of the nation's leading experts in health care policy and public health, this book provides a much-needed perspective on how our health care system evolved, why we face the challenges that we do, and why reform is so difficult to achieve. The essays tackle tough issues including: socioeconomic disadvantage, tobacco, obesity, gun violence, insurance gaps, the rationing of services, the power of special interests, medical errors, and the nursing shortage.
Linking the nation's health problems to larger political, cultural, and philosophical contexts, Policy Challenges in Modern Health Care offers a compelling look at where we stand and where we need to be headed.
(Rutgers University Press, rutgerspress.rutgers.edu)(ISBN:0-8135-3578-6)Research In Profile » Current Issue: Section InfoResearch In Profile is a series of pieces about investigators and their work that focuses on project findings, research insights, and policy implications. Summaries are provided on the website and each issue is available for download in Adobe Acrobat PDF format. Print copies can be requested from the National Program Office by sending an email to depdir@ifh.rutgers.edu.Go to the Research In Profile Index Paying the Tab: Reducing the Social Costs of Alcohol Use through PolicyPhilip J. Cook, Ph.D.Issue 24, August 2008Download the full issue in PDF formatGo to Issue IndexShow SummaryAccording to Philip J. Cook, alcohol in the United States is simply too cheap, and it’s costing all of us: through addiction, lost lives, broken families, crime, violence, poor health, and wasted human potential. Although decades of efforts to reduce these costs – by cracking down on drunken driving and curbing underage drinking – have produced some effects, they’ve fallen short overall, in Cook’s opinion. Cook, the ITT/Terry Sanford Professor of Public Policy Studies and Professor of Economics and Sociology at Duke University, declares that alcohol is our nation’s No. 1 “drug” problem, and it needs to be confronted more aggressively.
The most obvious approach would be to focus on the supply side of the equation. Beer and liquor are far cheaper and more readily available today than in the 1950s and 1960s. But while federal and state excise taxes on cigarettes have risen remarkably over the past decade, real tax rates on beer, wine, and liquor have fallen dramatically during the past 50 years. Federal and state excise tax revenues on cigarettes amount to $21.5 billion a year; for alcohol, that total is just over $14 billion.
Now, pressed by both federal budget shortfalls and alcohol’s continuing high cost to society, more than 60 prominent economists and four Nobel laureates have called on Congress to raise alcohol taxes. Among those leading the call for higher taxes is Cook, author of Paying The Tab: The Costs and Benefits of Alcohol Control, published in 2007 with support from a Robert Wood Johnson Foundation (RWJF) Investigator Award in Health Policy Research.Read More... (PDF)Featured Books by Investigators:Section InfoInvestigator publications listed on this site relate to research funded through the Investigator Awards program. References are provided for books and selected journal articles written by the investigators. Abstracts are available for some featured publications.Go to: All Books | Book Chapters | Journal Articles Unnatural History: Breast Cancer and American SocietyAronowitz, R.A.Published: 2007Cambridge University PressMore detailsShow summaryUnnatural History explores the change over the last two centuries from isolated, private fears to an immense individual and collective risk of breast cancer. The book begins with the experiences of a Quaker woman diagnosed with breast cancer in 1812 and ends with our problematic era in which almost every woman is waiting for 'the axe to fall'. In between, the book traces changes in the beliefs and values of women and their doctors, medical knowledge and technology, clinical and public health practices, and the biological impact of the disease. Unnatural History suggests that we have oversold both the fear of breast cancer and the effectiveness of screening and treatment, leading to miscalculation at the individual and societal levels. Searching Eyes: Privacy, the State and Disease Surveillance in AmericaBayer, R., Fairchild, A., Colgrove, J.Published: 2007University of California PressMore detailsShow summaryThis is the first history of public health surveillance in the United States to span more than a century of conflict and controversy. The practice of reporting the names of those with disease to health authorities inevitably poses questions about the interplay between the imperative to control threats to the public's health and legal and ethical concerns about privacy. Authors Amy L. Fairchild, Ronald Bayer, and James Colgrove situate the tension inherent in public health surveillance in a broad social and political context and show how the changing meaning and significance of privacy have marked the politics and practice of surveillance since the end of the nineteenth century.
"This is a stunning book -- comprehensive and perceptive. Searching Eyes: Privacy, the State, and Disease Surveillance in America is a major achievement in interdisciplinary scholarship and historical interpretation, and will remain the definitive work on this important subject for many years to come."--Theodore M. Brown, Ph.D., Professor of History, Community and Preventive Medicine, and Medical Humanities, University of Rochester.
"A landmark in the history and ethics of public health. Meticulously researched, it provides the first overarching account of the evolution of public health surveillance in the United States, from the debates over tuberculosis and venereal disease at the start of the 20th century to the tensions over AIDS and bioterrorism at century's end. Fairchild, Bayer, and Colgrove provide insights not only into how concerns about privacy shaped the politics of public health but also about how the need for protection and services could fuel the demand for extending surveillance. Searching Eyes is invaluable not only for those who want to understand the past but for those who will be called on to make and debate public health policy in the future."--Larry O. Gostin, Associate Dean and O'Neill Professor of Global Health Law, Georgetown University. Toxic Exposures: Contested Illnesses and the Environmental Health MovementBrown, P.Published: 2007Columbia University PressMore detailsShow summaryReview
"Brown's book presents new analytic arguments and sound suggestions for what works in community-based environmental health movements and what does not." -- Kelly Moore, University of Cincinatti
Book Description
The alarming increase in the incidence of environmentally induced diseases has led many scientists and environmental health advocates to challenge prevailing epidemiological paradigms. Focusing specifically on "contested illnesses" whose origins have generated intense debate in the medical and political communities-breast cancer, asthma, and Gulf War-related health conditions-Phil Brown shows how the debate has prompted scientists and concerned citizens to launch an environmental health movement that has revolutionized scientific thinking and policy. Brown argues that organized social movements are crucial in recognizing and acting to combat environmental diseases. His probing look at dominant biomedical models, the ways scientific findings are made available to the public, and the changing nature of policy offers a new perspective on health and the environment and the relationship between people, knowledge, power, and authority.
(ISBN-10: 0231129483) Paying the Tab: The Costs and Benefits of Alcohol ControlCook, P.J.Published: 2007Princeton University PressMore detailsShow summaryWhat drug provides Americans with the greatest pleasure and the greatest pain? The answer, hands down, is alcohol. The pain comes not only from drunk driving and lost lives but also addiction, family strife, crime, violence, poor health, and squandered human potential. Young and old, drinkers and abstainers alike, all are affected. Every American is paying for alcohol abuse.
Paying the Tab, the first comprehensive analysis of this complex policy issue, calls for broadening our approach to curbing destructive drinking. Over the last few decades, efforts to reduce the societal costs--curbing youth drinking and cracking down on drunk driving--have been somewhat effective, but woefully incomplete. In fact, American policymakers have ignored the influence of the supply side of the equation. Beer and liquor are far cheaper and more readily available today than in the 1950s and 1960s.
Philip Cook's well-researched and engaging account chronicles the history of our attempts to "legislate morality," the overlooked lessons from Prohibition, and the rise of Alcoholics Anonymous. He provides a thorough account of the scientific evidence that has accumulated over the last twenty-five years of economic and public-health research, which demonstrates that higher alcohol excise taxes and other supply restrictions are effective and underutilized policy tools that can cut abuse while preserving the pleasures of moderate consumption. Paying the Tab makes a powerful case for a policy course correction. Alcohol is too cheap, and it's costing all of us. Inclusion: The Politics of Difference in Medical ResearchEpstein, S.G.Published: 2007U of Chicago PressMore detailsShow summaryAs a society, we have learned to value diversity. But can some strategies to achieve diversity mask deeper problems, ones that might require a different approach and different solutions? With Inclusion, Steven Epstein argues that in the field of medical research, the answer is an emphatic yes.
Formal concern with diversity in American medical research, Epstein shows, is a fairly recent phenomenon. Until the mid-1980s, few paid close attention to who was included in research subject pools. Not uncommonly, scientists studied groups of mostly white, middle-aged men—and assumed that conclusions drawn from studying them would apply to the rest of the population. But struggles involving advocacy groups, experts, and Congress led to reforms that forced researchers and pharmaceutical companies to diversify the population from which they drew for clinical research. That change has gone hand in hand with bold assertions that group differences in society are encoded in our biology—for example, that there are important biological differences in the ways that people of different races and sexes respond to drugs and other treatments.
While the prominence of these inclusive practices has offered hope to traditionally underserved groups, Epstein argues forcefully that it has drawn attention away from the tremendous inequalities in health that are rooted not in biology but in society. There is, for instance, a direct relationship between social class and health status—and Epstein believes that a focus on bodily differences can obscure the importance of this factor. Only when connected to a broad-based effort to address health disparities, Epstein explains, can a medical policy of inclusion achieve its intended effects.
A fascinating history, powerful analysis, and call to action, Inclusion will be essential reading for medical professionals, policymakers, and any concerned citizen. Science for Sale: The Perils, Rewards, and Delusions of Campus CapitalismGreenberg, D.S.Published: 2007University of Chicago PressMore detailsShow summaryIn recent years the news media have been awash in stories about increasingly close ties between college campuses and multimillion-dollar corporations. Our nation’s universities, the story goes, reap enormous windfalls patenting products of scientific research that have been primarily funded by taxpayers. Meanwhile, hoping for new streams of revenue from their innovations, the same universities are allowing their research—and their very principles—to become compromised by quests for profit. But is that really the case? Is money really hopelessly corrupting science?
With Science for Sale, acclaimed journalist Daniel S. Greenberg reveals that campus capitalism is more complicated—and less profitable—than media reports would suggest. While universities seek out corporate funding, news stories rarely note that those industry dollars are dwarfed by government support and other funds. Also, while many universities have set up technology transfer offices to pursue profits through patents, many of those offices have been financial busts. Meanwhile, science is showing signs of providing its own solutions, as highly publicized misdeeds in pursuit of profits have provoked promising countermeasures within the field.
But just because the threat is overhyped, Greenberg argues, doesn’t mean that there’s no danger. From research that has shifted overseas so corporations can avoid regulations to conflicts of interest in scientific publishing, the temptations of money will always be a threat, and they can only be countered through the vigilance of scientists, the press, and the public.
Based on extensive, candid interviews with scientists and administrators, Science for Sale will be indispensable to anyone who cares about the future of scientific research. Healthy Voices, Unhealthy Silence: Advocacy and Health Policy for the PoorGrogan, C., Gusmano, M.Published: 2007Georgetown University PressMore detailsShow summaryPublic silence in policymaking can be deafening. When advocates for a disadvantaged group decline to speak up, not only are their concerns not recorded or acted upon, but also the collective strength of the unspoken argument is lessened—a situation that undermines the workings of deliberative democracy by reflecting only the concerns of more powerful interests. But why do so many advocates remain silent on key issues they care about and how does that silence contribute to narrowly defined policies? What can individuals and organizations do to amplify their privately expressed concerns for policy change?
In Healthy Voices, Unhealthy Silence, Colleen M. Grogan and Michael K. Gusmano address these questions through the lens of state-level health care advocacy for the poor. They examine how representatives for the poor participate in an advisory board process by tying together existing studies; extensive interviews with key players; and an in-depth, first-hand look at the Connecticut Medicaid advisory board's deliberations during the managed care debate. Drawing on the concepts of deliberative democracy, agenda setting, and nonprofit advocacy, Grogan and Gusmano reveal the reasons behind advocates' often unexpected silence on major issues, assess how capable nonprofits are at affecting policy debates, and provide prescriptive advice for creating a participatory process that adequately addresses the health care concerns of the poor and dispossessed.
Though exploring specifically state-level health care advocacy for the poor, the lessons Grogan and Gusmano offer here are transferable across issue areas and levels of government. Public policy scholars, advocacy organizations, government workers, and students of government administration will be well-served by this significant study. Fads, Fallacies and Foolishness in Medical Care Management and PolicyMarmor, T.R.Published: 2007World Scientific PublishingMore detailsShow summaryNo one misses the onslaught of claims about reforming modern medical care. How doctors should be paid, how hospitals should be paid or governed, how much patients should pay when sick in co-payments, how the quality of care could be improved, and how governments and other buyers could better control the costs of care — all find expression in the explosion of medical care conference proceedings, op-eds, news bulletins, journal articles, and books.
< p/>This collection of articles takes up a key set of what the author regards as particularly misleading fads and fashions — developments that produce a startling degree of foolishness in contemporary discussions of how to organize, deliver, finance, pay for and regulate medical care services in modern industrial democracies.
The policy fads addressed include the celebration of explicit rationing as a major cost control instrument, the belief in a "basic package" of health insurance benefits to constrain costs, the faith that contemporary cross-national research can deliver a large number of transferable models, and the notion that broadening the definition of what is meant by health will constitute some sort of useful advance in practice. The Public Private Health Care State: Essays on the History of American Health Care PolicyStevens, R.A.Published: 2007Transaction PublishersMore detailsShow summaryThe distinctive mixing and continuous remixing of pub- lic and private roles is a defining feature of health care in the United States. The Public-Private Health Care State explores the interweaving of public and private enterprise in health care in the United States as a basis for thinking about health care in terms of its history and its continuing evolution today. Historian and policy analyst Rosemary Stevens has selected and edited seventeen essays from both her published and unpublished work to illustrate continuing themes, such as: the flexible meanings of the terms “public” and “private,” and how useful their ambiguity has been and is; the role of ideology as ratifying rather than preordaining change; and the common behavior of public leaders and corporate entities in the face of fiscal opportunity.
The topics—covering the period of 1870 through the twenty-first century—represent Stevens’ research interests in hospital history and policy, the medical profession, government policy, and paying for health care. The volume also considers her involvement with policy questions, which include health services research, health maintenance organizations, and physician workforce policy.
Section I demonstrates the long history of state government involvement with private not-for-profit hospitals from the 1870s through the 1930s. Section II examines the federal role in health care from the 1920s through the 1970s, including the establishment of veterans’ hospitals and the implementation of Medicaid. Section III shows how shifting governmental roles require constantly changing organizing rhetoric, whether for inventing a federal role for health services research and HMOs, “regionalization” in the 1970s, or defining civil rights and “equity” as mobilizing vehicles in the 1980s. Section IV examines growing concerns from the 1970s through the present about the traditional “public” role of the largely “private” medical profession. Section V returns to the ambiguous public-private status of not-for profit hospitals, buffeted in the 1980s and 1990s by assumptions about the efficiency of the market.
Rosemary Stevens is a DeWitt Wallace Distinguished Scholar in social medicine and public policy at Weill Cornell Medical College, and Stanley I. Sheerr Professor Emeritus in the history and sociology of science at the University of Pennsylvania. Disease Prevention as Social Change: The State, Society, and Public Health in the U.S., France, Great Britain, and CanadaNathanson, C.A.Published: March 2007Russell Sage FoundationMore detailsShow summaryFrom 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. The Contested Boundaries of American Public HealthColgrove, J., Markowitz, G., Rosner, D., editors.Published: 2008Rutgers University PressMore detailsShow summaryThe role of public health services in America is generally considered to be the reduction of illness, suffering, and death. But what exactly does this mean in practice? At different points in history, professionals in the field have addressed housing reform, education about sex and illegal drugs, hospital and clinic care, gun violence, and even bioterrorism. But there is no agreement about how far public health efforts should go in attempting to modify behaviors seen as lifestyle choices, or whether the field's mandate extends to intervening in broader social and economic conditions.
The authors of the thirteen essays in this book attempt to understand what are, and what should be, the field's chief goals and activities. Drawing on examples that include September 11th, Hurricane Katrina, the anthrax scare, and more, contributors examine the historical evolution of the profession and show how public health is changing in the context of natural and human-made disasters and the politics that surround them. Just Health: Meeting Health Needs FairlyDaniels, N.Published: 2008Cambridge University PressMore detailsShow summaryIn this new book by the award-winning author of Just Healthcare, Norman Daniels develops a comprehensive theory of justice for health that answers three key questions: What is the special moral importance of health? When are health inequalities unjust? How can we meet health needs fairly when we cannot meet them all? The theory has implications for national and global health policy: Can we meet health needs fairly in aging societies? Or protect health in the workplace while respecting individual liberty? Or meet professional obligations and obligations of justice without conflict? Medical MalpracticeSloan, F.A., Chepke, L.M.Published: 2008MIT PressMore detailsShow summaryA comprehensive analysis of medical malpractice from legal, medical, economic, and insurance perspectives that considers why past efforts at reform have not worked and offers recommendations for realistic, achievable policy changes.
Most experts would agree that the current medical malpractice system in the United States does not work effectively either to compensate victims fairly or prevent injuries caused by medical errors. Policy responses to a series of medical malpractice crises have not resulted in effective reform and have not altered the fundamental incentives of the stakeholders. In Medical Malpractice, economist Frank Sloan and lawyer Lindsey Chepke examine the U.S. medical malpractice process from legal, medical, economic, and insurance perspectives, analyze past efforts at reform, and offer realistic, achievable policy recommendations. They review the considerable empirical evidence in a balanced fashion and assess objectively what works in the current system and what does not. Sloan and Chepke argue that the complexity of medical malpractice stems largely from the interaction of the four discrete markets that determine outcomes--legal, medical malpractice insurance, medical care, and government activity. After describing what the evidence shows about the functioning of medical malpractice, types of defensive medicine, and the effects of past reforms, they examine such topics as scheduling damages as an alternative to flat caps, jury behavior, health courts, incentives to prevent medical errors, insurance regulation, reinsurance, no-fault insurance, and suggestions for future reforms.
Medical Malpractice is the most comprehensive treatment of malpractice available, integrating findings from several different areas of research and describing them accessibly in nontechnical language. It will be an essential reference for anyone interested in medical malpractice. The Samaritan's Dilemma: Should Government Help Your Neighbor?Stone, D.A.Published: 2008Nation BooksMore detailsShow summaryFor at least a generation, experts have warned us not reach out to others. Too much help makes people passive and dependent, we are told, and self interest is the only motive that spurs people to work and contribute to society. Liberals and conservatives alike have endorsed this new moral code for government. The Samaritan's Dilemma challenges this conventional wisdom. We are born needing help, we die needing help, and we live out our days getting and giving help. We live by everyday altruism. So when leaders define the ideal citizen as someone who pursues his self interest and withholds help from others, good people are repelled by politics.
The Samaritan's Dilemma calls on us to restore the public sphere as a place where citizens can fulfill their moral aspirations. If government helps the neighbors, citizens will once again want to help govern. With unforgettable stories of how real people think and feel when they practice kindness, Stone shows that everyday altruism is the premier school for citizenship. At a time when millions of citizens ache to put the Bush and Reagan era behind us and feel proud of their government, award-winning political scientist Deborah Stone offers an enormously hopeful vision of politics.This Year's Investigator Awards:Section InfoThis section contains information about all of the projects and researchers that have been funded through the Investigator Awards program since the first grants were made in 1993. The indexes in this section can be used to identify investigators by name, area of expertise, or year of award. Throughout the site, you will find that each investigator’s name links to details including contact and project information.May 2008
The Robert Wood Johnson Foundation (RWJF) has announced the selection of this year’s recipients of its Investigator Awards in Health Policy Research. Fifteen scholars affiliated with major universities across the country will receive a total of $3.5 million to support 11 new research projects. The winning researchers will explore many challenging policy issues facing America today, as well as wide-ranging concerns about the nation’s health and health care system.
This highly competitive funding program attracts investigators from a variety of disciplines, including medicine, nursing, public health, economics, sociology, political science, psychology, history, law, ethics, journalism, and public and social policy. A national advisory committee of distinguished experts from fields similar to those of the investigators reviews applications.
RWJF created the Investigator Awards in Health Policy Research program to support researchers whose cross-cutting and innovative ideas promise to contribute meaningfully to improving health and health care policy. The program provides one of the few funding opportunities in the United States for investigator-initiated projects that are broad in scope, innovative in approach, and have national policy relevance. Since 1992, the Foundation has supported 147 projects involving 186 investigators.
“Through the Investigators’ program, the Foundation invests in ideas and individuals – investments that pay off long after the research grants have ended,” says Lori Melichar, Ph.D., economist and senior program officer in research and evaluation at RWJF. “The books and articles resulting from Investigators’ research contribute to the public discourse in health policy. The program also provides the Investigators with opportunities to join the debate on health policy issues and influence how policymakers think about the challenges of providing and financing health care and improving the health of the nation.”
For details of the 2007 Investigator Awards click "Show Awards" below. Show AwardsCarol M. Ashton, M.D., M.P.H.Nelda P. Wray, M.D., M.P.H.Improving the Evidence Base for Invasive Therapeutic ProceduresAward Year: 2007Show AbstractDespite the American fascination with high-tech medicine, new treatments don’t always deliver desired cures or improvements. While pharmaceutical products must be rigorously tested and approved by the U.S. Food and Drug Administration before going to market, any surgeon or interventionist can provide a new therapeutic procedure without valid scientific proof of its effectiveness. This can pose real problems for people seeking to make health care decisions – whether it’s a physician considering how to treat a medical problem, a health plan deciding whether to cover a procedure, or a patient considering surgery. Oftentimes, the evidence needed to make those decisions simply doesn’t exist. Carol M. Ashton, M.D., M.P.H., and Nelda P. Wray, M.D., M.P.H. explore how studies that generate evidence of what works best by comparing alternatives could be applied to surgical and other therapeutic procedures. They examine how payment incentives might be used to encourage physicians and patients to help generate the data needed to quantify the risks and benefits of procedures and to create the evidence upon which more informed treatment decisions can be made. Their project, Improving the Evidence Base for Invasive Therapeutic Procedures, should help inform the design of payment policies to promote the use of procedures with scientifically proven benefits and reduce the use of those for which safer, more effective, and less expensive alternatives exist.Jason Corburn, Ph.D., M.C.P.Toward the Healthy City: Urban Planning and Policy for Healthy People and PlacesAward Year: 2007Show AbstractAlthough the fields of urban planning and public health worked together in the 19th century to improve the health and well-being of poor American city dwellers, today’s urban land-use decisions are no longer driven by public health and social justice concerns. Jason Corburn, Ph.D., is interested in how the two fields might be reconnected to encourage the development of healthier and more just cities. He examines common urban challenges, including health disparities, declines in affordable housing, residential segregation, and unequal access among neighborhoods to transit, open space, and quality food markets. Through case studies of policy innovations in the San Francisco Bay area, where urban planners, public health and community organizations are beginning to work together, Corburn explores how a population health approach might be integrated into land-use decisions through policy processes such as health impact assessment. His project, Toward the Healthy City: Urban Planning and Policy for Healthy People and Places, aims to change views on the connections between public health and urban design, to identify the policy levers that contribute to innovation, and to provide insights for how similar policies can be used in other cities and states.Thomas H. Gallagher, M.D.Michelle M. Mello, J.D., Ph.D., M.Phil.Responding Justly to Patients Harmed by Medical Care: Disclosure, Compensation, and LitigationAward Year: 2007Show AbstractThe Institute of Medicine’s 2000 report, To Err Is Human, and the widespread media attention it received, dramatically increased awareness of the extent of medical mistakes in U.S. hospitals. Since then, a number of states and national quality organizations have adopted policies requiring or encouraging medical professionals to tell patients and families when unanticipated “adverse events” occur. Some organizations and insurers have gone even further by adopting programs through which disclosures of adverse events are accompanied by offers of compensation (known as disclosure and offer or D&O programs). Still, prompt disclosure of medical errors and fair compensation remain the exception rather than the rule. Thomas H. Gallagher, M.D. and Michelle M. Mello, J.D., Ph.D., M.Phil., seek to more fully understand the effects of disclosure initiatives and innovative D&O programs on malpractice costs and patients’ access to compensation. Their project, Responding Justly to Patients Harmed by Medical Care: Disclosure, Compensation, and Litigation, explores how policy levers can be used to make disclosing errors more routine and evaluates the design and effectiveness of D&O programs. Their work should help policymakers better understand the potential of these initiatives and how they might best be integrated into broader medical liability reforms.David S. Jones, M.D., Ph.D.The Rise and Fall of Cardiac Revascularization: Therapeutic Evolution and Health Policy in the Late Twentieth CenturyAward Year: 2007Show AbstractOver the last 15 to 20 years, evidence-based medicine and clinical practice guidelines have been embraced as ways to rationalize medical decisions about how to treat patients. But the results so far have been mixed, as the treatment of coronary artery disease (CAD) demonstrates. Two of the standard treatments for CAD, coronary artery bypass grafting and percutaneous transluminal coronary angioplasty, have been used far more frequently than indicated, with periods of growth and decline not associated with changes in the evidence base on why and when they should be used. David S. Jones, M.D., Ph.D. explores this disconnect between clinical evidence and medical practice. He considers how physicians have responded to competing hypotheses about the causes of CAD, treatment risks and unexpected complications, and evidence of wide disparities in the use of cardiac surgery and angioplasty. His project, The Rise and Fall of Cardiac Revascularization: Therapeutic Evolution and Health Policy in the Late 20th Century, aims to uncover the range of factors that influence clinical decision making in American medicine. Results should increase understanding of the appropriate uses of bypass grafting and angioplasty, as well as newer technologies such as intravascular ultrasound, stents, and possibly even gene therapy.Shoou-Yih Daniel Lee, Ph.D.Bryan J. Weiner, Ph.D.Transformation of Government Health Care: Experience of the New Veterans Health AdministrationAward Year: 2007Show AbstractMany Americans strongly oppose the idea of “government-run” health care, preferring market-driven strategies for solving the problems of the U.S. health care system. Yet, over the last decade, the federally financed Veterans Health Administration (VHA) has become one of the great success stories of health care improvement in America. How did the VHA, a massive, government-operated health system, rescue itself from congressional threats of overhaul and privatization? And how did the VHA become a model of high-quality, lower-cost care that now surpasses Medicare and private health plans on many quality measures? Shoou-Yih Daniel Lee, Ph.D. and Bryan Weiner, PhD. probe these questions in their case study of the VHA’s success. Using a framework of “punctuated change,” Lee and Weiner explore how VHA’s leaders and management responded to Congress, overcame organizational inertia, and set a new course. Their project, Transformation of Government Health Care: Experience of the VHA, considers the importance of leadership, the paths and pace of change, internal and external resistance, and the leverage points that help move change along. Their findings should provide a clearer picture of how the VHA became a quality-driven health system and how other public and private health care systems might use the lessons of its success.Frank Levy, Ph.D.Curbing the Use of Medical Imaging: Searching for Efficient Technology Utilization in a Fee-for-Service WorldAward Year: 2007Show AbstractHigh-tech diagnostic imaging equipment is now available in hospitals, imaging centers, large multi-specialty group practices, and more types of doctors’ offices than ever before. While this has made things easier for physicians and patients, it has also produced rapid growth in medical expenditures for scans and contributed to the overall rise in U.S. health care spending. Although medical professionals generally agree that imaging’s rapid growth includes significant waste due to overuse, scientific evidence is lacking on which imaging is unnecessary. Frank Levy, Ph.D. seeks to better understand the drivers of the rapid growth in spending for imaging and the ways that waste might be identified. His Investigator Award project, Curbing the Use of Medical Imaging – Searching for Efficient Technology Utilization in a Fee-for-Service World, analyzes spending growth and examines initiatives by health care organizations to define and limit unnecessary imaging and to influence physician behavior. Levy notes that this “soft rationing” – limiting medical expenditures and unnecessary procedures through strategies such as prior authorization requirements and physician profiling – may also become important in other areas of health care. His research findings should help inform efforts to contain the growth and costs of imaging as well as other medical procedures.Howard Markel, M.D., Ph.D., F.A.A.P.Alexandra Minna Stern, Ph.D.History Informing Public Health Preparedness Policy in the 21st Century: A Qualitative Study of Non-Pharmaceutical Interventions and Community Experiences during the 1918-1919 Influenza PandemicAward Year: 2007Show AbstractThe influenza pandemic of 1918-1919 was the deadliest contagious calamity in human history, killing 650,000 people in the United States and 50 million worldwide. But the pandemic’s effects varied geographically – some communities were devastated while others suffered few if any deaths. To learn why, Howard Markel, M.D., Ph.D., F.A.A.P. and Alexandra Minna Stern, Ph.D., conduct a comprehensive review of the strategies used by 43 U.S. cities during the 1918-1919 flu epidemic. Markel and Stern examine such public health measures as isolation of the ill, quarantines on those suspected of contact with the ill, school closures, and bans on public gatherings. They also analyze the cities’ demographic and housing characteristics, morbidity and mortality patterns, political leadership and coordination among government agencies, supply of health care facilities and medical personnel, and compliance with public health measures. Their project, History Informing Public Health Preparedness Policy in the 21st Century: A Qualitative Study of NonPharmaceutical Interventions and Community Experiences during the 1918-1919 Influenza Pandemic, aims to extract lessons that can inform pubic health policymaking and preparedness planning today.David Meltzer, M.D., Ph.D.Hospitalists and American Medicine: A Quantitative History of a New Medical SpecialtyAward Year: 2007Show AbstractThe emergence of hospitalists – physicians who specialize in the medical care of hospitalized patients – represents a major transformation in the practice of modern American medicine. Over the past decade, the field has grown from a few hundred physicians to more than 20,000. David O. Meltzer, M.D., Ph.D. believes that many factors may have contributed to this growth – from shifts in the nature and organization of primary care to Medicare payment incentives that make it more profitable for hospitals to discharge patients quickly. His project, Hospitalists and American Medicine: A Quantitative History of a New Medical Specialty, investigates the rise of the hospitalist movement, its effects on the organization of patient care in hospitals and ambulatory care settings, the potential contributions of hospitalists to improving health care quality, and how their emergence might help inform broader efforts aimed at reorganizing the practice of medicine. His findings should shed light on some of the forces and special interests at play in rethinking the roles of primary care physicians and medical specialists in the United States.Dorothy E. Roberts, J.D.Race Consciousness in Biomedicine, Law, and Social PolicyAward Year: 2007Show AbstractThe validity of race-based medicine remains highly controversial. Some scientists, policymakers, and activists criticize it as flawed given scientific evidence that there is far more genetic variation within racial groupings than between them. Others welcome it for its potential to address health disparities, past discrimination in the provision of medical care, and lack of minority representation in biomedical research. What is the proper role of race in medicine, biomedical and disparities research, and health policy? And how are views about race in medicine related to broader debates in America about racial equality? Dorothy E. Roberts, J.D. explores the development of race-based medicine and its relationship to concepts of social justice. Her project, Race Consciousness in Biomedicine, Law, and Social Policy, uses legal doctrine and theories of racial equality to examine scientific and political debates about race consciousness and colorblindness and to evaluate the ethics of using race in biomedical research and policy development. The results of her study should provide practical guidance to researchers and policymakers concerned with the proper role of race in science and health policy.Frank J. Thompson, Ph.D.Medicaid: Political Durability, Democratic Process and Health Care ReformAward Year: 2007Show AbstractIn the face of mounting pressures to contain health care costs and strongly held partisan views about entitlement programs, what does the future hold for Medicaid? Will Medicaid, which costs more than $300 billion annually and provides coverage to some 55 million low-income Americans, be subjected to deep budget cuts? Or can it resist erosion and perhaps even expand to cover more of the nation’s 47 million uninsured? Frank J. Thompson, Ph.D. explores these questions in his project, Medicaid: Political Durability, Democratic Process, and Health Care Reform. He examines Medicaid’s structure as a federal grant program; its varied constituents, including the disabled and middle-class elderly as well as low-income mothers and children; characteristics of the American political system, such as federalism and party division, that often make program cuts more difficult; and the use of administrative rather than legislative strategies by the Clinton and Bush administrations to try to transform Medicaid. Thompson considers the possibilities for using Medicaid to expand insurance coverage, to shift more long-term care from institutions to communities, and to achieve other reforms that could promote innovation, transparency, and broader participation in policymaking.Peter A. Ubel, M.D.Emotional Adaptation and the Goals of Health Care PolicyAward Year: 2007Show AbstractResearchers have shown that people can adapt emotionally to a wide range of adverse circumstances. But predictions about how fully people will or will not adapt to serious illness and disability, either physical or mental, are often wrong. For example, people with quadriplegia report moods and quality of life that are similar to those reported by people who are healthy, and exceed what healthy people believe their moods and quality of life would be if they were to become quadriplegic. How do these beliefs affect the choices made when patients seek treatments for illnesses, when payers determine coverage policies, and when policymakers weigh programmatic or financing options? What role should well-being play in determining health care priorities, and how should policies that aim to maximize health address conditions where improving physical functioning and well-being do not go hand in hand? Peter A. Ubel, M.D. examines these complicated questions in his project, Emotional Adaptation and the Goals of Health Care Policy. This study attempts to break new ground by introducing insights from well-being research to debates about the cost-effectiveness of medical treatments, coverage decisions by payers, and discussions about health care priorities in the United States.Applications » Important DatesSection InfoThis section provides information about how to apply for an Investigator Award as well as background information about the program.Next Important Date:July 29, 2008 - Deadline for receipt of full proposals.Go to: 2008 Call For Applications | How to Apply | Downloads2008 Application Cycle: January 7, 2008Announcement of Call for Applications March 26, 2008(5 p.m. ET)Deadline for receipt of letters of intent. Applications must be received by 5 p.m. June 13, 2008Applicants will be notified by mail whether they have been selected to submit a full proposal. July 29, 2008Deadline for receipt of full proposals. December 15, 2008Notification letters mailed to proposal applicants. March 1 to September 1, 2009Acceptable start dates for projects.
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