Disease Prevention as Social Change: A Comparative Study of Public Health Policymaking in the U.S., Canada, Great Britain, and France

Award Year: 1994	Investigator: Constance Nathanson	Budget: $248,582	Categories: Comparative Healthcare Systems, History of Health Policy and Public Health
Abstract: This project explores social and political factors, which foster or impede effective public health policymaking, and the development of a sociological theory of change in parameters of health and disease. Historical and demographic research indicates that public health policies play a significant role in mortality decline and that these policies are the outcome of identifiable social and political processes. Dr. Nathanson examines: the roles of state characteristics, grass-roots social and/or political movements, and issue-specific social characteristics in public health policy adoption and implementation. These variables and their relative importance are investigated through comparative analysis of infant health, tuberculosis, sexually transmitted diseases/HIV infection, and smoking as they have evolved from the late nineteenth century to the present in the U.S., Canada, Great Britain, and France. Drawing from case studies, she clarifies the unique aspects of the U.S. experience in public health policymaking, highlighting its limits and possibilities.