Amy L. Fairchild

Fatal misconception: The struggle to control world population

The delicate subject of unbridled human population growth in the developing world and how the international community might seek to reduce it is inching its way back into the global health discourse. Economist Jeffrey Sachs (2008) speaks unabashedly about the need for population control, arguing in his latest book that sub-Saharan subsistence farmers will never be able to feed their families until they start having fewer babies. The only way out of this ‘demographic trap’, he writes, is for rich countries to ‘speed the voluntary reduction of fertility rates’ by buying birth control for poor Africans. Thomas Hayden and Malcolm Potts (2010) detail the ‘biological’ repercussions of high fertility in a recent Miller-McCune cover story, warning that unchecked population growth in poor countries leads to a glut of young males and thus a ‘quantifiable increase in the likelihood of bloody conflict’. And in May, the news magazine Mother Jones published a 10,000-word dispatch (Whitty 2010) on India’s crisis of ‘ecological overshoot’ the threshold at which a nation begins to consume more than the environment can replenish to which the ‘only known solution’, according to the piece, is population control. These numbers-driven arguments, founded on economic, national security and environmental concerns, are hardly the safe appeals to women’s rights that have dominated population discussions in recent years and made family planning, in the estimation of Helen Epstein (2008), ‘one of the great success stories of public health’. Indeed, they more closely resemble the neo-Malthusian calculus that motivated the architects of the planet’s first mass experiment with fertility limitation from the 1960s to the 1980s a history described in withering detail in Matthew Connelly’s Fatal misconception. This book follows a clique of mainly American doctors, demographers, feminists, philanthropists and bureaucrats the ‘population establishment’ as they travel from boardroom to boardroom building the institutions that would funnel money and personnel into Asia to slash the high birth rate among the provincial poor. Connelly (2010) has suggested that his work can be viewed as ‘an ethnographic survey of a transnational elite’ the story of a band of jetsetters who perceived a global world and set out to persuade entire nations that their reproductive traditions threatened the planetary order. He powerfully indicts the movement by drawing upon its own archives in places like the Ford Foundation and the World Bank. Using these sources, he shows how advocates often publicly touted birth control as a humanitarian gesture while noting in private that their goal was to make poor people ‘immune’ to pregnancy and thereby head off the danger that famished masses might one day engulf the west. Global Public Health Vol. 6, No. 1, January 2011, 98 101

The renormalization of smoking? E-cigarettes and the tobacco "endgame".

Whereas some experts welcome e-cigarettes as a pathway to reducing tobacco use, others characterize them as dangerous products that could undermine efforts to denormalize smoking. But the goal of eliminating the risks of smoking is not incompatible with e-cigarette use.

Public health nihilism vs pragmatism: history, politics, and the control of tuberculosis.

Tuberculosis (TB) began to decline in the Western world in the mid- to late 1800s. In the United States, the disease receded until the mid-1980s, when that trend was reversed. Although the TB epidemic in the United States subsided in response to public health interventions, it sparked a controversy regarding the relative value of targeted public health measures vs broad social reform. That controversy, which echoed earlier debates calling for structural reform over public health programs, was further strengthened by the historical and demographic studies of Thomas McKeown. His influential thesis maintains that clinical and primary prevention efforts had little effect on TB mortality. In this paper, the historical literature is used to examine whether public health had a significant impact on the decline of TB mortality rates in several countries. Specifically, the paper describes the arguments for and data affirming the efficacy of 2 major public health interventions over time: segregation of those infected with pulmonary TB and eradication of bovine TB. This review finds support for the hypothesis that public health measures, along with other factors, led to falling rates of TB mortality beginning in the late 19th century.

The EXODUS of Public Health What History Can Tell Us About the Future

We trace the shifting definitions of the American public health professions 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.

Science at the Borders: Immigrant Medical Inspection and the Shaping of the Modern Industrial Labor Force

Contents:Acknowledgments List of AbbreviationsIntroduction. Immigration by the Numbers: Rethinking the Immigrant Medical ExperiencePart I. Numbers Large: Immigrant Medical Inspection as an Inclusionary Tool One. Immigrants and the New Industrial Economy Two. The Function of Medical Inspection: Restriction, Instruction, and Discipline of the Laboring Body Three. The Medical Gaze: Science in Industrial-Era AmericaPart II. Numbers Small: Immigrant Medical Inspection as an Exclusionary Tool Four. The Shape of the Line: Immigrant Medical Inspection from Coast to Coast Five. At the Borders of Science: Diagnostic Technology at the Intersection of Race, Class, Disease, and Industrial Citizenship Six. Drawing the Color Line: Radical Patterns of Medical Certification and ExclusionEpilogue. The End of the Line: Immigrant Medical Inspection after 1924Appendix. Note on Data Collection, Cleaning, Coding, and Analysis Notes Index

Evidence, Policy, and E-Cigarettes — Will England Reframe the Debate?

Public Health England claims that e-cigarettes are 95% less harmful than combustible cigarettes and suggests that they can help reduce health inequalities. But the United Kingdoms long-standing commitment to harm reduction contrasts dramatically with the U.S. position.

HIV surveillance, public health, and clinical medicine--will the walls come tumbling down?

The U.S. HIV surveillance system was built with robust firewalls ensuring that data can go in but not come out. Now, gaps in continuity of HIV care and the improved ability to reduce transmission argue for opening up HIV registries for public health use.

Public Goods, Private Data: HIV and the History, Ethics, and Uses of Identifiable Public Health Information

b d Public health departments collect a vast array of identifiable information in the course of mandatory reporting efforts and other surveillance activities. These undertakings span a range of conditions from infectious threats and chronic diseases including cancer, to immunization status and birth defects. Advocates for expanded surveillance extended the practice to occupational diseases and, most ambitiously, to profiles of childhood health status. Syndromic surveillance is also increasingly undertaken in the new post-September 11 security environ - ment. In the one Supreme Court case addressing public health surveillance, a unanimous tribunal upheld the right of the state to conduct surveillance. 1

Policies of Inclusion: Immigrants, Disease, Dependency, and American Immigration Policy at the Dawn and Dusk of the 20th Century

The racial politics of immigration have punctuated national discussions about immigration at different periods in US history, particularly when concerns about losing an American way of life or American population have coincided with concerns about infectious diseases. Nevertheless, the main theme running through American immigration policy is one of inclusion. The United States has historically been a nation reliant on immigrant labor and, accordingly, the most consequential public policies regarding immigration have responded to disease and its economic burdens by seeking to control the behavior of immigrants within our borders rather than excluding immigrants at our borders.

Smoke and fire over e-cigarettes

As nations adopt regulatory measures for e-cigarettes, it is imperative to understand how approaches to risk, cost-benefit, and trade-offs have shaped interpretations of evidence In advance of a critical Framework Convention on Tobacco Control (FCTC) held in October 2014, two groups of scientists and public health experts launched a global battle royal over electronic cigarettes—devices that heat liquid nicotine but involve no tobacco.