James Colgrove

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.

HPV Vaccination Mandates - Lawmaking amid Political and Scientific Controversy

In 2006 and 2007, legislation to include the human papillomavirus (HPV) vaccine among the vaccines required for school entry was introduced in 24 states; only two bills were adopted. The factors that impeded the adoption of mandates included the newness of the vaccine, the sexually transmitted nature of HPV, the manufacturers involvement in policymaking, and antivaccination activism.

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, politics, and ideology in the campaign against environmental tobacco smoke

The issue of environmental tobacco smoke (ETS) and the harms it causes to nonsmoking bystanders has occupied a central place in the rhetoric and strategy of antismoking forces in the United States over the past 3 decades. Beginning in the 1970s, anti-tobacco activists drew on suggestive and incomplete evidence to push for far-reaching prohibitions on smoking in a variety of public settings. Public health professionals and other antismoking activists, although concerned about the potential illness and death that ETS might cause in nonsmokers, also used restrictions on public smoking as a way to erode the social acceptability of cigarettes and thereby reduce smoking prevalence. This strategy was necessitated by the context of American political culture, especially the hostility toward public health interventions that are overtly paternalistic.

Changes in Tdap and MCV4 Vaccine Coverage Following Enactment of a Statewide Requirement of Tdap Vaccination for Entry Into Sixth Grade

OBJECTIVES We evaluated changes in tetanus toxoid, reduced diphtheria toxoid, acellular pertussis (Tdap), and tetravalen meningococcal (MCV4) vaccine coverage following enactment of a New York State mandate requiring Tdap before entering sixth grade. METHODS Using data from a hospital-based immunization registry, we measured Tdap and MCV4 coverage among youths aged 11 to 14 years in New York City at 3 time points: premandate, mandate year 1, and mandate year 2. RESULTS Among overlapping cohorts of 4316 (premandate), 4131 (mandate year 1), and 3639 (mandate year 2) youths, Tdap coverage increased steadily over time (29%, 58%, and 83%, respectively). Increases were observed among all ages. Across the same time points, MCV4 coverage also increased (10%, 30%, and 60%, respectively). Most adolescents did not receive MCV4 during the same visit they received Tdap. CONCLUSIONS A Tdap school-entry mandate was associated with substantial increases in immunization coverage, even in age groups not directly affected by the mandate. At the postmandate time points, MCV4 coverage remained lower than Tdap coverage. Provider education should emphasize the importance of reviewing vaccine records and administering all recommended vaccines at every clinical encounter.

Nowhere left to hide? The banishment of smoking from public spaces.

On May 23, in the continuation of a four-decade trend, smoking in New York City parks, beaches, and pedestrian malls became illegal. But absent direct health risks to others, such bans raise questions about the acceptable limits for government to impose on conduct.

Manifold Restraints: Liberty, Public Health, and the Legacy of Jacobson v Massachusetts

February 2005 marks the centenary of one of the most important pieces of public health jurisprudence, the US Supreme Court case of Jacobson v Massachusetts, which upheld the authority of states to pass compulsory vaccination laws. The Courts decision articulated the view that the freedom of the individual must sometimes be subordinated to the common welfare. We examined the relationship between the individual and society in 20th-century public health practice and law and the ways that compulsory measures have been used to constrain personal liberty for the sake of protecting the public health.

Health and human rights: old wine in new bottles?

t is one of the remarkable and significant consequences of the AIDS epidemic that out of the context of enorI mous suffering and death there emerged a forceful set of ideas linking the domains of health and human rights. At first, the effort centered on the observation that protecting individuals from discrimination and unwarranted intrusions on liberty were, contrary to previous epidemics, crucial to protecting the public health and interrupting the spread of HIV But in fairly short order, the scope of the health and human rights perspective expanded dramatically to focus on the ways in which the most fundamental social arrangements rendered individuals and communities vulnerable to H N Racial and ethnic minorities, those who were marginalized, and women were at risk because of their subordinate status. In the face of such an understanding, nothing short of social change could be adequate to the challenge posed by the AIDS epidemic. While many long-time workers in the fields of public health and human rights contributed to the forging of a new ideological perspective, there is little question that Jonathan Mann played a singular role in challenging not only those who rejected the new-found centrality of human rights for public health, but those with whom he worked most closely as well. No greater respect can be paid to visionary work than to engage it critically. Of elemental importance at this juncture is to understand the nature of the innovations forged by Mann and others committed to linking health and human rights. It is also vital to assess the extent to which such innovations represented a fundamental departure. These are the tasks of this paper. As the AIDS epidemic took shape in the early 1980s in economically advanced nations bounded by the liberal-demo-

Placebo use in vaccine trials: Recommendations of a WHO expert panel

Highlights • Placebo controls may be acceptable even when an efficacious vaccine exists, in the following four possible situations:• When developing a locally affordable vaccine.• When evaluating the local safety and efficacy of an existing vaccine.• When testing a new vaccine when an existing vaccine is not considered appropriate locally.• When determining the local burden of disease.

Schools of public health: essential infrastructure of a responsible society and a 21st-century health system.

Mailman School of Public Health, Columbia University, New York, NYAddress correspondence to: James Colgrove, PhD, MPH, Mailman School of Public Health, Columbia University, 722 West 168th St., New York, NY 10032; tel. 212-305-0561; fax 212-342-1986; e-mail .©2010 Association of Schools of Public Health