Leonard J. Duhl

Conditions for healthy cities; diversity, game boards and social entrepreneurs

Conditions for healthy cities; diversity, game boards and social entrepreneurs describes how our inability to develop systems of governance that respond to the diversity and complexity evident in all cities helps explain why city authorities have proved so ineffective at addressing urban problems. The paper also promotes new ways of understanding cities and the roles of social entrepreneurs in moving towards more healthy cities.

Superfluous people in tomorrow's society.

This paper looks to a future in which society makes creative use of “superfluous” people.This paper looks to a future in which society makes creative use of “superfluous” people.

The Job Corps: Proposals for Redesign

This article delineates some alternate models for redesign of job Corps Centers located in both rural and urban settings. Significant observations, especially from the standpoint of mental health programs, based on interviews, documents, and site visits indicated the presence of communications difficulties and problems of mission and lack of shared social goals among and within the wide variety of existing Job Corps Centers. A series of alternate models for redesign is presented. For each model, the presuppositions, objectives, evaluation methods and outcomes, and a critique of feasibility and shortcomings are included.

Handbook of religion and health.

Handbook of religion and health. Harold G Koenig, Michael E McCullough, David B Larsen. New York: Oxford Press, 2001. During the past few years there has been a resurgence in concern with the role of religion and spirituality and health. Before that there were anecdotal reports, as well as a beginning awareness of the impact of other spiritual belief systems on human illness and growth. This can be seen in the non-Western treatment activities in a wide variety of cultures around the world. In several instances, it takes a willingness to suspend judgement and be open to other paradigms of health. Many use the concept of balance, and a holistic multidimensional or ecological approach. Those belief …

Transitions and paradigms

“Poverty is the inability to command events that affect our lives.” At this important time of crisis, I am reminded of the work of three of my good friends: Jonas Salk, Ernest Callenbach, Tarzie Vittachi. Each has contributed something very important in trying to understand the future. Jonas Salk, involved with bacteriology, chose as a metaphor the S shaped curve. In this curve, he states that when resources are infinite the growth of bacteria is rapid. There is competition, a self concern, and a preoccupation with growth. Later, when the resources become diminished, there is a need to replace competition with collaboration, the birth rate slows down, and a completely new value system emerges. The period between the two curves he calls a transition period. This is a transition between what he calls epoch A and epoch B. He believes that we are now in the midst of that transition. Transitions are uncomfortable and often chaotic. Time is required, and as the Bible relates going from Egypt to the Promised Land took 40 years. One might say it took that long for the old people and the ideas to be replaced by new ones. Ernest Callenbach has written a book called Ecotopia. This book, although a novel, tries to create an area where new values are supreme. The values that he considers important …

Review article Healthy cities: Controlling the costs of health care

ConclusionWhile it is true that health care costs are straining personal and governmental budgets, it does appear to be a manageable problem. There are tools available to moderate costs, efforts are already underway to control costs by modifying the financing of health care. Whether or not these will be effective remains to be seen. There also are efforts to control costs by modifying unhealthy habits. These efforts are showing notable success. Moreover, there are efforts underway to reduce health care costs by altering the overall context of peoples lives. This latter effort—to improve the health of whole communities—holds the greatest promise.

Comments on the debate on primary prevention

Though I was not present at the discussions on prevention, I felt that I could very well have been there. The discussions, though brought upto-date with references to recent studies and reports, nevertheless are all too reminiscent of meetings that go back, for me, to 1954. At that time, I participated in a meeting of schools of public health, in which mental health people and epidemiologists discussed how to develop a program dealing with issues of prevention. I can remember Erich Lindemann, Gerald Caplans predecessor at the School of Public Health, discussing the broad range of concerns which he had under the rubric of prevention. Clearly, nothing significant emerged from that meeting except to encourage the schools to hire mental health personnel. Though I have been deeply involved with concerns that come under the rubric of mental health prevention activities for many years, I have always wondered why the discussions seemed to always be the same and that very few programs developed which one might call preventive. There are two conclusions not focused upon by the various presentations and discussions. First, most people, including scientists, are involved in a linear model of cause and effect. Their studies are basically reductionist in quality, demanding quanti tat ive proof of an analytic variety. While this is well and good for some issues, I am not convinced that issues of prevention or of emotional disturbances, that Albee points to, are capable of being studied by either the linear or reductionist model. Certainly some aspects of the issue are, but the critical questions having to do with a tremendous organized complexity at this moment do not seem to be subject to quantitative, but rather to a qualitative, non-reductionist type of research. Though I will come back to this issue later, I would like to go to my second point. Since prevention of mental illness is in my eyes a nonlinear phenomenon, most of the things that can be done are not the responsibility, concern, or preoccupation of people in mental health as