Merlin Chowkwanyun

IMMIGRATION AND THE NEW METROPOLITAN GEOGRAPHY

ABSTRACT: In this article, we argue for understanding immigrant suburbanization as one outcome of the mass migrations associated with economic globalization, a process that has coincided with and shaped the decentralization and reconfiguration of the American metropolis. We contend, as well, that economic differentiation among the foreign-born translates into distinctive residential patterns that reflect the diversity of new metropolitan geographies. Using individual and tract-level data from metropolitan Philadelphia since 1970, we describe the intersection of spatial differentiation (suburban variety) with both demographic diversity (ethnic and racial differentiation) and linked patterns of ethnic and racial population growth and decline. We highlight the importance of immigration to population and economic growth, the diversity among immigrants, the inability of “suburb” to capture the region’s residential ecology, and the surprising links between the growth of immigrant and African-American populations in the same places. We clearly show how the residential experience of African Americans differs from that of both immigrants and native-born whites.

THE STRANGE DISAPPEARANCE OF HISTORY FROM RACIAL HEALTH DISPARITIES RESEARCH

Although thriving in many respects, racial health disparities research suffers from a lack of historical analysis and may be in danger of reaching a saturation point. This article examines how renewed attention to history can enhance the explanatory power of such research. First, it surveys a body of writing on what history can contribute to contemporary social science and policy debates. Next, it compares current racial health disparities research to the analytical impasse encountered by urban poverty researchers of the late 1980s and early 1990s. It contrasts that work with two classic post-Second World War urban histories, and identifies qualities of the latter lacking in conventional social science. The essay then surveys historically oriented works on race and health, pointing out their usefulness to racial health disparities research while discussing promising future research directions. It concludes with a brief reflection on changes in the academic institutional context necessary for fruitful synergy between public health researchers and historians.

The New Left and Public Health The Health Policy Advisory Center, Community Organizing, and the Big Business of Health, 1967–1975

Soon after its founding in the politically tumultuous late 1960s, the Health Policy Advisory Center (Health/PAC) and its Health/PAC Bulletin became the strategic hub of an intense urban social movement around health care equality in New York City. I discuss its early formation, its intellectual influences, and the analytical framework that it devised to interpret power relations in municipal health care. I also describe Health/PACs interpretation of health activism, focusing in particular on a protracted struggle regarding Lincoln Hospital in the South Bronx. Over the years, the organizations stance toward community-oriented health politics evolved considerably, from enthusiastically promoting its potential to later confronting its limits. I conclude with a discussion of Health/PACs major theoretical contributions, often taken for granted today, and its book American Health Empire.

“Precision” Public Health — Between Novelty and Hype

“Precision” Public Health Does the turn toward “precision” public health offer the opportunity for a reconceptualized, empowered public health enterprise — or might it represent an abandonment of the traditional mission of enhancing population well-being? And how novel is it, anyway?

Beyond the Precautionary Principle: Protecting Public Health and the Environment in the Face of Uncertainty

In this article, we scrutinize the ability of the Precautionary Principle to serve as a unifying principle for public health. Although most commonly invoked in environmental health regulatory debates, implicit and explicit invocations of the Principle have spread to other contexts. Here we seek to understand the potential uses of the Precautionary Principle for those concerned with population health by considering its invocation in five cases: vaccination, quarantine for SARS, needle exchange to prevent the spread of HIV/AIDS, e-cigarettes as an alternative to tobacco cigarettes, and climate change mitigation. We ask whether the Precautionary Principle offers a philosophical approach precise and sufficiently stringent to guide health policy in a range of circumstances where evidence may be less than definitive and the course of action contested. We find there are far more ambiguities in the Principle’s application than might appear at first and conclude that it is best used in concert with other frameworks for guiding action in the face of uncertainty.

“The Neurosis That Has Possessed Us”: Political Repression in the Cold War Medical Profession

ABSTRACT:Political repression played a central role in shaping the political complexion of the American medical profession, the policies it advocated, and those allowed to function comfortably in it. Previous work on the impact of McCarthyism and medicine focuses heavily on the mid-century failure of national health insurance (NHI) and medical reform organizations that suffered from McCarthyist attacks. The focus is national and birds-eye but says less about the impact on the day-to-day life of physicians caught in a McCarthyist web; and how exactly the machinery of political repression within the medical profession worked on the ground. This study shifts orientation by using the abrupt dismissal of three Los Angeles physicians from their jobs as a starting point for exploring these dynamics. I argue that the rise of the medical profession and the repressive state at mid-century, frequently studied apart, worked hand-in-hand, with institutions from each playing symbiotic and mutually reinforcing roles. I also explore tactics of resistance – rhetorical and organizational – to medical repression by physicians who came under attack.

The Seat at the Table Problem: Broadening Reception for Historians of Medicine and Public Health

In “Making the Case for History in Medical Education,” David Jones et al. identify a promising inroad for the history of medicine into the medical curriculum: the ability to satisfy multiple curricular competencies. Alongside the field’s virtues, however, they discuss persistent difficulties with inconsistent funding, curricular time, and qualified instructors that reflect a lower priority for history in medical education. Their essay addresses one dimension of what I call the Seat at the Table Problem: the frustration historians face in proving their importance and weaving their way into nonhistory circles, both inside and outside the academy. Here, I explore the problem further by moving the discussion beyond medical schools and into health policy and public health. But I examine the history discipline itself as well and ask whether it is doing everything it can when it comes to training students who can widen the discipline’s reception and appeal, especially at a time when history and the humanities’ relevance are being called into question. I base these remarks on my own recent experience as a graduate student, and some are more impressionistic, meant as fodder for further debate. The more critical observations, in fact, arise from a longstanding sense of what I wish I could do better as a scholar but cannot. In , I received a degree from a traditional history department but did so in a less orthodox way, earning a Masters in Public Health (M.P.H.) simultaneously. During my last two years of graduate school, the United States Department of Education funded my studies, and afterwards, I left for a two-year postdoctoral fellow in a school of medicine and public health. The program requirements of all three meant that I took courses and interacted with as many nonhistorians as historians. In these orbits, I soon noticed—whether attending seminars on changing Medicare reimbursement or reading Institute of Medicine (IOM) reports for class—that historians were not nearly as Commentaries 