Ronald M. Davis

Achieving Racial Harmony for the Benefit of Patients and Communities: Contrition, Reconciliation, and Collaboration

Like the nation as a whole, organized medicine in the United States carries a legacy of racial bias and segregation that should be understood and acknowledged. For more than 100 years, many state and local medical societies openly discriminated against black physicians, barring them from membership and from professional support and advancement. The American Medical Association was early and persistent in countenancing this racial segregation. Several key historical episodes demonstrate that many of the decisions and practices that established and maintained medical professional segregation were challenged by black and white physicians, both within and outside organized medicine. The effects of this history have been far reaching for the medical profession and, in particular, the legacy of segregation, bias, and exclusion continues to adversely affect African American physicians and the patients they serve.

Improving Cross‐sectoral and Cross‐jurisdictional Coordination for Public Health Emergency Legal Preparedness

This paper is one of the four interrelated action agenda papers resulting from the National Summit on Public Health Legal Preparedness (Summit) convened in June 2007 by the Centers for Disease Control and Prevention (CDC) and multi-disciplinary partners. Each of the action agenda papers deals with one of the four core elements of public health legal preparedness: laws and legal authorities; competency in using those laws; coordination of law-based public health actions; and information. Options presented in this paper are for consideration by policy makers and practitioners – in all jurisdictions and all relevant sectors and disciplines – with responsibilities for all-hazards emergency preparedness. Advancing and protecting the public’s health depends upon the coordination of actions by many, diverse partners. For effective public health preparedness, there must be effective coordination of legal tools and law-based strategies across local, state, tribal, and federal jurisdictions, and also across sectors such as public health, health care, emergency management, education, law enforcement, community design, and academia. Needs for Strengthening Coordination of Law-Based Responses Recent catastrophic events and other public health emergencies – such as the terrorism attacks of late 2001 and the hurricane disasters of 2005 – have yielded many lessons for overall emergency preparedness, including exposing issues and gaps in legal preparedness for emergencies.1 Particularly important are issues concerning coordinating the application of legal authorities across sectors and jurisdictions including, but not limited to, public health and private health care providers, tribes and tribal authorities, the judiciary and court system, the military,2 and federal, state, and local governments. Other gaps in legal preparedness that have been identified concern the use of mutual aid agreements for preparedness and response, and directing and enforcing social distancing measures to control transmission of influenza or other serious communicable diseases. Summit deliberations focused particularly on challenges and options for improving coordinated applications of law-based interventions across sectors and jurisdictions during emergencies. A set of fundamen-

Assessing Community Interventions to Reduce Smoking

Few major, community-based antismoking programs have undergone specific evaluation in developed countries; the number is even lower in developing countries. Yet not all evaluation need be elaborate, expensive, or overly time-consuming. Data on tobacco trade, import and export, taxation, mortality, and morbidity may already exist within government departments and can be used for evaluation. Published information from the tobacco industry may be obtained easily in trade journals and annual reports. Universities and international and overseas national health agencies may offer information, assistance, and expertise. Indirect evaluation of the importance of any particular antismoking intervention can be measured by how strongly the tobacco industry opposes that measure.