bluuebunny/crossref_metadata_2025 huggingface dataset:
What Is Right Is Not Taken Out of the Rule, but Let the Rule Arise Out of What Is Right
Authors: Wilson Bart J.
Published: April 2020

This chapter explains the relationship between what is right in a moral claim of “This is mine” and the particular rules that make up the custom of property. What is right regarding things is not derived from the rules of property, but a rule of property arises from the collective background knowledge of what is right regarding people and things. The chapter draws from the spontaneous conversations of participants in two different economic experiments to illustrate such a distinction, beginning with what is meant by “what is right.” Resentment prompts people to act when someone takes something that they claim is theirs. Property is the moral scheduling pattern that emerges to protect members of a society from real and positive hurt.
My Claims Tie Together Modern Philosophies of Property Law
Authors: Wilson Bart J.
Published: April 2020

This chapter argues that the book’s claims on property reinforce and tie together several legal philosophies of property including Neo-Lockean, Kantian a priorism, exclusive use, and in rem. The language of “rights” muddies the meaning of property, and the conception of possession discards mind and custom. The British lawyer and jurist A. M. Honoré would seem to agree the book’s claims on property. The Neo-Lockean theory of property invokes custom but doesn’t go far enough. Kantian a priorism cannot account for the moral significance and transmission of property, and exclusive use cannot explain property as a scheduling pattern. The in rem theory of property has the right idea by returning to the thingness of property, but ultimately it cannot explain the micro- and meso-foundations of the property.
The Results of a Test Are Agreeable to the Prediction
Authors: Wilson Bart J.
Published: April 2020

Using a first-person three-dimensional virtual world experiment, this chapter reports a test of an implication of the book’s theory, namely that if A has property in Y and X is in Y, then A has property in X, which is in Y, even if someone else finds X. The results of the test are robustly agreeable to the prediction with an unexpected but consistent-with-the-prediction proviso.
Economics Is Founded Upon Property, Not Property Rights
Authors: Wilson Bart J.
Published: April 2020

This chapter discusses the implications for economics and its treatment of property rights, not property. The language of “property rights” contains a tacit assumption about how we think they work. Property, not property rights, is a fundamental principle of economics. Property rights are the expectations defined by property, not the content of property. In other words, property effects property rights. Such a view challenges the felicitousness of the bundle-of-sticks metaphor, which inverts how humans cognize property. We can no longer think about the rules of property as mere external constraints imposed upon an individual. The alternative theory this book presents situates the idea of property in a bidirectional relationship that extends to and from the minds of individuals and the moral scheduling pattern of their community. Property, not property rights, is the very foundation of economics.
The Discourse of Ethnicity
Authors: Chittick Andrew
Published: April 2020

Chapter 2, “The Discourse of Ethnicity,” identifies environmental determinism as the primary discourse in early medieval East Asia within which cultural differences were discussed and evaluated. Those differences can be regarded as “ethnic” if they were understood to be both inherent/immutable and politically salient. The chapter explores the evolution of this discourse in the Central Plains region of the Yellow River, particularly as it was applied to the peoples south of the Huai River, especially the Wu people, or Wuren. The conclusion is that the discourse increasingly became more ethnicizing, and clearly identified the Wuren as a distinct, and inferior, ethnic group.
The Buddhist Repertoire, Part 1
Authors: Chittick Andrew
Published: April 2020

Chapter 10, “The Buddhist Repertoire, Part 1: The Era of Pluralist Patronage,” is the first half of the third study of various repertoires of political legitimation. This chapter focuses on the development of Buddhist institutions and historiography in the fifth century, a period of pluralist patronage under the banner of Sinitic universalism. The Buddhist repertoire in maritime diplomatic relations with South Seas regimes proved an important staging ground for the ruler’s performance as a cakravartin, or Buddhist universal ruler, as well as a conduit for Buddhist expertise. By the end of the fifth century, Jiankang elites had developed Buddhist legends and practices that asserted that the Jiankang regime’s legitimacy derived, not from the Han Empire, but from its direct inheritance of legitimacy from the cakravartin Asoka, who had ruled in northern India in the third century BCE. This set the stage for the striking developments of the sixth century.
Reconnecting Social Work to Social Questions
Authors: Coussée Filip , Spatscheck Christian , Bradt Lieve , Roose Rudi
Published: April 2020

Social pedagogy as an academic discipline and social practice has gained importance in many European countries during the past two decades. This popularity boost is often driven by the observation that social work has adopted a one-sided focus on individual needs and does not address the roots of social problems. The pedagogical approach is then called upon to help solve recurrent social problems. Increasing the effectiveness of social practices, however, does not only lie in their repedagogization. This is only part of the answer. Resocialization should be equally on the agenda. Therefore, it makes little sense to approach social work and social pedagogy as separate fields. This chapter argues for social pedagogy as a perspective on social work in order to enable social practices to cross the counterproductive dividing lines between culture, welfare, and politics and reconnect social practices to social movements.
Experience, Culture, and a Future Project
Authors: Silva Balerio Diego , Pastore Paola
Published: April 2020

Many young people in South America experience repeated conditions of economic, social, and cultural exclusion, with low rates of secondary school completion and high unemployment exposing them to social violence. Yet, they are also the driving force for change in the region; their creativity is a transformative power. This chapter proposes a pedagogical reflection on the learning process and on social and educational participation. Each young person’s individual experiences and the knowledge they acquire in institutions and diverse social contexts are a platform to develop cultural promotion opportunities that produce the conditions to build a future project. Social educators practice one of the social tie professions that help generate bonds with culture, institutions, and other people, whereas educational action relates each young person to common cultural heritage. Social pedagogy faces the challenge and responsibility of creating strategies and cultural transmission methods for all youth, becoming a political action that fosters equality.
Training and Professionalization of Youth Workers in Europe
Authors: Planas-Lladó Anna , Llena Asun , Vila-Mumbrú Carles
Published: April 2020

The training and professionalization of youth workers in Europe has been implemented differently in each social and political context. This chapter focuses on how the training and professionalization of youth workers has evolved at a European level and its current situation, as well as concerns and challenges that arise in international debates. The training and professionalization of youth workers in Europe is currently being systematized through the deployment of regulatory frameworks, most of which are promoted by the Council of Europe and the European Union within the framework of the European convergence process. Despite this, there is much diversity in terms of types of training, recognition levels, and intervention models. However, consensus is gradually being reached regarding functions and competences that can contribute both to the credibility and recognition of professionals and to the improvement of their working conditions and quality of interventions.
Youth Work and Social Pedagogy
Authors: Williamson Howard , Conroy Mick
Published: April 2020

The most visible differentiation between models of youth justice across Europe exists in tensions between welfare-based and justice-based approaches. Proponents of welfare-based interventions often find themselves conflicted by the current growth of a right-wing, nationalistic, and perhaps at times xenophobic political climate throughout Europe, calling for tougher sanctions and sentences for young offenders. As a consequence, the promotion of any primarily welfare-based approaches within youth justice settings throughout Europe has been slow to emerge within key strategies to develop effective interventions with young offenders. This chapter explores the merits of a youth justice model that embraces the “children first—offenders second” approach, and it examines the potential role that a hybrid model of youth work practice and social pedagogy theory might play in achieving one of the key principles of the Council of Europe: integrating young offenders back into society, and not their marginalization and social exclusion.
Youth and Participation in a Digital Society
Authors: Gros Begoña , Schwartzman Gisela
Published: April 2020

This chapter describes how most young people use online networks to extend and maintain their lives in the familiar contexts of school, cultural organizations, sports, and other activities. The new generations move about on social networks, create links, and share knowledge, and the delocalization of these connections allows them to function beyond any physical space. This chapter presents examples of different youth perspectives on digital participation (social, political and citizen, community participation projects, etc.) and examines some assumptions about what youth participation means (online, online–offline, click participation, new content production, projects owned by youth, and projects for youth). Finally, it provides some guidelines to support social pedagogy professionals in this area.
Introduction
Authors: Devine A. M. , Stephens Laurence D.
Published: April 2020

This chapter discusses theoretical issues related to the application of formal semantics and pragmatics to Latin syntax. Various approaches to the semantics of free word order are reviewed and their suitability for the Latin evidence evaluated. Different frameworks used in formal pragmatics are also presented, and it is argued that for Latin the Structured Meanings theory is more suitable than the Alternative Semantics theory.
Narrow Focus
Authors: Devine A. M. , Stephens Laurence D.
Published: April 2020

This chapter discusses a range of issues relating to the syntax and semantics of narrow focus in Latin: discourse congruence, event presupposition, the formalization of narrow focus, the activation of a set of alternates, focus and intensionality, narrow focus in a branching phrase, double focus, second mention focus and verb focus.
Introduction
Authors: Larson Rhett B.
Published: April 2020

Virtually every major social challenge—from gender inequality to racial discrimination, terrorism to space exploration, disease epidemics to mass migration—has a significant water component. Sometimes the water component is obvious—such as increased drought and flood cycles due to climate change, as evidenced in the ongoing crises in Cape Town and Puerto Rico, or water contamination and racism in Flint, Michigan. But the water component to the rise of ISIS or the Zika epidemic is less obvious. Each chapter of this book takes a major social problem, illustrates the role water plays in that problem, and proposes reforms to address the water aspect of that problem. My goal in this book is to convince the reader that the answer, or at least one part of the answer, to our most serious problems is the oft-repeated late-night infomercial exhortation: “Just add water.”
Water Security and Racial Discrimination
Authors: Larson Rhett B.
Published: April 2020

Water policies around the world are developed or applied in ways that perpetuate racial or ethnic inequalities and discrimination. From the health crisis in Flint, Michigan, in the United States, to inadequate water provision to Romani communities in Europe, to disparate impacts of water pricing in South Africa, marginalized communities consistently face greater threats of water insecurity. For indigenous peoples, the challenge of water insecurity is often all the more poignant because of the unique cultural relationship these communities often have with their traditional waters. This chapter discusses how water laws and policies can deepen and perpetuate racial and ethnic inequalities, how existing laws can be asserted to promote the water rights and water security of racial and ethnic minorities, and the unique legal tools available to indigenous communities to pursue reforms and advances to achieve water security.
American Avant-Garde Cinema's Philosophy of the In-Between
Authors: Sheehan Rebecca A.
Published: April 2020

Can films philosophize rather than simply represent philosophical ideas developed outside the cinematic medium? Taking up this question crucial to the field of film-philosophy, this book argues that the films of the American avant-garde indeed “do” philosophy, and it illuminates the ethical and political stakes of their aesthetic interventions. The author traces the avant-garde’s philosophy by developing a history and theory of its investment in dimensional, conceptual, and material in-betweens, clarifying how reflections on the creation and reception of images construct an ethics of perception itself. This entails the avant-garde’s locating of cinema’s—and thought’s—ends or meanings in their means, and their advancement of an image of truth that is made rather than found, that unites with the philosophies of Ludwig Wittgenstein and Ralph Waldo Emerson. Rectifying film-philosophy’s neglect of the American avant-garde, the book demonstrates how, rather than showing their interest in the revelation of authoritative truths, the avant-garde’s interest in the re-encounter and review of the seen and known emerge from an American Transcendentalist tradition that opposes such notions. The author reads the avant-garde’s interest in the contingencies of spectatorial experience as an extension of Pragmatism’s commitment to replacing the authority of a priori knowledge with that of individual experience. She also shows how Emerson’s influence on Friedrich Nietzsche connects the American avant-garde’s philosophies to Deleuze’s time-image, premised largely upon Nietzsche’s “powers of the false.”
Introduction
Authors: Sheehan Rebecca A.
Published: April 2020

The book’s introductory chapter situates its study of American avant-garde cinema in the context of the field of film-philosophy and the post-theory debates within cinema studies. The chapter rectifies influential misreadings of American avant-garde films by film-philosophers, and goes on to trace philosophy’s influences on the avant-garde, laying the groundwork for putting their films in conversation with the philosophies of Gilles Deleuze, Stanley Cavell, Ralph Waldo Emerson, Henry David Thoreau, Friedrich Nietzsche, and Ludwig Wittgenstein. This chapter outlines the various kinds of dimensional, conceptual, and material in-betweens at work in American avant-garde cinema, and explains the various ways in which American avant-garde filmmakers have used this figure to advance a philosophy that promotes behaviors of re-encounter and review applicable to the off-screen world.
From Figures of Paradox to a Philosophy of Review
Authors: Sheehan Rebecca A.
Published: April 2020

This chapter examines the role of paradox in the films and film theory of Ken Jacobs, Hollis Frampton, and Michael Snow. Paradoxes such as Zeno’s paradox, Gödel’s incompleteness theorem, and Benoît Mandelbrot’s fractal theory of geometry, which inform the work of these filmmakers, propose and repeat the unresolvable gap between subject and world that informs skepticism. This chapter argues that the skeptical encounters these films invite, which entice the spectator to work toward solving a riddle or problem of incompleteness, also provide a model for overcoming skepticism by prompting re-encounters with the images on screen and the world to which they refer. These re-encounters occur in the same way that Stanley Cavell imagined the images of mainstream cinema could overcome problems of philosophical skepticism by drawing the subject closer to the world. The author argues, however, that these avant-garde meditations on mises en abyme are possibly more effective than Hollywood filmmaking for overcoming skepticism because of their more immediate emphasis on cinema’s very ability to engage and stage re-encounters between the subject and the limits of the world, rather than their reference to the world through images.
Dimensions of Perceptual Content
Authors: Audi Robert
Published: April 2020

This chapter presents a causal theory of perception according to which perceiving something is, in outline, equivalent to its producing or sustaining, in the right way, a phenomenal representation of it. Commonly, the perceived object plays this causal role reliably enough to yield perceptual knowledge, provided we form perceptual beliefs that appropriately correspond to what we see. But the theory does not imply that seeing is conceptual, entails believing, or has propositional perceptual content. The notion of content is clarified, and several types are described, including a hallucinatory kind. This causal representational view also accommodates “inner perception” of elements, such as images—as is appropriate to the breadth of “perception.” But the most important point here is that explaining the causal character of the perceptual relation partly on the basis of information represented in the phenomenal character of the perceptual experience does not entail the perceiver’s acquiring beliefs that propositionalize that information.
Toward a Theory of the A Priori
Authors: Audi Robert
Published: April 2020

Self-evident propositions are important in their own right and crucial for the a priori in general. They are here shown to be justifiedly believable and knowable on the basis of adequately understanding them. Such understanding is multidimensional, and its adequacy in relation to a self-evident proposition, p, is explicable only on the basis of at least these cognitive variables, each of which is illustrated in appropriate relations to p: recognitional range regarding applications of p; the sense of rejectability of purported equivalents; explicative capacity; logical comprehension; confirmational sensitivity; discriminative acuity; translational capacity; readiness to meet objections to p; and, considerability (a kind of contemplatability needed to get p appropriately “in mind”). The account of adequate understanding also helps in explicating understanding in empirical cases, even propositions perceptually believed. The self-evident is shown to differ from the obvious, and thereby as neither necessarily compelling conviction nor limited to formal or other non-substantive truths.
Apriority, Disputability, and Necessity
Authors: Audi Robert
Published: April 2020

This chapter shows how the self-evident and, by extension, a priori propositions in general may plausibly be considered necessary. These propositions are best taken to have, as truthmakers, abstract objects and their interrelations. It is also argued that the a priori may be plausibly taken to extend to certain normative truths and to many propositions that, like some perceptual principles discussed in earlier chapters, belong to philosophy itself. As the case of philosophy well illustrates, when a priori propositions are substantive, there may be widespread rational disagreement on them. This is especially clear if, as argued here, beliefs can be rational even if not sufficiently well-grounded to be justified. This possibility implies that someone may rationally, though unjustifiedly, reject even certain self-evident propositions. How this happens is explained, and the chapter also shows both difficulties in identifying rational disagreements and some prospects for resolving them.
Inference and Its Role in Rational Action
Authors: Audi Robert
Published: April 2020

Action, like knowledge, is portrayed in this chapter as having grounds, but neither acting nor knowing requires a basis in inference. We can view agency as information-responsive, reasons-responsive, and rational without endorsing such intellectualist views. Acting for a reason need not be reasoned action. Beliefs or perceptible cues can guide intentional action without constituting knowledge. Intentions may have wide scope and complex content, much as beliefs can have complex propositional objects, and this enables a single intention to govern multiple deeds. Rational actions, moreover, are immensely various, extending to things we do rationally, without these actions being reason-based or even intentional. Granted, learning how to do many of the important things we do, say in speaking, playing instruments, and hiking, normally requires gaining propositional knowledge along the developmental route. Nonetheless, some propositional knowledge is like a ladder that, once having climbed up on it, we can do without.
The Prevailing British View of Freedoms of Press and Speech, in the Decade Before the American Revolution and Declarations of Rights
Authors: Bird Wendell
Published: April 2020

The seditious libel prosecution of John Wilkes, beginning in 1763, showed more clearly than ever that the crimes of seditious libel and seditious words were political crimes, and provoked many in Britain to advocate a more robust concept of freedoms of press and speech, and to question the criminalization of criticism of government and officials. George Wallace, a Scottish lawyer (publishing in London in 1760), set the stage by rejecting limitations on freedoms of press and speech, and rejecting seditious libel as a crime, as others did thereafter. Spurred by the Wilkes prosecutions and then the Junius prosecutions in 1770, scores of writers advocated broad understandings of freedoms of press and speech, such as “the right of free enquiry and fair discussion,” and condemned the entirety or parts of the main restrictions (criminalization of seditious libels and words). The narrow understanding of Blackstone, even before he published it, was a minority understanding.
Reasons for the Spread of Broad Views of Freedoms of Press and Speech in America, During and After the Colonial Crisis
Authors: Bird Wendell
Published: April 2020

Colonial leaders and newspaper editors came to care deeply about the breadth of freedoms of press and speech and the danger of prosecution of seditious libel, because they were repeatedly threatened with such prosecutions as they spoke and wrote critically of Britain’s actions. They became more likely to support broad freedoms, and less likely to support criminalization of seditious libel and words, as they perceived that those were political crimes and that they were the likely victims.
Epilogue
Authors: Bird Wendell
Published: April 2020

A number of conundrums are explained by the fact that an expansive understanding of freedom of press and freedom of speech prevailed and became dominant in Britain and America after the mid-1760s, and are unsolved by those who claim that the narrow Blackstone-Mansfield definition of freedoms of press and speech was universally or generally accepted during the late eighteenth century. Those conundrums include why those freedoms would be defined as mere protection from licensing that ended nearly a century before, why there was a steady stream of essays championing a broad definition and opposing a narrow definition, why American colonists and English radical Whigs threatened with prosecution would advocate narrow instead of broad freedoms, why there was such a wide chasm between restrictive law and permissive practices of speech and press, why nine of the eleven new states that adopted new fundamental law found it necessary to protect freedom of press, why every one of those declarations of rights gave the broadest protection without express exceptions rather than using Blackstone’s language, why the federal Bill of Rights similarly used the broadest language and rejected common law limitations, as well as why Fox’s Libel Act was able to attract majority support in Parliament.
Introduction: The Supreme Court’s Place in UK Politics
Authors: Hanretty Chris
Published: April 2020

This chapter introduces readers to the UK Supreme Court by describing two cases heard by the court: one case that almost no readers will have heard of, and that involved public access to land; and one case that was hugely controversial and that profoundly affected the process of the UK’s exit from the European Union. After describing the structure and operation of the court, the chapter steps back in time to explore the reasons for the court’s creation, and makes a case for the importance of understanding the court’s political role—and, as a consequence, for modeling the judges’ behaviors in ways that allow for subtle political influences alongside more consequential legal and organizational factors.
Trends in Ethnic Recognition
Authors: King Elisabeth
Published: April 2020

This chapter provides details on how the concept of “ethnic recognition” is defined and measured in a dataset of conflict-affected countries between 1990 and 2012. It compares and contrasts ethnic recognition to other related concepts, such as informal recognition and factional power sharing. Using the dataset, the chapter presents trends over time and across regions in the adoption of ethnic recognition in constitutions and comprehensive political settlements. It shows that ethnic recognition has been a common strategy in recent decades, with an overall adoption rate of approximately 40 percent. While rates of adoption have been relatively consistent over time, there are important regional differences in rates of recognition.
Pained
Authors: Stein Michael , Galea Sandro
Published: April 2020

As a country, the United States overinvests in medical care, often at the expense of the social, economic, and cultural forces that produce health. Indeed, the rise of medicine as a cornerstone of American life and culture has coincided with a social and political devaluation of factors demonstrated to mean more to one’s vitality than anything else—influences like where one lives, works, and plays; livable wages that create opportunity for healthy living; and gender and racial equity. As such, this book moves the conversation around American health toward matters of class, money, and culture. It highlights how the structural components of everyday life ultimately determine who gets to be healthy in today’s America. In doing so, it makes a case for reframing the political discourse on public health in less myopic, more effectual terms.
Creating Health Is Like Winning at Soccer
Authors: Stein Michael D. , Galea Sandro
Published: April 2020

This chapter presents soccer as a metaphor for how societies can generate health. Health is shaped by the water one drinks; by the air one breathes; by whether one lives in a safe environment where exercise opportunities and healthy food are available; and by social policies that create a world free from inequity. One can imagine these conditions as the 10 soccer players moving the ball upfield, to maximize one’s chance of winning, of staying healthy. The goalie is medicine. It is one’s last resort—what can restore one to health if one gets sick. The chapter then emphasizes the need for a shift in the way people think about health. As in soccer, ten elevenths of one’s effort should be preventive, with medicine being the last line of defense. Health is about medicine, but it is far more about the politics that create the world one lives in; about housing, transportation, and livable wage; about community networks. Indeed, medicine is only a small part of a larger “team” of forces that shape health.
A Party Trick
Authors: Stein Michael D. , Galea Sandro
Published: April 2020

This chapter distinguishes between health and health care. Health is a desired state of well-being that allows people to do what they want to do, enabling them to live full, rich lives, and to realize their human potential. Health care is the system that aims to restore people to health when they get sick. The conflation of health and health care is not without consequence. In fact, it fundamentally affects the health of the country. When people believe that health and health care are synonymous, they pour money into health care, thinking they are investing in health. This leads them away from addressing the true foundations of health, such as early childhood education, parks and recreation, prevention of suicide and substance use, gender equity, and economic fairness. This results in a one-sided focus on health care, at the expense of investing in the roots causes of health.
Public Health and a President’s Racism
Authors: Stein Michael D. , Galea Sandro
Published: April 2020

This chapter addresses how racism presents a clear threat to the health of populations. In 2018, President Donald Trump made racist comments toward countries with predominantly nonwhite populations. Why did the president’s racism matter for the health of the public? To answer this question, one needs to understand where health comes from. Health is the product of the social, economic, and cultural context in which people live. This context is also shaped by social norms that do much to determine people’s behaviors and their consequences. Changing these norms can produce both positive and negative health effects. On the positive side, changing norms can promote health, by making unacceptable unhealthy conditions and behaviors that were once common, even celebrated. On the negative side, changing norms for the worse can empower elements of hate in society. When a president promotes hate, it shifts norms, suggesting that hate does in fact have a place in the country and the world. This opens the door to more hate crimes, more exclusion of minority groups from salutary resources, and little to no effort to address racial health gaps.
The Census and Public Health
Authors: Stein Michael D. , Galea Sandro
Published: April 2020

This chapter describes the importance of the census for public health. The US Constitution mandates that each resident of the country be counted at least every 10 years. As the 2020 census approached, the Trump administration launched an effort to meddle with how to perform this head count, by adding a question about citizenship to the census. This move was roundly criticized by the Census Bureau’s Scientific Advisory committee and became the target of lawsuits. It looked very much like an attempt to depress the 2020 population count in immigrant-rich and predominantly Democratic areas, in advance of redistricting in 2021. Accurate census data are critical for the public's health. These data drive federal grants to states for the Special Supplemental Nutrition Program for Women, Infants, and Children. They guide disaster response and disease outbreak planning. Moreover, the Centers for Disease Control and Prevention (CDC) uses census information to locate geographic areas with low education levels and high poverty rates, so as to expand screening and outreach programs. Thus, these data inform the building of roads, schools, and health centers. As such, political moves to influence the census is a matter of great concern for public health.
When We Talk about Public Health
Authors: Stein Michael D. , Galea Sandro
Published: April 2020

This chapter studies how people talk about public health issues. During the 2016 presidential campaign, there was little discussion by candidates Donald Trump and Hillary Clinton of public health issues. Indeed, according to a study that combed the texts of major campaign speeches, interviews, and advertisements made by candidates Trump and Clinton for public health keywords, general references to “health” accounted for less than 1% of the words used by the candidates. It is worth noting what the authors of the study considered to be “health topics.” The study focused on six “public health issues”: wellness, diet, disease prevention, substance abuse, workplace standards, and vaccinations. There is no disagreement that these are public health issues. However, it would be a shame if this short list constitutes the entire political discourse about public health. Housing, health disparities, immigration, aging, mental health and substance use, military medicine, the environment, criminal justice, food policy, health technology, disability/injury, and health care delivery—this is something closer to the full list of forces that shape the public’s health in contemporary America. Politicians and the public already use more than 1% of their words discussing these topics. However, the public health implications of these issues are rarely addressed.
What Kills Our Kids?
Authors: Stein Michael D. , Galea Sandro
Published: April 2020

This chapter asks what kills children and what people can do about it. One of the greatest triumphs in health over the past century has been the dramatic decrease in childhood mortality, yet children still die. In 2016, there were, in the United States, about 38,000 deaths of children under the age of 19. Roughly half of deaths occur in early childhood due to genetic conditions, chromosomal abnormalities, and other perinatal conditions, many of which people do not know how to treat. However, we should be able to prevent most of the other half. The leading causes of injury deaths are motor vehicle deaths and gun-related deaths. Understanding how to prevent them can provide a template for stopping other childhood deaths. The chapter then considers the Vision Zero initiative, passed by the Swedish parliament 20 years ago, which aims to reduce traffic fatalities to zero. Just like motor vehicle accidents, childhood deaths from guns will not end until people work to create a safer environment by reducing the availability of firearms.
Dying Young in the United States
Authors: Stein Michael D. , Galea Sandro
Published: April 2020

This chapter focuses on child mortality. Child mortality is declining worldwide, according to a half-century’s worth of data from the Human Mortality Database and the World Health Organization (WHO). Since the 1980s, however, the United States has had higher rates of mortality for kids aged 0 to 19, compared to other wealthy Organization for Economic Cooperation and Development (OECD) nations. In 2013, the United Nations Children’s Fund (UNICEF) ranked the health and safety of children in the United States 25th out of 29 developed countries. Meanwhile, according to a 2018 Health Affairs study, from 2001 to 2010, the risk of death in the United States compared to peer nations was 76% greater for infants and 57% greater for children and youth age 1 to 19. In that same time frame, American teens age 15 to 19 were 82 times likelier to die from gun-related homicide. As such, US policymakers need to focus on preventing child mortality by preventing the largest contributors to this challenge: perinatal deaths, car accidents, and firearm assaults.
Vaccines and Conspiracies
Authors: Stein Michael D. , Galea Sandro
Published: April 2020

This chapter looks at the effect of conspiracy theories on vaccines. Near the end of 2018, data released by the Centers for Disease Control and Prevention (CDC) showed that a small, but growing, number of children in the United States were not getting recommended vaccinations. Some of this may be due to lack of access to vaccines; populations without insurance and those living in rural areas have greater rates of nonvaccination. However, part of it is also likely due to the rise of conspiracy theories and the willful dismissal of scientific evidence when it comes to vaccines. Vaccinations have always provoked anxiety; but the data on vaccines that are in widespread use are now clear: vaccines are safe and save lives. Nevertheless, conspiracism fuels the anti-vaccine movement, urging people to accept anecdotes over statistics. Unlike conspiracists, public health advocates adhere to standards of evidence and falsifiability; when conspiracists disregard explanation and refuse any form of correction, they place health at risk.
Health Systems and Public Health Thinking
Authors: Stein Michael D. , Galea Sandro
Published: April 2020

This chapter addresses how homelessness affects health. The disordered lives of homeless patients disrupt appointment-keeping and medication adherence, even as they generate need for more treatment by driving health challenges like depression, high blood pressure, and hospitalizations. As such, some health systems have begun to address the link between homelessness and health. One Boston health system, for example, announced plans to subsidize housing for the patients for whom it is accountable, to give this population some measure of the shelter and stability necessary for good health. As a society, people tend to forget that health is a public good supported by their collective investment in resources such as education, the environment, and, indeed, housing. Health systems can help people remember, by investing in these resources, to improve the health of patients. Indeed, health systems can direct people toward a better understanding of what truly shapes health, but it is ultimately the people’s responsibility to act on that knowledge and build a world that generates health.
Can We Promote Public Health and Generate Return on Our Investment?
Authors: Stein Michael D. , Galea Sandro
Published: April 2020

This chapter looks at how the country’s health investment remains resolutely focused on curative care. Perhaps people spend more on cure than they do on prevention because they believe keeping people healthy is too expensive. But is this true? An analysis set out to assess the return on investment for high-income countries that adopt efforts to improve health. The authors found that the median return on investment for public health interventions was 14 to 1—that is, for every dollar invested, it yields the same dollar back and another 14. They also found that the more these interventions were established at the wider, national level, the higher the return, rising up to about 40 to 1 for the best investments. These interventions include vaccination programs, taxes on sugar-sweetened beverages, building better cities to reduce falls, and early youth interventions to limit teenage pregnancy and delinquency. In other words, these are classic efforts to promote the public’s health by shaping the conditions in which people live.
Clarifying Medical Bankruptcy
Authors: Stein Michael D. , Galea Sandro
Published: April 2020

This chapter explores medical bankruptcy, which is a much-debated topic, with most questions focused on exactly how many people file for it and how often it occurs. In 2005, Elizabeth Warren and her colleagues found that medical costs led to over 40% of bankruptcies in the United States. This was followed by an update in 2009, pushing the proportion of bankruptcies due to medical expenses to 62%. The Consumer Financial Protection Bureau’s 2014 report conflicts with this causal attribution, citing that less than 1% of adults in the United States file for bankruptcy, even though 20% of the population has great medical debt. In 2018, a group of economists reexamined this issue, concerned that the discrepancies in statistics were causing a misunderstanding of the problem. Their findings show an increase in people filing for bankruptcy after hospitalization. The researchers suggest that paying for medical bills out of pocket and losing income because of missed work are key reasons people file for personal bankruptcy. Ultimately, one thing is clear: the better people understand the causes of medical bankruptcy, the easier it is to see that an investment in disease prevention could boost Americans’ financial health, as well as their physical and mental well-being.
Violence Is a Public Health Issue
Authors: Stein Michael D. , Galea Sandro
Published: April 2020

This chapter looks at how violence is a public health issue. Even as rates of violence from several causes have declined, the persistent prevalence of violence in people’s daily lives, both domestically and globally, should give people pause. In theory, violence is eminently preventable. Decreasing violence should therefore be a top priority in the broader pursuit of preventing disease and poor health. Yet violence continues to injure and kill worldwide. At the heart of this failure to prevent violence is the belief that violence is not a health issue. Overwhelmingly, people think of violence as a criminal justice problem, or a sociopolitical concern. This has resulted in the heavy-handed approach to incarceration, which has exacerbated racial divides in the United States and done little to prevent violence. Yet violence is a public health problem, with consequences both individual and collective. Some individuals who experience violence die; those who do not will go on to bear a physical or mental health burden that can last a lifetime. As such, solutions to violence must be rooted in a public health perspective. This means understanding how the context that shapes people’s health each day can raise the likelihood of violence.
Three Notes on the Opioid Crisis
Authors: Stein Michael D. , Galea Sandro
Published: April 2020

This chapter focuses on the opioid crisis. There has been substantial attention devoted—appropriately—to this issue. However, there are three areas that receive far less attention than they should. First, while opioids have attracted most of the headlines, two other drugs are being misused in America at newly alarming rates, their rise paralleling that of opioids. These are cocaine and its prescription-based stimulant cousins, such as Adderall and Ritalin. Then there is the issue of who is affected by opioids. This opioid crisis has presented countless news stories about the toll on white, middle-class, suburban, and rural users. While there have indeed been dramatic increases in opioid deaths in these groups, the opioid-related deaths of black Americans have doubled in the past 15 years. Thus, people must remind themselves that this is not just a white epidemic. Finally, because access to treatment for opioid addiction remains fragile, with national treatment rates low, people should keep in mind that Medicaid remains a key source of coverage for many people who use drugs. As Americans shore up a treatment system for opioid, cocaine, and stimulant misuse that has been woefully inadequate, threats to Medicaid’s structure and funding need ongoing attention, or the consequences of drug use will continue to grow.
Firearm Legislation Linked with Fewer Fatal Police Shootings
Authors: Stein Michael D. , Galea Sandro
Published: April 2020

This chapter studies how states with stricter firearm legislation have fewer fatal police shootings—defined as the rate of people killed by law enforcement agencies. The authors of a 2017 study used two data sources to show this relationship: the Brady Center to Prevent Gun Violence’s legislative scorecard for firearm laws; and The Counted, an online database produced by The Guardian to assess the number of fatal police shootings. The analysis showed that, even after controlling for age, education, violent crime rates, and household gun ownership, states with the strongest firearm legislation had a 51% lower incidence of fatal police shootings compared to states with the weakest firearm laws. The study also assessed the relationship between different types of legislation and rates of fatal police shootings. Laws that strengthen background checks, promote child and consumer safety, and reduce gun trafficking are linked to lower rates of fatal police shootings.
Food Justice
Authors: Stein Michael D. , Galea Sandro
Published: April 2020

This chapter highlights food insecurity. One in six people in the United States experiences food insecurity. Food insecurity has dramatic effects on the health of children and the elderly in particular, influencing educational progress, family stress, and nutritional deficiencies. Yet, as millions of Americans remain food insecure, they throw away 40% of their food every day. The largest source of this waste is the food people buy and bring home; 70% of all food discarded in people’s homes is edible. Restaurants are second in waste generation. If people could recover and redistribute one third of the food they waste, they could end food insecurity. Other countries are already moving in this direction; people may be starting to take similar steps in the United States. The 2018 Farm Bill supports food waste reduction plans in 10 states, creates a new Food Loss and Waste Liaison position within the US Department of Agriculture, and, following the European example, promotes the expansion of liability protections for food donations. In the private sector, there has been a rush of money into food waste reduction start-ups. Ultimately, reducing food waste creates economic, environmental, and public health benefits, as well as jobs, climate change deceleration, and hunger relief.
Guns and Suicide
Authors: Stein Michael D. , Galea Sandro
Published: April 2020

This chapter examines whether limiting the means to commit suicide can prevent suicide. South Korea has long had suicide rates higher than other high-income countries. In the 2006–2010 time period, suicide by pesticides accounted for more than a fifth of all suicides in the country. Then South Korea banned the sale of paraquat—the leading pesticide—in 2012. This was followed by an immediate decline in suicide rates across all groups. The success of such an effort rests on a simple observation: close to half of all suicides are acts of impulse, decided with an hour, if not a few minutes, before the suicide itself. This means that having access to lethal means matters enormously. And lethality varies between means. The likelihood of a successful suicide by drug overdose is less than 10%; the likelihood of successful suicide by gun is more than 90%. That means, with guns around, the suicidal impulse is much more likely to end in the act’s completion. It is not surprising then, given how many guns there are in the country, that firearms account for about half of all suicides in the United States. As such, as people discuss suicide, measures to limit the role of guns should be part of the national conversation.
Air Quality Standards Have Room to Improve
Authors: Stein Michael D. , Galea Sandro
Published: April 2020

This chapter focuses on the improvement of air quality in the United States. Laws such as the Clean Air Act (CAA), signed in 1970, resulted in a drastic reduction in air pollution. Since then, emissions have decreased by 50%. Despite these advances, adverse health effects associated with long-term exposure to air pollution continue. Researchers examined the health effects of pollution in a nationwide cohort of 61 million Medicare beneficiaries from 2000 to 2012. They created maps by linking Medicare mortality data, zip codes, and previously published estimates of ozone and fine particle pollutants (PM2.5). The study’s authors found that long-term exposures to fine particle pollutants and ozone, even at levels below current nationally “acceptable” standards, were associated with an increased risk of death. Persons with low incomes showed the highest risks associated with exposures. Vast improvements in air quality have been made in the past decades in the United States, but this study shows that air quality adhering to National Ambient Air Quality Standards still exposes Americans to levels of pollution that can be lethal over many years of exposure. Thus, air quality standards must be revisited in order to alleviate the burden on the most vulnerable populations.