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This chapter analyses the routes by which Parliamentary bodies move from consultation to formulating public policy in the controversial field of assisted conception and related technological developments. It explores the findings of the Department of Health consultation, focusing not only on the official interpretation of the data, but to alternative constructions and problems created by the quasi-quantitative representation of the material at some junctures. On the one hand, this process has led to greater empathy for the Department of Health and other official bodies in sifting through the myriad responses, but on the other hand a creeping cynicism has also taken hold. It is clear that there are significant issues about the way that data is presented by governmental and Parliamentary bodies, and even in the absence of the use of statistical data it remains feasible to skew the presentation of data in ways that are, strictly speaking, factually correct but simultaneously misleading about the dataset as a whole.

This chapter discusses the development of health impact assessment (HIA) in the USA. The use of HIA in the USA began in approximately 1999. Early HIAs by the San Francisco Department of Public Health and the University of California, Los Angeles examined the impacts on health of proposed living wage ordinances. Subsequently, a number of efforts led to increasing interest in HIA as a tool to inform decision making related to the built environment, such as urban planning, redevelopment proposals, and transportation projects, and related to policies outside the health sector that affect health. To date, most HIAs in the USA have been carried out without a specific legislative mandate or regulatory requirement. They have been led by public health officials in local, state, or tribal health departments; by academic public health professionals; by community-based organizations seeking to promote the consideration of health; and by professionals in allied disciplines such as urban planning.

This chapter presents background on the nature of health policy and the role of regulation in translating policy into action. It describes the fundamental policy goals of improving quality, enhancing access, and controlling costs and the ways in which they compete, as improvements in one goal inevitably harm one or both of the others. Over the course of the 20th century, the primary emphasis of most new regulatory initiatives evolved from quality to access to cost. The chapter then explains the process of regulation and the legal rules for governmental regulatory agencies, particularly the federal Administrative Procedures Act. It also describes the basic structure of the largest regulatory body of all, the Federal Department of Health and Human Services. It concludes with a discussion of perennial policy conflicts, including the balance between regulation and market forces, between private and governmental regulation, and between state and federal primacy in regulation.

This chapter provides an introduction to and national context for the importance of Advance Care Planning (ACP) in the Department of Health End of Life Care Strategy in England. It also presents background publications which have highlighted the need for ACP, issues surrounding ACP, resources to support the process of ACP, the practicalities of implementation, and further developments. ACP is delivered as a process of discussion between an individual and their care provider, irrespective of discipline, with or without their carer/family involvement. Outputs may include a statement of wishes and preferences, decisions to refuse treatment, and/or Lasting Power of Attorney. Meanwhile, guidance from Health and Social Care Staff has been published. Further work is underway in areas of education, communication, and information transfer.

This chapter describes how the establishment of Yale's Department of Public Health resulted from the creation of the Anna R. Lauder Chair of Public Health with a gift of $500,000 from the Lauder bequest in 1915. George Blumer had chaired a university committee soon after his arrival in 1906 to consider establishing a department or school to provide education in working with public-health bureaus and philanthropic or charitable organizations. Much of the impetus for the committee had come from Irving Fisher, a political economist at Yale, who was interested in the economic impact of disease on society. He felt that Yale was well positioned to serve the public-health movement, given the combined interests of the medical school, the Sheffield Scientific School, and the Department of Economics.

Molecular genetics was an area in which elite British scientists and research institutions sought to compete on a global scale. Sickle cell anaemia and thalassaemia, genetic conditions strongly linked to specific racialized ethnic communities, offered British researchers an opportunity to leapfrog their US counterparts: here, the UK’s newly diverse population and less toxic racial politics represented a huge advantage. So too was the availability of the NHS as a source of universal healthcare, and the discretionary power held by research elites within it to mediate access to both specialist and general services in the name of research. Yet service provision to affected communities lagged behind research funding, emerging only in response to community activism. While sickle cell anaemia and thalassaemia were not significant sources of morbidity or mortality, their symbolism and scientific potential attracted clinical and political attention denied to other more mundane (and more prevalent) chronic conditions.

This chapter emphasises the importance of a local and regional perspective in examining the emergence and early history of the National Health Service (NHS) in Britain. Focusing on health centres in Scotland, the chapter demonstrates the importance of regional variations within Scotland as well as the differences between Scotland and other parts of the United Kingdom. The Scottish NHS was recognisably ‘British’, but there were some differences in terms of administration and governance. The Department of Health for Scotland proposed a programme of health centres in the late 1940s, but they did not appear in large numbers until the 1960s. The chapter examines two contrasting health centre programmes, in Livingston and Glasgow, which illustrate the differences between a ‘top-down’ model on the one hand, and, on the other, a model in which general practitioners themselves too the initiative.

This chapter studies civilian biodefense as a “natural experiment” to compare with research, development, acquisition, and doctrine in the military. Foreshadowed during the Korean War, the rise of civilian biodefense began in earnest during the 1990s when prominent scientists constructed a new relationship between bioterrorism and emerging infectious diseases. These ideas helped situate biological weapons inside the biomedical frame at the Department of Health and Human Services (HHS), enabling it to respond to increasing demands from the president and Congress. Unlike the military, the HHS lobbied hard to win funds money on the table for biodefense rather than let the funding go to the Department of Homeland Security after September 11 and the anthrax attacks of 2001. Moreover, the HHS did not rely on the military's inaccurate stereotypes.

This chapter discusses the initial emergence of BSE as a novel veterinary disease in the UK, and the process by which it came to be acknowledged officially. The initial response from MAFF to the emergence of BSE, involving first secrecy and then reassurances that were not based on sound science. The political and scientific conditions under which expert scientific advice was initially recruited are outlined, emphasizing how the severe limitations of scientific knowledge about risks to human health and the policy dilemmas this raised, complicated the tensions between MAFF and the Department of Health (DoH).

This chapter describes the complex new public health system in place in England from April 2013, the rationale behind it, interrelationships between different sectors and tiers. It outlines the implications for the public health workforce and where they sit and, whilst the new system is bedding down, raises some issues and challenges and poses some questions about the future. The chapter concludes with a description of the new professional public health system in the context of the 2013 Strategy for the public health workforce, including workforce development issues the strategy aims to address.

This chapter draws on empirical evidence regarding professionals and service users' views. It draws on the results of a Department of Health-funded study to explore understanding of health and well-being from the perspective of community members and professionals. It describes how the literature on concepts of health and illness has broadened in recent years to include a growing focus on positive health and well-being. It argues that specific definitions of positive health are, however, difficult to identify. It further argues using findings from the HealthCounts study that more work is needed to develop theoretical frameworks around positive health. It finds that concepts of well-being in themselves are not sufficient unless well specified, and are closely linked with formal or official discourse rather than individual or community views. It argues that lay accounts of positive health can help to broaden understanding of health and its influences as well as improve its measurement.

The Holloway redevelopment project was regarded as a quite exceptional and daunting enterprise marked by an unparalleled scale and ambition. All prison-building is formidable, not unlike the planning and construction of a small town with all its utilities, but with additional requirements of surveillance and discipline unknown to most civil design. Reconstructing Holloway prison was without precedent, requiring uncommon powers of management as, side by side, the old prison was razed and the new prison erected, inmates and staff were shuffled about, buildings were evacuated and replaced, and temporary security fences and gates were manoeuvred about the site. The project was both the first prison specifically built for women in Britain and an extraordinary prison in its own right. The character of the new prison was foreshadowed, the participation of the medical specialists and the Department of Health clearly signifying Holloway's medical future.

The book focuses principally on changes since 2000 affecting the public health workforce in England. To balance this, this chapter describes briefly the different systems for employing the public health workforce across the rest of the UK and their different approaches to developing public health.

This chapter illuminates the specific significance and character of embodied knowledge in policy-making, through a case-study of civil servants in England's Department of Health. It describes the importance of embodied knowledge to the ways in which civil servants constructed understandings of the objects of national health policy. It sets out how the civil servants identified to whom they should turn for ideas and information, providing an analysis of the in-practice principles guiding whose knowledge was permitted to contribute to policy formulation. The chapter explores the distinctive properties of embodied knowledge, offering an account of why this form of knowledge was so appealing to the participants of the study. It concludes by returning to the book's organising framework to emphasise the importance of inter-enactment in determining the significance and meaning of embodied knowledge in policy-making.

This chapter focuses on the small number of marriage workshops directed both at poor single mothers in conjunction with receiving Temporary Assistance to Needy Families (TANF) benefits and at the prison population. While marriage advocates seek to redraw a definitive boundary to compel marriage as a moral and social good, some are more willing to recognize the obstacles to marriage for low-income individuals and prioritize a number of relationship- and work-related services. To disseminate these services to a low-income population, the marriage initiative trains employees of the Department of Health, the Cooperative Extension Service at OSU, and Oklahoma Department of Human Services (OKDHS) to conduct workshops and make referrals to their clients. In the first two years of the program, the Department of Health agreed to meet a quota of workshops offered by staff members trained in the Prevention and Relationship Enhancement Program (PREP), with each conducting at least four workshops.

This chapter draws upon the work of both critical-race theorists and feminist sociologists to analyze how the California Department of Health Services’ “Partnership for Responsible Parenting” disguises national and local concerns about changing racial demographics and non-traditional family structures within the rhetoric of the “teenage pregnancy” problem. The discourses that mark the maternal bodies of women of color as racialized, sexualized threats to moral and civic “responsibility,” “family values,” and “public health” achieve their distinctly racialized character and racializing function through their status as part of deviant sexuality, deficient motherhood, and national economic and social threat burden. The chapter also locates the visual print media components of state-authored teen pregnancy prevention initiatives within the same public “screening space” as other U.S. visual constructions of maternal bodies.

This chapter provides an introduction to and national context for the importance of advance care planning (ACP) in the Department of Health End of Life Care Strategy in England. It also presents background publications which have highlighted the need for ACP, issues surrounding ACP, resources to support the process of ACP, the practicalities of implementation, and further developments. ACP is delivered as a process of discussion between an individual and their care provider, irrespective of discipline, with or without their carer/family involvement. Outputs may include a statement of wishes and preferences, decisions to refuse treatment, and/or Lasting Power of Attorney. Meanwhile, guidance from Health and Social Care Staff has been published. Further work is underway in areas of education, communication, and information transfer.

This chapter describes the three explanations for biodefense—realism, bureaucratic interests, and organizational frames—that this book will test. First, realist theory predicts that the United States will fear biological weapons and help protect itself through biodefense because the threat is credible. Bureaucratic interests predict that both the Department of Defense (DoD) and the Department of Health and Human Services (HHS) will compete for funding and autonomy. Drawing on the organizational frame theory, the chapter then identifies organizational frames and stereotypes regarding biodefense, illustrate the military's kinetic frame of reference, and explain why military biodefense is expected to be neglected as a result.