Preface
In the Preface to the First Edition, I wrote about the public’s general ignorance of the
field of public health and my own uncertainty about what public health was when, in
1986, I first went to work for the newly established School of Public Health, a collaboration between the University at Albany and the New York State Department of Health. After working with public health professionals from the Department of Health to design curricula for the programs at the school, and after teaching an introductory course in public health for more than ten years in collaboration with many of the same health department faculty, I feel much more confident about what the term means. After the bioterrorism scare of 2001 and the public health disasters of Hurricane Katrina in 2005 and Hurricane Sandy in 2012. I believe that the public has a better sense of the field as well.
This book was written as a text for an introductory course that could be included in the general education curriculum for college undergraduates. As I wrote in the Preface to the First Edition, I believe that every citizen of the United States should know something about public health, just as they should know something about democracy, law, and other functions of government. Public health issues are inherently interesting and important to almost everyone. They are featured almost every day on the front pages of newspapers and in the headlines of television news programs, although often they are not labeled as public health issues. One of my goals is to help people put these news stories into context when they occur.
The Fifth Edition of this textbook follows the plan of the first four editions, bringing it
up to date and including new developments in infectious disease, injury control,
environmental health controversies, the reform of the American healthcare system, and many other issues. I have illustrated public health principles by presenting stories that have been in the news; some of these stories have been ongoing sagas that have been supplemented with each edition. The Second and Third Editions focused on political interference with science, but as discussed in the Fourth Edition, the Obama administration vowed to restore honest science as a basis of policy decisions. Issues new to the Fifth Edition include the arrival of Ebola in the United States, involving the death of an African visitor and the involuntary quarantine of an uninfected healthcare worker returning from work in an affected country; the introduction of electronic cigarettes and questions of how they should be regulated; the importance of eating disorders as a major mental health issue; and the lawsuit by retired professional athletes against the National Football League for not disclosing risks of traumatic brain injury. Other issues discussed more extensively here are population growth and climate change as contributors to wars and migrations in the Middle East and the implementation of President Obama’s healthcare reform law, the Patient Protection and Affordable Care Act.
I have tried to make this book easily comprehensible to the general reader. One of the things that makes public health fascinating to me is the fact that it is often controversial, depending on political decisions as well as scientific evidence. The politics are frustrating to many practitioners, but it is often the politics that put public health in the headlines. I hope that by describing both the science and the politics, I will contribute to making public health as fascinating to the readers as it is to me.