A Century Later: Rural Public Health's Enduring Challenges and Opportunities.

The US public health community has demonstrated increasing awareness of rural health disparities in the past several years. Although current interest is high, the topic is not new, and some of the earliest public health literature includes reports on infectious disease and sanitation in rural places. Continuing through the first third of the 20th century, dozens of articles documented rural disparities in infant and maternal mortality, sanitation and water safety, health care access, and among Black, Indigenous, and People of Color communities. Current rural research reveals similar challenges, and strategies suggested for addressing rural-urban health disparities 100 years ago resonate today. This article examines rural public health literature from a century ago and its connections to contemporary rural health disparities. We describe parallels between current and historical rural public health challenges and discuss how strategies proposed in the early 20th century may inform current policy and practice. As we explore the new frontier of rural public health, it is critical to consider enduring rural challenges and how to ensure that proposed solutions translate into actual health improvements. (Am J Public Health. 2020;110:1678-1686. https://doi.org/10.2105/AJPH.2020.305868).

Social and institutional Reactions to the Influenza Pandemic of 1918-20.

This essay challenges generalizations since the late enlightenment about the effects of epidemics and pandemics on collective mentalities: that from antiquity to the present, epidemics, regardless of the disease, have sparked distrust, social violence, and the blaming of others. By contrast, the pandemic that killed the greatest numbers in world history-the Influenza of 1918-20 - was a pandemic of compassion. No one has yet to uncover this pandemic sparking collective violence or blaming any minorities for spreading the disease anywhere in the globe. The essay then explores the variety of charitable reactions and abnegation that cut across social divisions in communities from theatres of war in Europe to nations thousands of miles from the direct military encounters. Most remarkable, however, was the overflowing volunteerism of women, especially in the US, Canada, and Australia. To explain this widespread charitable reaction, the essay investigates the milieu of the First World War, showing how that context in domestic war settings was not conducive to risking life to aid total strangers, especially when those strangers came from different foreign countries classes, races, or religious faiths. I end with a reflection on the unfolding socio-psychological reactions to Covid-19 from the perspective of 1918-20.

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/PAC's interpretation of health activism, focusing in particular on a protracted struggle regarding Lincoln Hospital in the South Bronx. Over the years, the organization's 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/PAC's major theoretical contributions, often taken for granted today, and its book American Health Empire.

The broad challenge of public engagement in science: commentary on: "Constitutional moments in governing science and technology".

Timely public engagement in science presents a broad challenge. It includes more than research into the ethical, legal and social dimensions of science and state-initiated citizen's participation. Introducing a public perspective on science while safeguarding its public value involves a diverse set of actors: natural scientists and engineers, technology assessment institutes, policy makers, social scientists, citizens, interest organisations, artists, and last, but not least, politicians.

Constitutional moments in governing science and technology.

Scholars in science and technology studies (STS) have recently been called upon to advise governments on the design of procedures for public engagement. Any such instrumental function should be carried out consistently with STS's interpretive and normative obligations as a social science discipline. This article illustrates how such threefold integration can be achieved by reviewing current US participatory politics against a 70-year backdrop of tacit constitutional developments in governing science and technology. Two broad cycles of constitutional adjustment are discerned: the first enlarging the scope of state action as well as public participation, with liberalized rules of access and sympathetic judicial review; the second cutting back on the role of the state, fostering the rise of an academic-industrial complex for technology transfer, and privatizing value debates through increasing delegation to professional ethicists. New rules for public engagement in the United Sates should take account of these historical developments and seek to counteract some of the anti-democratic tendencies observable in recent decades.

Addressing disparities in access to care: lessons from the Kercheval Street clinic in the 1960s.

Health disparities for racial and ethnic minorities have been present in the United States and persist today. NMHCs (Nurse-Managed Health Center), which can serve as "Medical Homes," are one mechanism by which nurses can attempt to overcome these disparities within communities. In the mid-1960s, Nancy Milio developed and found funding for a NMHC to address disparities in Detroit, Michigan. History shows that the center was so valued by community members that it remained untouched during the Detroit riot of 1967, despite all buildings surrounding it having been burned down or destroyed. This article uses traditional historic methods to describe the establishment of the center in inner-city Detroit in the 1960s in historical context and analyze factors that led to Milio's success. To address disparities via NMHCs, nurses must be persistent in acquiring funding and should involve a racially and culturally diverse group representative of community members in the development, planning, and ongoing operation of the enterprise.

Local practice and global data: loyalty cards, social practices, and consumer surveillance.

Monitoring of consumers has become the most widespread mode of surveillance today. Being a multi-billion dollar business, the collected data are traded globally without much concern by the consumers themselves. Loyalty cards are an element with which such data are collected. Analyzing the role of loyalty cards in everyday practices such as shopping, I discuss how new modes of surveillance evolve and work and why they eventually make communication about data protection a difficult matter. Further, I will propose an alternative approach to the study of surveillance. This approach is concerned with local practices, focusing on subjective narratives in order to view surveillance as an integral part of culturally or socially manifested contexts and actions and not to view surveillance as something alien to society and human interaction. This will open up other possibilities to study modes of subjectivity or how individuals situate themselves within society.

[Users' participation in mental health services]. / La participación de los usuarios en los servicios de salud mental.

Users' participation in mental health services isn't precisely a novelty but its recent form is that of a movement impossible to imagine twenty years ago. The present paper distinguishes the terms "consumer", "client", "patient" and "user", as well as "participation", "perspective", "inv olvement" and "users' control of services". Some historical milestones are described and also the relationship between users' movement and the recovery concept, the Human Rights doctrine and the development of Post Psychiatry. Self-help and mutual-aid groups, participation in planning, provision and evaluation of services, and also in selection and training of mental health professionals are pointed as the main types of participation. Some aspects of the local users' movement are also depicted. Finally, the personal narratives are presented as potentially subjectivity creators and ways of coming out of isolation and fighting stigma.

The rise of the eclectic cultural consumer in Denmark, 1964-2004.

Existing research on cultural stratification and consumption patterns rarely presents a cross-time comparative perspective and rarely goes back before the 1980s. This article employs a unique series of surveys on cultural participation collected in Denmark over the period 1964-2004 to map the historical development of three distinct cultural consumption groups (eclectic, moderate, limited) also identified in previous research. We report two major findings. First, the eclectic (or "omnivorous") cultural consumption group existed as far back as the 1960s and has since the 1980s comprised about 10 percent of the Danish population. Second, the major stratification variables-income, education, and social class-are strong predictors of cultural eclecticism in Denmark, and the predictive power of these stratification variables appears not to have declined in any substantive way over the past 40 years.

Health care consumerism movement takes a step forward.

One of the contributing factors to both the increase in health care costs and the backlash to managed care was the lack of consumer awareness of the cost of health care service, the effect of health care costs on profits and wages, and the need to engage consumers more actively as consumers in health care decisions. This article reviews the birth of the health care consumerism movement and identifies gaps in health care consumerism today. The authors reveal some of the keys to building a sustainable health care consumerism framework, which involves enlisting consumers as well as other stakeholders.

Locating oneself in the past to influence the present: Impacts of Neolithic landscapes on mental health well-being.

There are well-established links between mental health and the environment. Mental illness is a global issue, and international policies increasingly focus on promoting mental health well-being through community-based approaches, including non-clinical initiatives such as therapeutic landscapes and the use of heritage assets. However, the empirical evidence-base for the impact of such initiatives is limited. This innovative study, known as Human Henge, used a mixed-methods approach to investigate the impact of immersive experiences of prehistoric landscapes on the well-being of participants with mental health issues. Uniquely, the study followed participants for a year after their participation in the project to explore the long-term impact of their experiences on their mental well-being. Findings highlight that, overall, participants experienced improved mental health well-being from baseline to mid- and end-of programme (p = 0.01 & 0.003), as well as one-year post-programme (p = 0.03). Qualitative data indicated the reconnection of participants with local communities, and with other people, in ways that improved their mental health well-being. These data highlight the effectiveness of using heritage as a means of improving the well-being of people with mental health issues.

The evolution of health care in America.

The evolution of health care in America had its beginnings even before the founding of the nation. This article divides the evolution of American health care into six historical periods: (1) the charitable era, (2) the origins of medical education era, (3) the insurance era, (4) the government era, (5) the managed care era, and (6) the consumerism era.

[In the heart of Brazil, a healthy capital--the participation of doctors and sanitarists in the construction of Brasília (1956-1960)]. / No coraçro do Brasil, uma capital saudável--a participação dos médicos e sanitaristas na construção de Brasília (1956-1960).

Projected as an expression of the daring and modernity of an age, Brasília could not overlook planning that considered the conditions where it would be located in the interior of Brazil. Constructed in a region historically associated with isolation, poverty and diseases, the new capital required the participation of doctors and sanitarists from the very beginning of construction to ensure healthy conditions. Seeing the opportunity to expand their sphere of action, until then restricted to the interior, doctors from Goiás stood out in this process, highlighted by concerns of the profession manifested in the periodical published by its association and their extensive mobility and modern practice, contradicting the common conceptions regarding doctors in the interior.

History and challenges of Brazilian social movements for the achievement of the right to adequate food.

The historical struggles that Brazil faced to overcome malnutrition coincided with the empowerment of civil society and social movements which played a crucial role in the affirmation of health and food as social rights. After two decades under military dictatorship, Brazil went through a redemocratization process in the 1980s when activism emerged to demand spaces to participate in policy-making regarding the social agenda, including food and nutrition security (FNS). From 1988 onward institutional structures were established: the National Council of FNS (CONSEA) convenes government and civil society sectors to develop and monitor the implementation of policies, systems and actions. Social participation has been at the heart of structural changes achieved since then. Nevertheless, the country faces multiple challenges regarding FNS such as the double burden of disease, increasing use of pesticides and genetically modified seeds, weak regulation of ultra-processed products, and marketing practices that affect the environment, population health, and food sovereignty. This article aims at examining the development of the participatory political system and the role played by Brazilian social movements in the country's policies on FNS, in addition to outlining challenges faced by those policies.

Civic programmatic participation in public health: the case of Argentina.

Since the Alma Ata World Health Organization Conference in 1978, countries around the world have adopted institutions that promote the participation of citizens in their public health systems. The main objectives of this article are two-fold. First, we describe the origins and implementation of a national-level civic participatory program that was in place in Argentina in the mid-2000s: the Local Participatory Projects (Proyectos Locales Participativos). Second, we analyze the 201 local participatory projects that were carried out in Argentina between 2007 and 2008. We study health and environmental problems that prompt people's participation in the program and the social dynamics through which such participation is executed.

"Be receptive to the good earth": health, nature, and labor in countercultural back-to-the-land settlements.

Modern environmental activists unified behind calls for a change in how humans understood their relationships with nature. Yet they approached their concerns through a variety of historical lenses. Countering arguments that suggest environmentalism had its deepest roots in outdoor leisure, the countercultural back-to-the-land movement turned to a markedly American practice of pastoral mythmaking that held rural life and labor as counter to the urban-industrial condition. Counterculturalists relied specifically on notions of simple work in rural collective endeavors as the means to producing a healthy body and environment. Yet the individuals who went back-to-the-land often failed to remedy conflicts that arose as they attempted to abandon American consumer practices and take up a "primitive" and down-to-early pastoral existence. Contact with rural nature time and again translated to physical maladies, impoverishment, and community clashes in many rural countercultural communes. As the back-to-the-land encounter faded, the greater movement's ethos did not disappear. Counterculturalists used the consumption of nature through rural labor as a fundamental idea in a growing cooperative food movement. The back-to-the-land belief in the connection between healthy bodies, environments, and a collective identity helped to expand a new form of consumer environmentalism.

[Do-it-yourself biology and medicine: history, practices, issues]. / Biologie et médecine « do-it-yourself ¼ - Histoire, pratiques, enjeux.

Do-it-yourself (DIY) biology and medicine are based on various practices and logics: amateur and DIY practices, the ethics of hacking and open source, the drive to domesticate molecular biology and genetics, the ideal of participation and citizen science. The article shows that this democratization is a process that is at once spatial (construction of new spaces), technical (creative workarounds equipment), social (establishment of accessible networks/laboratories) and political. It is therefore through their practices, gestures and questions - tinkering, experimenting, working around, amaterializing, ethicizing, comparing, valuating, etc. - that we need to grasp DIY sciences.