California's Prisoner Protections for Family and Community Health Act : Implementing a Mandated Condom Access Program in State Prisons, 2015-2016.

In 2014, California passed Assembly Bill 966, which required condom access for persons incarcerated in all 35 California state prisons (33 men's and 2 women's prisons). The California Correctional Health Care Services and the Sexually Transmitted Disease Control Branch and the Office of AIDS of the California Department of Public Health collaborated in a prison administration-led multidisciplinary implementation workgroup. Our workgroup, representing public health, correctional health, legal and legislative affairs, labor relations, and prison staff members, participated in 4 planning meetings during May-September 2015. We surveyed prison staff members and incarcerated men to identify and address potential challenges; conceptualized a tamper-resistant condom dispenser; developed educational materials, frequently asked questions for staff members, and fact sheets for the public; and conducted forums for custody and medical staff members at each prison. Key lessons learned included the need for high-level custody support, engagement of labor unions early in the decision-making process, and flexibility within defined parameters for sites to determine best practices given their unique institutional population, culture, and physical layout. Condom access was initiated at 4 prisons in July 2015 and expanded incrementally to the remaining 29 men's prisons through July 2016. A total of 243 563 condoms were accessed in the men's prisons, for an average of 354 condoms per 1000 population per month. The start-up dispenser cost was $69 825 (735 dispensers at $95 each). We estimated an annual condom cost of $0.60 per person. Although staff members and incarcerated men expressed concern that this legislation would condone sex and provide repositories for contraband, no serious adverse incidents involving condoms were reported. California demonstrated that condom access is a safe, low-cost intervention with high uptake for a large correctional system and provided a replicable implementation model for other states. Prison condom programs have the potential to decrease transmission of sexually transmitted infections (STIs) among incarcerated persons and their communities, which are often disproportionately affected by STIs, HIV, and other chronic diseases.

"¡Viva La Clinica!": The United Farm Workers' Fight for Medical Care.

Farm work is among the most dangerous and unhealthy occupations in the United States, but efforts to address farm workers' health needs have been sporadic and inadequate. In the 1960s and 1970s, the United Farm Workers of America (UFW) famously organized workers in California's grape and lettuce fields and won national and international recognition through its boycott tactics. The UFW also opened several medical clinics, staffed by volunteer nurses and physicians, and created the Robert F. Kennedy Medical Plan, a medical insurance program, for its members. Both efforts were initially successful, but foundered in the face of many obstacles, including the reluctance of the UFW leadership to organize undocumented farm workers. However, the UFW's medical work laid the foundation for continuing efforts on behalf of farm workers' and undocumented people's right to health care.

Right-to-Work-for-Less: How Janus v. AFSCME Threatens Public Health.

In February 2018, the Supreme Court heard oral arguments in Janus v. AFSCME, a case poised to make right-to-work (or, as some call it, right-to-work-for-less) the law in the public sector. At issue is the constitutionality of requiring non-union members, who benefit from collective bargaining, to pay fees that support contract negotiations on the terms and conditions of their employment. We argue that a win for Janus would threaten public health by eroding organized labor's power to improve working conditions. Furthermore, we critique the dubious legal theory underpinning Janus's case and describe the moneyed political interests backing his legal representation. Finally, we chart a path forward for labor organizing in a post- Janus world, drawing inspiration from the winter 2018 educators' strike in West Virginia. Regardless of how Janus itself is decided, the issues raised in this article remain crucial because the ongoing weakening of unions by legislative and judicial means undermines workers' health and exacerbates inequities.

Six stormy years and the audacity to confront a challenging future: taking stock of the Kenyan Doctors' Union.

The Kenya Medical Practitioners, Pharmacists and Dentists Union (KMPDU) was formed in August 2011. Within the last six years, this union has galvanized the Kenyan doctors together, agitated for healthcare policy reforms and successfully negotiated and registered a Collective Bargaining Agreement (CBA). Though political will and the national citizens' psyche on matters pertaining to public healthcare remain a challenge, this union has made its foot prints on the Kenyan conversation space. KMPDU looks forward to engaging local, regional and international health stake holders to improve the state of the country's health care, key among these being to have a national commission handling all the human resources for health.

The Role of Labor Unions in Creating Working Conditions That Promote Public Health.

We sought to portray how collective bargaining contracts promote public health, beyond their known effect on individual, family, and community well-being. In November 2014, we created an abstraction tool to identify health-related elements in 16 union contracts from industries in the Pacific Northwest. After enumerating the contract-protected benefits and working conditions, we interviewed union organizers and members to learn how these promoted health. Labor union contracts create higher wage and benefit standards, working hours limits, workplace hazards protections, and other factors. Unions also promote well-being by encouraging democratic participation and a sense of community among workers. Labor union contracts are largely underutilized, but a potentially fertile ground for public health innovation. Public health practitioners and labor unions would benefit by partnering to create sophisticated contracts to address social determinants of health.

The Perils of Integrating Wellness and Safety and Health and the Possibility of a Worker-Oriented Alternative.

Integration of workplace wellness with safety and health has gained momentum on the initiative of the state allied with a segment of large employers and some health and safety professionals. Integration has a dual potential: to fundamentally reshape occupational health in ways that profoundly benefit workers, or to serve neoliberal corporate goals. A focus on the workplace and the ways work and health interact broaden the definition of a work-related injury or illness and emphasize and challenge the employer decisions that create hazards and determine risk. However, the implementation of integration is taking place in a context of corporate dominance and the aggressive pursuit of a neoliberal agenda. Consequently, in practice, integration efforts have emphasized individual worker responsibility for health and fail to actually integrate wellness with safety and health in a meaningful way. Can an alternative be envisioned and pursued that realizes the promise of integration for workers?

The Marikana Massacre: Why Heads Must Roll.

The massacre of thirty-four striking platinum miners on the 16 August 2012 near the village of Marikana in South Africa revealed the collusion of the state, mining capital, and sections of the labor movement. Analysis of the buildup to the killings highlight the way the mining industry systematically ignored evidence of the potential for social conflict as a result of its labor policies over many years. Further, the way in which the killings unfolded and were covered up are evidence that justice was denied to workers and their families. It should provide a sobering reminder of the power of elite alliances and the elite capture of seemingly democratic institutions within the labor movement, even in a post-apartheid South Africa.

Emerging from the tragedies in Bangladesh: a challenge to voluntarism in the global economy.

Under the regime of private company or multi-stakeholder voluntary codes of conduct and industry social auditing, workers have absorbed low wages and unsafe and abusive conditions; labor leaders and union members have become the targets of both government and factory harassment and violence; and trade union power has waned. Nowhere have these private systems of codes and audits so clearly failed to protect workers as in Bangladesh's apparel industry. However, international labor groups and Bangladeshi unions have succeeded in mounting a challenge to voluntarism in the global economy, persuading more than 180 companies to make a binding and enforceable commitment to workers' safety in an agreement with 12 unions. The extent to which this Bangladesh Accord will be able to influence the entrenched global regime of voluntary codes and weak trade unions remains an open question. But if the Accord can make progress in Bangladesh, it can help to inspire similar efforts in other countries and in other industries.

Public health agenda setting in a global context: the International Labor Organization's decent work agenda.

We drew on two agenda-setting theories usually applied at the state or national level to assess their utility at the global level: Kingdon's multiple streams theory and Baumgartner and Jones's punctuated equilibrium theory. We illustrate our analysis with findings from a qualitative study of the International Labor Organization's Decent Work Agenda. We found that both theories help explain the agenda-setting mechanisms that operate in the global context, including how windows of opportunity open and what role institutions play as policy entrepreneurs. Future application of these theories could help characterize power struggles between global actors, whose voices are heard or silenced, and their impact on global policy agenda setting.

Labor unions: a public health institution.

Using a social-ecological framework, we drew on a targeted literature review and historical and contemporary cases from the US labor movement to illustrate how unions address physical and psychosocial conditions of work and the underlying inequalities and social determinants of health. We reviewed labor involvement in tobacco cessation, hypertension control, and asthma, limiting articles to those in English published in peer-reviewed public health or medical journals from 1970 to 2013. More rigorous research is needed on potential pathways from union membership to health outcomes and the facilitators of and barriers to union-public health collaboration. Despite occasional challenges, public health professionals should increase their efforts to engage with unions as critical partners.