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Currently, population health science is an integral part of academic curricula around the world. For over a century, the principles of the reductionist paradigm have guided population health curricula, training, research, and action. Researchers continue to draw upon these principles when theorizing, conceptualizing, designing studies, analyzing, and devising interventions to tackle complex population health problems. However, unresolved impasses in delineating and managing pressing population health challenges have catalyzed calls for the integration of complex systems science–grounded theoretical, methodological, and analytical approaches into population health science. Mounting evidence denotes that a complex systems paradigm can bring about dramatic, multipronged changes for education and training and lead to innovative research, interventions, and policies. Despite the large and untapped promise of complex systems, the haphazard knowledge base from which academics, researchers, students, policymakers, and practitioners can draw has slowed their integration into the population health sciences. This volume fulfills this growing need by providing the knowledge base necessary to introduce a holistic complex systems paradigm in population health science. As such, it is the first comprehensive book in population health science that meaningfully integrates complex systems theory, methodology, modeling, computational simulation, and real-world applications, while incorporating current population health theoretical, methodological, and analytical perspectives. It is intended as a programmatic primer across a broad spectrum of population health stakeholders—from university professors and graduate students to researchers, policymakers, and practitioners. This book also aims to provoke long-overdue discourse on the need for updated new curricula in the population health sciences.

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.

Essentials for Health Protection: Four Key Components is an introductory to intermediate level textbook and reference book for undergraduate and postgraduate students, as well as healthcare professionals, non-health actors, and policymakers who are interested in obtaining an overview of an integrated and comprehensive public health approach to health protection. Health protection is one of the three major core theoretical domains of public health, which aims to prevent and manage communicable disease outbreaks and environmental health risks and related diseases. Effective health protection measures may enhance individual, community, and institutional resilience in coping with extreme events. In addition to introducing the four areas covering both health and environmental protection, namely, climate change adaptation and mitigation, emergency preparedness, communicable disease control, and environmental health, this book will also explore a number of new health protection frontiers, such as key discussions in Health Emergency and Disaster Risk Management (H-EDRM), planetary health, and sustainability. The whole health protection spectrum from risk mitigation, prevention interventions, and emergency response are discussed in a comprehensive, contextual, multidisciplinary, and cross-national way. Various text boxes and case examples are included throughout the book to illustrate what the current status of health protection is globally and impart the latest controversies and dynamics that might change the landscape and reality of health protection practices and development.

This book explores the lives and work of scientists who unraveled the mysteries of meningitis and describes the steps (and sometimes missteps) they used to accomplish their splendid achievements. Although symptoms of meningitis were recorded as early as the time of Hippocrates, its origin remained obscure. Then, in 1892, one of the bacteria that cause meningitis in children, Haemophilus influenzae, was discovered when Richard Pfeiffer saw it in material coughed up by a patient with influenza. Pfeiffer mistakenly thought the bacteria caused influenza, and it has carried that unfortunate, erroneous name since that time. Discovery, however, marched forward, and Quincke discovered how to obtain spinal fluid by inserting a needle between two bones in the patient’s back. Pittman discovered the sugar overcoat that protects H. influenzae from being eaten by white blood cells. Flexner managed epidemics of meningitis with serum from a horse. Griffith unknowingly stumbled on DNA, the master of all life. Weech gave the first antibiotic used in America to a little girl with meningitis. Alexander learned why antibiotics sometimes fail in such patients. Smith won the Nobel Prize for showing how DNA invades bacteria, the right conclusion for the wrong reasons. And four scientists, in two teams, vied to be the first to create the best vaccine to prevent meningitis in infants.

Patient safety suddenly burst into public consciousness in the late 1990s and became a “celebrated” cause in the 2000s. It has since gradually faltered, and little improvement has been noted over almost 20 years. Both the rise and fall of patient safety demand explanation. Medical harm had been known long before the 1990s, so why did it suddenly become popular? And why were safety efforts ineffective? The authors propose that this rise was due to a discursive shift that reframed “medical harm” into “medical error” in the setting of anxiety about industrialization and great change in healthcare. The “error” framing, with its inherent notion of agency, was useful in advancing the agenda of a technocratic, managerial group of health professionals and diminishing the authority of the old guard based on clinical expertise. The fall was due to this “medicalization” of safety. Health professionals and managers with little knowledge of safety science came to dominate the patient safety field, crowding out expertise from the safety sciences (e.g., psychology, engineering) and thus keeping reform under the control of the healthcare establishment. Operating with a sort of delusional clarity, this scientific-bureaucratic cabal generated a great deal of activity but made little progress because they failed to engage with expertise in the safety sciences. Twenty years after sudden popularity, there is general agreement that little of value has been achieved. The future of patient safety is in doubt, and radical reform in approaches to safety will be required for progress to be made.

Sleep, along with the sleep-related behaviors that impact sleep quality, have emerged as one of the major determinants of health and well-being (alongside good diet, regular exercise, and not smoking). In turn research is beginning to identify that sleep is strongly socially patterned—by socioeconomic status, race/ethnicity, immigrant status, stage of the life course, work experiences, stress, and neighborhood contexts. Yet no textbook currently exists that brings together the accumulated evidence on the social epidemiology of sleep. This book is targeted toward (a) social epidemiologists who wish to study sleep as a health outcome, (b) sleep epidemiologists who want to learn about the social determinants of sleep, and (c) other scholars working in the intersection between sleep health, social epidemiology, and health disparities. The textbook begins with an introduction of social epidemiology and sleep epidemiology, that is, a brief overview of the social epidemiology of sleep as well as the methods of assessment in sleep epidemiology and their validity, the descriptive epidemiology of sleep, and some basic biology of sleep. Part II focuses on what is known about the basic descriptive epidemiology of sleep, including consideration of sleep across the life span and among special populations. Each chapter of the remaining sections of the book (Part III) covers the major social determinants of sleep (socioeconomic status, immigration status, neighborhood contexts, etc.) from the accumulated research as well as research needs/opportunities as they relate to that social dimension of health.

As the cornerstone science of public health, evidence-based medicine, and comparative effectiveness research, a clear understanding of study designs is central to the study of epidemiology. Causal inference is increasingly being understood as the theoretical foundation underlying epidemiologic study designs and the science as a whole. This textbook takes a causal approach to traditional introductory epidemiology, through the organizing principle of study designs and the lens of modern causal inference approaches (potential outcomes, counterfactuals, identification conditions). The intended audience is first-year graduate students and advanced undergraduates in epidemiology and allied fields more broadly. Section I introduces measures of prevalence and incidence (survival curves, risks, rates, odds) and measures of contrast (differences, ratios), the fundamentals of causal inference, and principles of diagnostic testing, screening, and surveillance. Section II describes three key study designs through the lens of causal inference: randomized trials, prospective observational cohort studies, and case-control studies. For each, the author discusses logistics and conduct, advantages and disadvantages including biases, basic approaches to analysis, and briefly reviews several additional study designs. Section III extends material in previous sections, moving from concerns about internal validity (within a sample) to questions of external validity and population impact. This book provides new students with a rigorous foundation in epidemiologic methods and an introduction to methods and thinking in causal inference, serving as an excellent foundation for further study of the field.

This book is based on over 40 years work in public health at a time of unprecedented change and challenge. The emphasis is on the practical aspects of working at different levels of action, very much ‘how to do it and how it was done’. As such it is a personal account. This period marked a new era in which the previous medical paradigm, dating from the mid-nineteenth century, was replaced by a broader, multidisciplinary approach, grounded in social science, the humanities, ecology, and public engagement with the politics of health once more coming into focus. The author uses case studies, storytelling, and real-life experience of establishing a new and revitalized public health system in the North West of England to bring the subject alive for a new generation of students and practitioners. Building on historic insights and timeless lessons from the Victorian and early-twentieth-century pioneers, he traces the evolution of the new thinking and its translation into action. The volume offers a rich menu of examples of responses to an array of new challenges ranging from new infections, such as HIV/AIDS and Ebola, to the lifestyle diseases of the new age, and the application of public health thinking to mental health and the problems of an ageing population. The external threats to health from the environment and as a result of man-made disasters and emergencies are extensively covered. The author brings a fresh approach to public health and the communication of public health issues. This work is accessible and stimulating, speaking to a wide range of audiences and sharing his passion for the subject.

Few contributions to the field concerning the current opioid crisis in the United States focus sufficient attention on the public health aspects of the epidemic and share examples that practitioners can use to prevent opioid use disorder and the broader issues of substance misuse and addiction. A great deal of prior published work has concentrated on health care and clinical perspectives related to the crisis, including developing prescribing guidelines, enhancing prescription drug monitoring programs, scaling up access to overdose reversal medication, and making medication-assisted treatment more widely available nationwide. This book adds to and complements this prior work by addressing the central tenets of the public health approach to the opioid crisis. Topics include how to best support community-based, primary prevention of substance misuse and addiction in various settings with diverse populations and how to effectively address the cultural, social, and environmental aspects of health that are driving the epidemic. Chapters describe how governmental public health agencies play a significant role in responding to the epidemic, in both public health’s traditional approach to disease surveillance and control and contemporary approaches to health promotion that include building community resilience, addressing the impact of adverse childhood events, and mitigating the root causes of addiction community-wide. This volume can be used to explore what it means to address primary prevention of addiction and how public health practitioners have led efforts to promote “opioid stewardship” at the local, state, and federal levels.

‘Health inequalities—persistence and change in European welfare states’ studies why frequencies of disease, disability, and premature mortality are higher among people with a lower socioeconomic position, even in countries with advanced welfare states. Drawing upon data from 30 countries covering more than three decades, it provides a comprehensive overview of trends and patterns of health inequalities, showing that these are not only ubiquitous and persistent, but also highly variable and dynamic. It provides a critical assessment of recent research into the explanation of health inequalities, discussing methodological pitfalls, summarizing findings from epidemiological, sociological, economic, and genetic studies, and reviewing nine overarching theories. Based on in-depth studies of the determinants of health inequalities in European countries, it shows that the persistence of health inequalities is due to a combination of mostly favourable changes in social stratification, massive but differential health improvements, and persistence of social inequality in material and non-material living conditions. It discusses why social inequality is so persistent, and whether welfare state reform could contribute to reducing health inequalities, and provides a systematic analysis of the inequitableness of health inequalities according to five theories of justice. It reviews recent attempts by European national governments to reduce health inequalities, showing that it is realistic to expect evidence-based policies to reduce absolute but not relative inequalities in health. This title is written for scientists and advanced students from various disciplines, as well as for public health professionals and policymakers, and is profusely illustrated and referenced.