Fertility control policy, social policy and population policy in an industrialized country.
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Catholicism↗
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Discretionary death: conditions, dilemmas, and normative regulation.
The author examines a major shift in the conceptualization and practices relating to death and dying in Western and other societies with advanced medicine. This shift is the result of socio-technical and cultural developments characterized by but not limited to the routine widespread application of life support technologies in the hospital together with notions of increased patient rights. It has resulted in a class of end-of-life situations, which the author defines as "discretionary death." The concept of discretionary death underscores the role of contextual and discretionary factors in end-of-life decision-making. The author identifies and discusses the necessary and complex process of norm formation that informs and regulates end-of-life medical practice and establishes societal consensus across society with respect to legitimizing "discretionary death."
Attitude to Death↗
Effect of restrictions on smoking at home, at school, and in public places on teenage smoking: cross sectional study.
OBJECTIVE: To determine the relation between extent of restrictions on smoking at home, at school, and in public places and smoking uptake and smoking prevalence among school students. DESIGN: Cross sectional survey with merged records of extent of restrictions on smoking in public places. SETTING: United States. PARTICIPANTS: 17 287 high school students. MAIN OUTCOME MEASURES: Five point scale of smoking uptake; 30 day smoking prevalence. RESULTS: More restrictive arrangements on smoking at home were associated with a greater likelihood of being in an earlier stage of smoking uptake (P<0.05) and a lower 30 day prevalence (odds ratio 0.79 (95% confidence interval 0.67 to 0.91), P<0.001). These findings applied even when parents were smokers. More pervasive restrictions on smoking in public places were associated with a higher probability of being in a earlier stage of smoking uptake (P<0.05) and lower 30 day prevalence (0.91 (0.83 to 0.99), P=0.03). School smoking bans were related to a greater likelihood of being in an earlier stage of smoking uptake (0.89 (0.85 to 0.99), P<0.05) and lower prevalence (0. 86 (0.77 to 0.94), P<0.001) only when the ban was strongly enforced, as measured by instances when teenagers perceived that most or all students obeyed the rule. CONCLUSIONS: These findings suggest that restrictions on smoking at home, more extensive bans on smoking in public places, and enforced bans on smoking at school may reduce teenage smoking.
Adolescent↗
[Brazilian leadership in the context of the UNGASS Declaration of Commitment in HIV/AIDS].
The present article focuses on the subject of leadership in the United Nations Declaration of Commitment in HIV/AIDS, discussing the advancements, challenges, and limitations to the action of major social forces acting to control the HIV/AIDS epidemic in Brazil. The national policy on AIDS was characterized by the illustrative Brazilian experience in summoning multiple government, civil society, and private sector initiatives to fight the HIV/AIDS epidemic. The synergy between different partners needs to be enhanced and efforts in the field of scientific and technological development must be articulated in order to minimize the effects of technological dependence. These actions are aimed at the sustainable production of drugs and other products, with the perspective of improving the fulfillment of the constitutional precept of health as a universal right.
Acquired Immunodeficiency Syndrome↗
Patents & public health: international trade obligations and domestic policy development.
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Canada↗
Veneral disease, public health and social control: the Scottish experience in a comparative perspective.
During the first half of the twentieth century, VD became in many countries a metaphor for the forces of physical and moral pollution that appeared to threaten social order and racial progress. By reference to some central aspects of the Scottish experience in a comparative perspective, this article seeks to identify the common denominator of anxieties and assumptions which fuelled public health initiatives towards VD and which defined the boundaries within which VD policy options were discussed. In particular, it will explore various dimensions of social control associated with the treatment and regulation of VD; the degree to which VD controls and procedures have targetted and stigmatised sexually active women, their use to regulate the sexual behaviour of the young, and the way in which discourses shaping medical practice and policy towards VD have enshrined both class and racial stereotyping. The article also examines the powerful moral agenda which shaped the categories and content of treatment and the focus of epidemiology and public health debate. Finally, the institutional and cultural factors shaping the distinctively compulsionist stance of Scottish public health administration towards VD will be explored as a means of identifying some of the possible comparators needed for broader comparative analysis of VD policy in the twentieth century.
Disease Transmission, Infectious↗
The law, social control, and drug policy: models, factors, and processes.
The law is governmental social control; it is the state's most direct intervention in the normative life of its citizens. Psychoactive drugs are controlled through regulation and prohibition, depending on the legal status of the particular substance. Licit drugs are made available through a regulatory scheme of medical prescription and legal sale; health is protected through investigating, licensing, and monitoring the quality and quantity of drugs and the circumstances in which they are consumed. Illicit drugs are forbidden by criminal statutes which create offenses related to both use (i.e., possession) and distribution (i.e., trafficking, importing); no level of use is acceptable and there is no legal source of supply. The agents of control for licit drugs are physicians, scientists, and health bureaucrats. In contrast, the agents that enforce illicit drug laws are the police, prosecutors, courts, and customs officials. The general preventive effect of the criminal law is activated through the threat of punishment and the setting of educative and moral standards of permitted behavior. The acceptability of drug-use behavior has varied widely across time, culture, and substance. What have we learned about the legal control of psychoactive substances? It is evident that a state may become increasingly overdependent on the law and neglect other alternatives of social control that may sometimes be more effective or less costly in reducing the possible harmful effects of drug use. The law is a powerful but also blunt instrument of social control.
Cross-Cultural Comparison↗
Beyond the art of governmentality: unmasking the distributional consequences of health policies.
The aim of this article is to critique health policy discourses that are taken for granted. This perspective will allow for the identification of 'exclusionary' health policies, which we define as policies that are thought to offer universal benefit, despite yielding adverse effects for significant groups of people in society. As such, policies that are said to be designed 'for all' frequently benefit only a subset of the population. Our intent is to highlight the distributional consequences of certain health policies that are largely institutionalized in contemporary society. We believe that these distributional effects are explicit representations of power in society and that institutions may provide individual 'choice' and 'freedom' that, in turn, yields separation as an outcome, a separating equilibrium. Specifically, if those who benefit from policies of partition are numerous and are to obtain significant advantage or incur limited costs, or if those who are adversely affected are scarce (or hidden), or the size of these adverse effects are small (or perceived to be minor), then partition becomes more likely as a 'legitimate', but exclusionary, instrument of public policy.
Attitude to Health↗
Contributions of family violence research to criminal justice policy on wife assault: paradigms of science and social control.
Criminal justice policy on family violence has evolved over the past two decades, informed by political activism as well as theory and research from divergent and often competing perspectives. Experimental research on mandatory arrest of men who assault female partners, policy research on special prosecution programs, and the development of treatment programs for men who batter, typify the strategies for applying criminal sanctions to family violence. However, other critical research on family violence has not been integrated into criminal justice policy, limiting policy development and intervention strategies to practices which reflect contemporary models of sanctions and social control. The limited contributions of family violence research to criminal justice policy reflect competing paradigms of social science, the challenge of family violence cases to the normative processes and the social organization of the criminal courts, and divergent perspectives on social control of offenders in family and stranger violence cases. Strategies for an integrated policy development process are suggested.
Criminal Law↗
The politics of obesity: seven steps to government action.
Concern is rapidly growing about obesity rates in the United States. This paper analyzes the political consequences. Despite myths about individualism and self-reliance, the U.S. government has a long tradition of regulating ostensibly private behavior. We draw on the historical experience in four other private realms (alcohol, illegal drugs, tobacco, and sexuality) to identify seven "triggers" that prompt government to intervene in citizens' private habits. We suggest which of those triggers have been tripped--or are in play--in the case of obesity and food consumption. Finally, we review what government now does in this field and what it might do in the future.
Advertising↗
College campus smoking policies and programs and students' smoking behaviors.
BACKGROUND: Although tobacco use in the United States has declined over the past 20 years, cigarette use among college students remains high. Additional research is thus needed to determine how university tobacco control policies and preventive education programs affect college students' smoking behaviors. METHODS: Approximately 13,000 undergraduate students at 12 universities or colleges in the state of Texas completed a web-based survey. College smoking policies were obtained from a survey of college administrators and from college websites. Logistic regression analyses were conducted to estimate the effects of individual smoking policies and programs on the odds of cigarette smoking. RESULTS: Of the individual programs, only having a preventive education program on campus was associated with lower odds of smoking. The existence of smoking cessation programs and designated smoking areas were associated with higher odds of smoking. Policies governing the sale and distribution of cigarettes were insignificantly associated with smoking. CONCLUSION: Rather than focusing on policies restricting cigarette sales and use, college administrators should consider implementing or expanding tobacco prevention and education programs to further reduce student smoking rates.
Adolescent↗
From the community mental health movement to the war on drugs. A study in the definition of social problems.
In the 1980s, the Reagan and Bush administrations reduced funding for community mental health programs and began instead to support substance abuse treatment agencies. One reason for this shift in policy was that the social problem of mental illness had been captured by progressives in the community mental health movement. Conservatives, therefore, needed a new problem to redefine and use to enact new social control policies. The conservatives' claim that substance abuse is primarily the result of a defect in the character or constitution of the abuser has had profound effects on both social policy and the research community. Greater awareness is needed on the part of researchers as to how social problems have been defined and how government research grants affect our thinking about substance abuse.
Community Mental Health Centers↗
An agenda to combat substance abuse.
Despite their huge health toll, substance abuse disorders remain underappreciated and underfunded. Reasons include stigma, tolerance of personal choices, acceptance of youthful experimentation, pessimism about treatment efficacy, fragmented and weak leadership, powerful tobacco and alcohol industries, underinvestment in research, and difficult patients. Positive signs include declining prevalence rates, successful counter-marketing campaigns, changing public attitudes, new scientific discoveries that could yield new treatments, and effective new organizations. Further progress will require better treatment, more research, better education of health professionals, more nongovernmental support, and stronger leadership. Policy changes regarding each of the three substance groups are indicated, as are reforms in the criminal justice and educational systems.
Alcoholism↗
Public health law: a communitarian perspective.
American society has often favored individual rights disproportionately over the common good. In the aftermath of September 11, there is a need to readjust our criteria to allow for the strengthening of security, public safety, and public health policies. At the same time, we must assure that liberties are not trampled in the service of the common good. Clear criteria are needed to help determine when the proper balance has been reached. Although we should not expect that every public health policy will affect all members of society in exactly the same way, thought must be given to ways of compensating groups that are burdened more than others by a policy.
Bioterrorism↗
Public place restrictions on smoking in Canada: assessing the role of the state, media, science and public health advocacy.
While much is known about the impact of law and public policy, we know considerably less about their antecedents. Theories of policy adoption suggest that a variety of policy inputs help to shape legislative change. This research considers the enactment of municipal smoking bylaws in Canada between 1970 and 1995. The emergence of second-hand smoke (SHS) has been offered as a viable explanation for the increased enactment of local smoking restrictions. A number of indicators confirm the rising public health concern around SHS. Using Health Canada data on municipal smoking bylaw enactment in Canada, this paper employs an event history analysis to trace the role of four indicators of the increased recognition of SHS as a public health concern-scientific research, parliamentary debate, print media, and health advocacy. Findings indicate that the print media and health advocacy play the strongest role in explaining the increase in the adoption of municipal smoking bylaws in Canada. Results lend support to the quantitative study of the policy adoption process and to theories of policy making that consider multiple influences on policy adoption.
Canada↗
The role of public policies in reducing smoking and deaths caused by smoking in Vietnam: results from the Vietnam tobacco policy simulation model.
A simulation model is developed for Vietnam to project smoking prevalence and associated premature mortality. The model examines independently and as a package the effects of five types of tobacco control policies: tax increases, clean air laws, mass media campaigns, advertising bans, and youth access policies. Predictions suggest that the largest reductions in smoking rates will result from implementing a comprehensive tobacco control policy package. Significant inroads may be achieved through tax increases. A media campaign along with programs to publicize and enforce clean air laws, advertising bans and youth access laws would further reduce smoking rates. Tobacco control policies have the potential to make large dents in smoking rates, which in turn could lead to many lives saved. In the absence of these measures, deaths from smoking will increase. The model also helps to identify information gaps pertinent both to modeling and policy-making.
Adolescent↗
Sequences of powder cocaine and crack use among arrestees in Los Angeles County.
The epidemic of cocaine abuse has led to numerous studies on the substance. While extent of use, characteristics of users, patterns of use, and consequences of dependence are well documented for both powder cocaine and crack, few studies have dealt with the sequence or progression of use between the two forms of cocaine. This paper draws on arrestee data collected from county jails in Los Angeles, California. It identifies four sequences of powder cocaine and crack use and examines each sequence in terms of user characteristics, history of use, dependence, contact with the criminal justice system, and concomitant use of other drugs. Findings not only confirm some already established observations, but also offer new knowledge on powder cocaine and crack abuse. For instance, (a) whereas powder cocaine-initiated users are more likely to progress to crack than to restrict their use to powder cocaine only, crack-initiated users tend more often to use crack only than to progress to powder cocaine; and (b) powder cocaine and crack, when used interchangeably, can interact and reinforce each other, resulting in a higher level of use and dependence on both forms of the substance. This paper contributes to the understanding of powder cocaine and crack use among criminal offenders, in particular, and across the adult population, in general. It also sheds light on prevention, treatment, and social control policies of both cocaine abuse and overall illicit drug use.
Adolescent↗
Slippery slopes, wonder drugs, and cosmetic neurology: the neuroethics of enhancement.
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Behavior↗