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September 11, 2013

Reconsidering the Politics of Public Health

Author Affiliations
  • 1Department of Veterans Affairs, Washington, DC
  • 2New York City Health and Hospitals Corporation and New York University School of Medicine, New York, New York
JAMA. 2013;310(10):1025-1026. doi:10.1001/jama.2013.110872

A central dilemma in public health is reconciling the role of the individual with the role of the government in promoting health. On the one hand, governmental policy approaches—taxes, bans, and other regulations—are seen as emblematic of “nanny state” overreach. In this view, public health regulation is part of a slippery slope toward escalating government intrusion on individual liberty. On the other hand, regulatory policy is described as a fundamental instrument for a “savvy state” to combat the conditions underlying an inexorable epidemic of chronic diseases. Proponents of public health regulation cite the association of aggressive tobacco control, physical activity, and nutritional interventions with demonstrable increases in life expectancy.1

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