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January 17, 1996

Plagues, Products and Politics: Emergent Public Health Hazards and National Policymaking

Author Affiliations

University of Michigan School of Public Health Ann Arbor

JAMA. 1996;275(3):248-249. doi:10.1001/jama.1996.03530270088041

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Disease outbreaks are part and parcel of any public health officer's life, but the challenge can be daunting when an episode continues. Christopher Foreman, a senior fellow at the Brookings Institution, looks beyond the "health detective" approach of Berton Roueché's delightful "Eleven Blue Men" to examine policy implications and government's capacity to respond to "unpleasant surprises." His many examples include infectious diseases, like AIDS and Legionnaires' disease, and product-related dangers, like the Dalkon Shield and criminal insertion of poisons in over-the-counter remedies. "Hazard" comprises far more than the acute contagion or dread virus that usually captures the public eye.

Chapter titles are, successively, "Visible Victims," "Institutions," "Detection," "Interventions," "Education," "Regulation," "Research," and "Prospects." Although this sequence is unusual for the agent/host/environment— oriented health care worker and leads to unavoidable retracing of steps, it helps clarify the dilemmas policymakers often face when time to collect data is scarce and immediate action