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Historical problems and perspectives

The nature of the relationship between publics and their health has long been a concern for those seeking to improve collective and individual health. Attempts to secure the health of the population of any given place are one of the oldest forms of governmental action. Whether it be providing clean water or preventing the spread of disease, such efforts require the involvement of the publics these measures are designed to protect. Despite its importance, surprisingly little attention has been paid to who or what the ‘public’ of public health consisted of. This collection addresses this gap by considering ‘who’ the public of public health was in an array of places and around a variety of public health problems. Ranging across Europe and North and South America, and from the interwar period to the near present, this book explores the construction of ‘problem publics’ to deepen our understanding of the ‘who’ of public health. This book offers detailed case studies of the making of ‘problem’ publics and public health problems in different places and at different times. By placing examples of the construction of problem publics in contexts as diverse as the USA in the interwar period, East Germany in the 1980s and contemporary Argentina, this collection identifies what is general and what is specific to the processes that make certain kinds of publics appear problematic. In the wake of the COVID-19 pandemic, this volume offers fresh insights into the nature of public health problems, practices and publics.

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Why we need the ‘Health Society’
Authors: and

Saving sick Britain lays down a challenge to every citizen, to British institutions, policymakers and scientists. Epidemics in common diseases and conditions like diabetes and depression pose systemic risks to society, which are as serious as those from Covid-19. These modern plagues are the challenge of our times. The authors argue that these epidemics require us to think afresh about the prevention of disease. They first examine the basics of contemporary political philosophy and modern biology to redefine what ‘health’ really means. They then outline a practical way to focus society relentlessly on maintaining the health of all its citizens. This plan is not just another reform of the National Health Service. It calls for far more than that. The authors aim to construct a national ‘Health Society’ and this requires across-the-board reform of the entirety of public policy. Every department of government – national and local – needs to change. Every workplace, every employer, every community organisation and every citizen has a role to play. Because the authors have a background in basic biology, they come at the problem of prevention from a new direction, unburdened by the traditions of the medical profession or by ideological dogma. Two millennia ago, Hippocrates said prevention was better than cure, and Cicero said population health was the supreme law. They were right. But they could do precious little about it. Yuille and Ollier show how today we can turn their insights into reality.

The well-being of Europe’s citizens depends less on individual consumption and more on their social consumption of essential goods and services – from water and retail banking to schools and care homes – in what we call the foundational economy. Individual consumption depends on market income, while foundational consumption depends on social infrastructure and delivery systems of networks and branches, which are neither created nor renewed automatically, even as incomes increase. This historically created foundational economy has been wrecked in the last generation by privatisation, outsourcing, franchising and the widespread penetration of opportunistic and predatory business models. The distinctive, primary role of public policy should therefore be to secure the supply of basic services for all citizens (not a quantum of economic growth and jobs). Reconstructing the foundational has to start with a vision of citizenship that identifies foundational entitlements as the conditions for dignified human development, and likewise has to depend on treating the business enterprises central to the foundational economy as juridical persons with claims to entitlements but also with responsibilities and duties. If the aim is citizen well-being and flourishing for the many not the few, then European politics at regional, national and EU level needs to be refocused on foundational consumption and securing universal minimum access and quality. If/when government is unresponsive, the impetus for change has to come from engaging citizens locally and regionally in actions which break with the top down politics of ‘vote for us and we will do this for you’.

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Postcolonial governance and the policing of family
Author:

Bordering intimacy is a study of how borders and dominant forms of intimacy, such as family, are central to the governance of postcolonial states such as Britain. The book explores the connected history between contemporary border regimes and the policing of family with the role of borders under European and British empires. Building upon postcolonial, decolonial and black feminist theory, the investigation centres on how colonial bordering is remade in contemporary Britain through appeals to protect, sustain and make family life. Not only was family central to the making of colonial racism but claims to family continue to remake, shore up but also hide the organisation of racialised violence in liberal states. Drawing on historical investigations, the book investigates the continuity of colonial rule in numerous areas of contemporary government – family visa regimes, the policing of sham marriages, counterterror strategies, deprivation of citizenship, policing tactics, integration policy. In doing this, the book re-theorises how we think of the connection between liberal government, race, family, borders and empire. In using Britain as a case, this opens up further insights into the international/global circulations of liberal empire and its relationship to violence.

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Theatre and the politics of engagement
Author:

This book is about science in theatre and performance. It explores how theatre and performance engage with emerging scientific themes from artificial intelligence to genetics and climate change. The book covers a wide range of performance forms from the spectacle of the Paralympics Opening Ceremony to Broadway musicals, from experimental contemporary performance and opera to educational theatre, Somali poetic drama and grime videos. It features work by pioneering companies including Gob Squad, Headlong Theatre and Theatre of Debate as well as offering fresh analysis of global blockbusters such as Wicked and Urinetown. The book offers detailed description and analysis of theatre and performance practices as well as broader commentary on the politics of theatre as public engagement with science. It documents important examples of collaborative practice with extended discussion of the Theatre of Debate process developed by Y Touring theatre company, exploration of bilingual theatre-making in East London and an account of how grime MCs and dermatologists ended up making a film together in Birmingham. The interdisciplinary approach draws on contemporary research in theatre and performance studies in combination with key ideas from science studies. It shows how theatre can offer important perspectives on what the philosopher of science Isabelle Stengers has called ‘cosmopolitics’. The book argues that theatre can flatten knowledge hierarchies and hold together different ways of knowing.

Open Access (free)
Environmental justice and citizen science in a post-truth age
Editors: and

This book examines the relationship between environmental justice and citizen science, focusing on enduring issues and new challenges in a post-truth age. Debates over science, facts, and values have always been pivotal within environmental justice struggles. For decades, environmental justice activists have campaigned against the misuses of science, while at the same time engaging in community-led citizen science. However, post-truth politics has threatened science itself. This book makes the case for the importance of science, knowledge, and data that are produced by and for ordinary people living with environmental risks and hazards. The international, interdisciplinary contributions range from grassroots environmental justice struggles in American hog country and contaminated indigenous communities, to local environmental controversies in Spain and China, to questions about “knowledge justice,” citizenship, participation, and data in citizen science surrounding toxicity. The book features inspiring studies of community-based participatory environmental health and justice research; different ways of sensing, witnessing, and interpreting environmental injustice; political strategies for seeking environmental justice; and ways of expanding the concepts and forms of engagement of citizen science around the world. While the book will be of critical interest to specialists in social and environmental sciences, it will also be accessible to graduate and postgraduate audiences. More broadly, the book will appeal to members of the public interested in social justice issues, as well as community members who are thinking about participating in citizen science and activism. Toxic Truths includes distinguished contributing authors in the field of environmental justice, alongside cutting-edge research from emerging scholars and community activists.

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Martin Yuille
and
Bill Ollier

National Health Service Health Check One component of the national institutional framework that we say should contribute to the construction of the Health Society is the NHS Health Check. This service is delivered to citizens to provide individual advice on prevention of one or two of the modern plagues. This strength is also its weakness. While the original government aim in 1997 was to bring all stakeholders together to improve population health, this was lost when the Health Check system was set up a decade later. It now needs to be found again. The way to do this

in Saving sick Britain
Ruth Macklin

to maximising overall population health, since ‘each patient is entitled to have his or her benefit considered as of an importance equal to the chance of any other person, however small the chance and however small the benefit, so long as there is some chance of a benefit’.5 This is surely true; it is an example of a problem known as ‘fair chances versus best outcome’.6 Harris’s account of justice as equal opportunity is appealing because it focuses on the needs and desires of recipients of health care rather than on the cost-effectiveness that drives the policies

in From reason to practice in bioethics
Martin Yuille
and
Bill Ollier

organise the nuts and bolts; industry backs the idea. 6 The principal barrier is that there is not the drive and the coordination to get all the people and organisations working together. A unitary system for managing human samples is essential to the Health Society but it is also increasingly necessary for the development of new medicines. Health data In a perfect world, risk biomarkers would track the risks to health across the population. This biomarker data would be all that is required to guide the actions needed to improve individual and population health

in Saving sick Britain
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The COVID-19 pandemic
Martin Yuille
and
Bill Ollier

risk of death from COVID-19. Each column represents the proportion of COVID-19 patients in China who have died when they had an underlying condition. The data comes from a research paper examining data on over 70,000 patients in China. We noted the estimate by Public Health England that the overall annual price we pay for poor population health is £147–185bn. But, of course we failed to include the costs arising from another consequence of this poor health – the total financial cost of pandemics like COVID-19. The SARS-COV-2 virus targets the most serious

in Saving sick Britain