Professor of Sociomedical Sciences
James Colgrove studies the history of public health and the social, political, and legal processes through which public health policies have been shaped. In Epidemic City, his most recent book, Colgrove uses the history of New York City’s Department of Health to illustrate the tensions between public health interventions and individual rights. Colgrove directs the master’s program in Sociomedical Sciences.
You are one of the School’s resident historians, so it’s interesting that you’re part of the Lerner Center for Public Health Promotion. Is the history of public health part of “public health promotion?”
Absolutely. I’ve been working with the Lerner Center to look at the comments submitted in response to the U.S. Food and Drug Administration’s proposed guidelines on menu labeling. Reviewing more than 400 public comments, we’re creating a case study about how policymakers can frame a contentious public health issue. And when you consider how antagonistic different stakeholders are on this issue, from big food and agribusiness to anti-obesity advocates and nutritionists, you see the need to understand how evidence-based policies can survive the gauntlet of lawmaking. Debates like this have a long history, going back to the mid-19th century, so it’s very helpful to have a historical perspective.
Will your findings show that policymakers look carefully at evidence?
Well, it’s interesting. That’s actually the question I’m asking in another current project. Together with Peter Messeri and Connie Nathanson, I’m looking at whether scientific evidence is used in policymaking at all. When state legislators sit down to write policy, do they first look at any data? Is it credible? Is it objective? Is it ideological?
That sounds like an enormous undertaking.
That’s why we’ve narrowed our scope to two issues: HPV (human papillomavirus) immunization and childhood obesity. For the first, solid evidence exists showing that immunization policies reduce HPV infection. With childhood obesity, there is scant evidence that many of the proposed policy interventions do much at all. Yet in the six states we are studying, legislators are falling over themselves to pass laws.
How does that kind of study find its way into your classroom?
The same questions that drive my research drive the way I’ve structured the course. The bottom line is to prepare students to go out into the field as better public health practitioners and policymakers, to understand that scientific evidence should drive policy, and not the other way around. So when they are in a position—whether they go on to work as a legislator, a legislative staff member, a city or state health official, as somebody in think tank, even as president—they’ll be more likely to do an effective job.
It sounds as if you have high aspirations for Mailman School graduates.
I do. And with good reason. Remember, public health connects to every important question in society. The argument that I make on the first day of class is that public health is an inherently political enterprise. To the extent that we are concerned with populations rather than individuals, public health interventions inevitably raise questions about how we all get along together. In any diverse and pluralistic society like ours, and in an increasingly globalized world, there’s no more important question. So much of the way society is organized has influences for health, so in whatever way students professionalize their public health education, they will always be central to those debates.