| Fall 2001;
Volume 2, Number 2
Editor's NoteIn the Fall 2001 issue of the Harvard Health Policy Review, we focus on one of the most significant public health issues facing American society: violence. In the wake of Septembers tragic events, we need no reminder that the threat of violence is a grim reality in our society. Nonetheless, this issues feature endeavors to enhance our understanding of violence as a public health problem. In particular, we examine violence in two of its most common manifestations: gun violence and domestic or intimate partner violence (IPV).
Only in the past two decades have doctors, lawmakers, and government agencies come to view violence as a public health problem. Previously, it was understood solely as a criminal justice issue, and the health care community was largely left out of the discussion. However, the costs of violence to our society and to the health care system are undeniable. Moreover, in the face of these realities, physicians, nurses, and policymakers alike have come to realize how the health care system can play a critical role in the documentation, prevention, and treatment of cases of gun and domestic violence. The healthcare community is increasingly adopting this new perspective.
We hear the voice of this new outlook in the pair of interviews that begins our focus on domestic violence. Jacquelyn Campbell, a recognized expert on IPV, along with Esta Soler and Lisa James of the Family Violence Prevention Fund (FVPF), discuss trends in national domestic violence legislation and the role of the health care system in handling IPV cases. An article by Dr. Connie Mitchell on Californias groundbreaking IPV legislation accompanies our interviews on this subject.
How much do we value our safety? This is the provocative question that Phillip Cook, Director of the Sanford Institute of Public Policy at Duke University and Jens Ludwig, Assistant Professor of Public Policy at Georgetown University, ask in their article to open our section on gun violence. The authors take a unique approach by arguing that the costs of gun violence should not be understood by traditional measures, such as medical expenditures, but as the flipside of the value of safety. In the following article, Matthew Miller and David Hemenway, both of the Harvard School of Public Health, consider whether reducing firearm availability is actually correlated with reduced firearm and total suicide rates. Finally, Deborah Azrael, Catherine Barber, and James Mercy, from the Harvard Injury Control Research Center, consider the need for a national violence surveillance system that provides information about the circumstances of suicides and homicides.
The In Focus section of our Fall 2001 issue looks at public health problems in developing nations, which are, of course, of a different nature. Transmittable diseases take a devastating toll on these populations, particularly on the poor. Laura Tarter and Dr. Paul Farmer, Director of the Program in Infectious Disease and Social Change at Harvard Medical School, argue that treatment must accompany prevention efforts in addressing the global HIV epidemic. In the articles that follow, Dr. Arese Carrington and undergraduate, Ilana Brito, examine the intractable problem of malaria in developing countries. Carrington focuses on risk control strategies while Brito discusses the challenges faced by researchers striving to develop a vaccine.
Additional articles in this issue showcase a range of significant topics. David Bowen and Nancy Segal outline the current status of federal and state laws pertaining to genetic discrimination. In addition, recent Harvard graduate, Gwyneth Card, enters the debate surrounding direct-to-consumer advertising of pharmaceutical products. Finally, a study by undergraduate, Jenn Clark, looks at physicians prescribing habits for clues about racial disparities in asthma morbidity.
We are very pleased to hear that the Harvard Health Policy Review is making an impact on our readership. Bruce Vladecks and Harry Cains articles from our Spring 2001 issue helped frame the debate when they were cited in a recent Congressional hearing on the future of the Health Care Financing Association (HCFA now the Center for Medicare and Medicaid Services). We strive to inform all of our readers about significant health policy issues. We also hope to share our journal with a growing national readership. Organizations or persons interested in receiving the Harvard Health Policy Review are encouraged to request subscriptions. Please contact us at our email address: firstname.lastname@example.org.
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