Disease Prevention as Social Change: Toward a Theory of Public Health

This article argues that public health policies are critical to the prevention and control of disease. However public health policies are not adopted and implemented in a vacuum: they are the outcome of social and political change. The forces of change need to be understood in order for them to be harnessed in the interest of public health. The article proposes a conceptual framework to account for variation in the initiation and implementation of public health policies directed at reducing levels of mortality. This framework incorporates three sets of variables: pertaining to states to social movements and to constructions of risk. The frameworks usefulness for analytic purposes is tested in two case studies describing public health policymaking in France and the United States. Applicability of the framework in other settings is briefly discussed. (SUMMARY IN FRE AND SPA) (EXCERPT)