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Using a randomized evaluation in Kenya, we measure health impacts of spring protection, an investment that improves source water quality. We also estimate households' valuation of spring protection and simulate the welfare impacts of alternatives to the current system of common property rights in water, which limits incentives for private investment. Spring infrastructure investments reduce fecal contamination by 66%, but household water quality improves less, due to recontamination. Child diarrhea falls by one quarter. Travel-cost based revealed preference estimates of households' valuations are much smaller than both stated preference valuations and health planners' valuations, and are consistent with models in which the demand for health is highly income elastic. We estimate that private property norms would generate little additional investment while imposing large static costs due to above-marginal-cost pricing, private property would function better at higher income levels or under water scarcity, and alternative institutions could yield Pareto improvements.

World War II’s massive casualties were mitigated by lives saved as a result of medical care. Many of the advances made would persist long after the war concluded — a silver lining that perhaps will have parallels in our current struggle with Covid-19.

Serial forced displacement has been defined as the repetitive, coercive upheaval of groups. In this essay, we examine the history of serial forced displacement in American cities due to federal, state, and local government policies. We propose that serial forced displacement sets up a dynamic process that includes an increase in interpersonal and structural violence, an inability to react in a timely fashion to patterns of threat or opportunity, and a cycle of fragmentation as a result of the first two. We present the history of the policies as they affected one urban neighborhood, Pittsburgh’s Hill District. We conclude by examining ways in which this problematic process might be addressed.

The nation’s first broad-based, mandatory investment in public health and prevention, the Prevention and Public Health Fund (the Fund), has had a brief and controversial history. Advocates for the Fund have had to defend it from both Democratic and Republican threats, including being used as an offset for administration priorities, and from congressional efforts to repeal and replace the Patient Protection and Affordable Care Act. Lessons learned from efforts to sustain the Fund are instructive in addressing current and future challenges faced by advocates for public health programs and prevention policies.

In the 1960s, Pittsburgh’s Freedom House Ambulance Service supplanted the police in a role in which they were not effective, reimagined the role of Black citizens in improving community health, and helped establish national standards for emergency medical care.

The Bayh–Dole Act of 1980 permitted scientists, universities, and businesses to patent and profit from discoveries made through federally funded research. A review of the law's history supports the idea that such policies merit frequent reappraisal and reform. In June, the U.S. Supreme Court issued a unanimous opinion in Association for Molecular Pathology v. Myriad Genetics that invalidated the claim of ownership of the BRCA1 and BRCA2 genes. On one level, the legal contretemps leading up to this decision grew out of the University and Small Business Patent Procedures Act of 1980, commonly known as the Bayh–Dole Act. 1 Sponsored by Senators Birch Bayh (D-IN) and Robert Dole (R-KS), the law reversed decades of government policy by allowing scientists, universities, and small businesses to patent and profit from discoveries they made through federally funded research — like Myriad's research . . .

Context: A decade after the nation's Skid Rows were razed, homelessness reemerged in the early 1980s as a health policy issue in the United States. While activists advocated for government-funded programs to address homelessness, officials of the Reagan administration questioned the need for a federal response to the problem. In this climate, the National Institute of Mental Health (NIMH) launched a seminal program to investigate mental illness and substance abuse among homeless individuals. This program serves as a key case study of the social and behavioral sciences' role in the policy response to homelessness and how politics has shaped the federal research agenda. Methods: Drawing on interviews with former government officials, researchers, social activists, and others, along with archival material, news reports, scientific literature, and government publications, this article examines the emergence and impact of social and behavioral science research on homelessness. Findings: Research sponsored by the NIMH and other federal research bodies during the 1980s produced a rough picture of mental illness and substance abuse prevalence among the US homeless population, and private foundations supported projects that looked at this group's health care needs. The Reagan administration's opposition to funding \"social research,\" together with the lack of private-sector support for such research, meant that few studies examined the relationship between homelessness and structural factors such as housing, employment, and social services. Conclusions: The NIMH's homelessness research program led to improved understanding of substance abuse and mental illness in homeless populations. Its primary research focus on behavioral disorders nevertheless unwittingly reinforced the erroneous notion that homelessness was rooted solely in individual pathology. These distortions, shaped by the Reagan administration's policies and reflecting social and behavioral scientists' long-standing tendencies to emphasize individual and cultural rather than structural aspects of poverty, fragmented homelessness research and policy in enduring ways.

The ‘Rothschild reforms’ of the early 1970s established a new framework for the management of government-funded science. The subsequent dismantling of the Rothschild system for biomedical research and the return of funds to the Medical Research Council (MRC) in 1981 were a notable departure from this framework and ran contrary to the direction of national science policy. The exceptionalism of these measures was justified at the time with reference to the ‘particular circumstances’ of biomedical research. Conventional explanations for the reversal in biomedical research include the alleged greater competence and higher authority of the MRC, together with its claimed practical difficulties. Although they contain some elements of truth, such explanations are not wholly convincing. Alternative explanations hinge on the behaviour of senior medical administrators, who closed ranks to ensure that de facto control was yielded to the MRC. This created an accountability deficit, which the two organizations jointly resolved by dismantling the system for commissioning biomedical research. The nature and working of medical elites were central to this outcome.

An exploration of the major conflicts and historic events that shaped the current Israeli health care system. In this follow-up to her 2002 book, The Workers' Health Fund in Eretz, Israel: Kupat Holim, 1911-1937, historian Shifra Shvarts investigates the political and social forces that influenced Israel's health care system and policy during the early years of state building. Among the struggles Shvarts explores in this penetrating study are the debate over immigration health policy and the Law of Return, enacted in 1950; the battles over universal healthcare between the Workers' Health Fund and the Israeli government led by prime minister Ben Gurion; the urgent organization of military medical services during wartime; and the contested establishment of renown civilian medical facilities. These early conflicts have had far-reaching implications that continue to be felt throughout Israeli society. While many European countries successfully established unified, state-run health care systems, Israel's political rivalries and social turbulence gave rise to a mélange of \"sick funds,\" large and small, public and private, that influence and complicate the delivery of health care to this day. Health and Zionism: The Israeli HealthCare System, 1948-1960, sheds light on the major conflicts, leaders, and historic events that shaped the current Israeli health care system, and has relevance to developing health care systems worldwide. Shifra Shvarts is Associate Professor, Faculty of Health Sciences, Ben Gurion University, Israel, and is author of The Workers' Health Fund in Eretz Israel Kupat Holim, 1911-1937 (University of Rochester Press, 2002).

In 1981, no one would have believed that unusual infections in five young men were the harbinger of a worldwide health catastrophe. The disease now known as the acquired immunodeficiency syndrome, or AIDS, was first reported 20 years ago this week in the Morbidity and Mortality Weekly Report under the quiet title “ Pneumocystis pneumonia — Los Angeles.” 1 The description was not the lead article; that distinction went to a report of dengue infections in vacationers returning to the United States from the Caribbean. Not even the most pessimistic reader could have anticipated the scope and scale the epidemic would assume two decades later. By December 2000, 21.8 million people worldwide had died of the disease, including more Americans (438,795) than died . . .