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From the Editor
Alan B. Cohen
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This issue of the Quarterly contains a potpourri of opinion pieces, original scholarship articles, and a new feature, all of which are timely and relevant to population health and health policy. Among the scholarly opinions:
With each issue, the Quarterly pursues its aim of publishing long-form original research articles and brief scholarly opinions on important issues involving population health and health policy. From time to time, however, we receive manuscripts of intermediate length that fall neither into the category of original research or that of opinion, but nonetheless offer valuable insights into key issues of interest to our readers. These tend to be thoughtful, well-referenced manuscripts that redefine core concepts, definitions, and terminology, and, in some cases, offer novel perspectives challenging conventional wisdom. Such manuscripts can enhance our collective understanding of population health and health policy matters, and can stimulate beneficial dialogue and debate within the field. In this issue, we introduce a new medium-length article, Perspectives, that is intended to spark collegial debate on an important topic.
In a Perspective addressing the different meanings and interpretations of the words and concepts used by many in the field to describe “social determinants of health” and “population health,” Hugh Alderwick and Laura Gottlieb note the lack of a universal vocabulary and the growing use of jargon that threatens to sow confusion among researchers, policymakers, and practitioners. Their proposed solution is to offer a common lexicon that promotes a national discussion about these terms and hopefully untangles the Gordian knot of routinely conflated concepts. Readers also may find valuable perspective in an opinion piece authored by contributing writer Paula Lantz on The Medicalization of Population Health: Who Will Stay Upstream? which appeared in the March issue (pages 36-39).
Of the six original research articles featured in this issue, three are studies by investigators at RTI reporting evaluation findings from Round 1 of the State Innovation Models (SIM) initiative funded by the Center for Medicare and Medicaid Innovation (CMMI) within the federal Centers for Medicare and Medicaid Services (CMS). Joshua Sharfstein, a former state health official in Maryland, introduces the three articles, citing the importance of understanding the SIM Initiative and its impact as well as the lessons learned that may instruct the development of the next generation of state-based health care reforms. We are pleased to partner with CMS in disseminating the SIM evaluation findings. The three studies are:
A growing body of evidence in the scientific literature points to the likelihood that processed meats are carcinogenic, yet dietary guidelines in the United States have been slow to respond. In Legal Feasibility of US Government Policies to Reduce Cancer Risk by Reducing Intake of Processed and Red Meat, Parke Wilde and colleagues review the evidence and explore the legal feasibility of adopting different policy options for reducing the consumption of processed meats.
Strategies that aim to denormalize tobacco product manufacturers as deadly businesses have been used successfully by public health advocates to spur governments to enact tobacco control policies. However, as Holly Jarman describes in Normalizing Tobacco? The Politics of Trade, Investment and Tobacco Control, the tobacco industry increasingly is employing international trade and investment law to challenge such policies and to renormalize tobacco as part of world trade. The author discusses how the politics of trade and tobacco control raise questions about the role of the state in protecting public health.
Population-level health harms from stigma are pervasive in US society, but the anti-discrimination laws intended to protect stigmatized groups from such harms are slowly being eroded by the federal government, leading to health inequalities and other negative consequences. In Legal Remedies to Address Stigma-Based Health Inequalities in the United States: Challenges and Opportunities, Valarie Blake and Mark Hatzenbuehler identify the key challenges that currently limit the potential of anti-discrimination law to address stigma-based health inequalities, and offer several practical solutions for promoting health equity.
Alan B. Cohen became editor of The Milbank Quarterly in August 2018. He currently is a research professor in the Markets, Public Policy, and Law Department at the Boston University Questrom School of Business, and professor of health law, policy and management at the Boston University School of Public Health. He previously directed the Scholars in Health Policy Research Program and the Investigator Awards in Health Policy Research for the Robert Wood Johnson Foundation. Earlier in his career, he held faculty positions at Johns Hopkins University and Brandeis University, and spent 8 years at the Robert Wood Johnson Foundation. He is a member of the National Academy of Social Insurance. He received his BA in psychology from the University of Rochester, and his MS and ScD in health policy and management from the Harvard School of Public Health.
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