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Contents -- About the Author -- Acknowledgments -- Part I: Setting the Stage -- Chapter 1. Introduction -- Chapter 2. The Nineteenth Century: From Miasmas to Microbes -- Part II: The Turn of the Nineteenth Century -- Chapter 3. Infant Mortality -- Chapter 4. Tuberculosis -- Part III: The Late Twentieth Century -- Chapter 5. Smoking -- Chapter 6. HIV/AIDS in Injection Drug Users -- Part IV: Structures, Movements, and Ideologies in the Making of Public Health Policy -- Chapter 7. Engines of Policy Change: The State and Civil Society -- Chapter 8. Experts and Zealots

This paper proposes a theory-based approach to the understanding of social change and illustrates that theory with examples from the history and politics of public health. Based in large part on the work of anthropologist Marshall Sahlins (see in particular his Islands of History published in (1985) William Sewell Jr. has proposed an 'eventful sociology.' In this work 'event' is a term of art meaning occurrences in human affairs that result in social change. Sewell's approach and that of Charles Tilly are in many respects complementary, a major difference being Sewell's far greater emphasis on meaning and interpretation by engaged actors as essential to understanding of how historical processes unfold. In this paper I further elaborate Sahlins' and Sewell's ideas, first by showing their connection with concepts that may be more familiar to sociologists and, second, by examining the contingent character of social change. Drawing on my own research on the history of public health, I argue that the transformation of 'happenings' into events and of events into meaningful social change are highly contingent on the social and political context within which these events occur. More generally, I hope to show that 'eventful' sociology is an exciting and productive approach to sociological analysis.

Dangers to life and health abound. Even among the subset known to medicine and science, however, there is no guarantee that any particular danger will rise to the level of a recognized public health problem or elicit a response from the makers of public policy. The path from knowledge to policy is not straightforward; scientific consensus does not lead automatically to policy consensus. Judgments of what dangers should be most feared, how to explain them, what to do about them, and even whether they are public health problems at all are the outcome of social processes. A couple of examples may help to clarify these points. Adapted from the source document.

Dangers to life and health abound. Even among the subset known to medicine and science, however, there is no guarantee that any particular danger will rise to the level of a recognized public health problem or elicit a response from the makers of public policy. The path from knowledge to policy is not straightforward; scientific consensus does not lead automatically to policy consensus. Judgments of what dangers should be most feared, how to explain them, what to do about them, and even whether they are public health problems at all are the outcome of social processes. A couple of examples may help to clarify these points.

In The Social Production of Crisis, Constance A. Nathanson and Henri Bergeron focus on the profoundly troubling story of how blood banks and blood products manufacturers and distributors, as well as the authorities charged with regulating them in France and the US, knowingly allowed blood contaminated with HIV to be distributed to hemophiliacs and others needing transfusions in the early to mid-1980s. Based on detailed, lively, and exciting comparative analysis, the book explains why this drama became a political crisis in France and not in the United States. The authors use this comparison to advance more general ideas of how political crises are socially produced and to raise questions about disease policy and politics in the two countries.

In The Social Production of Crisis, Constance A. Nathanson and Henri Bergeron focus on the profoundly troubling story of how blood banks and blood products manufacturers and distributors, as well as the authorities charged with regulating them in France and the US, knowingly allowed blood contaminated with HIV to be distributed to hemophiliacs and others needing transfusions in the early to mid-1980s. Based on detailed, lively, and exciting comparative analysis, the book explains why this drama became a political crisis in France and not in the United States. The authors use this comparison to advance more general ideas of how political crises are socially produced and to raise questions about disease policy and politics in the two countries

Writing the law to lay down the law : the public health law of August, 2004The French parliament in August 2004 passed a law "concerning public health policies," labeled by its authors as the "first" public health law since 1904. Grounded in the sociology of Abbott, our analysis based on documentary sources and interviews both with participants in the law's construction and with knowledgeable observers, show that the motives for this law were complex. It was a marker laid down by a new health minister in a competition between professional epidemiologists and administrative elites about what "public health" should be and do. It was intended to mobilize the French population to more actively engage in preventive health behaviors, thereby (by implication) reducing the costs of medical care. It was an opportunity for a new health minister to put his name on a law, on a par with the loi Veil and the loi Evin. We conclude by commenting, first, on what has become a characteristic pattern in France of public health laws created "top-down" by tiny elite networks, and, second, on the question of how public action is legitimated in a neoliberal environment. ; Le Parlement français a adopté une loi en août 2004, considérée par ses promoteurs comme la première loi de santé publique depuis celle de 1902. À partir du cadre théorique défini par Abbott, l'analyse qui suit se fonde principalement sur l'étude d'archives et d'interviews réalisées avec ceux qui ont participé à son élaboration. Elle montre que les raisons au principe de la formation de la loi sont multiples : la loi signe la compétition entre des élites administratives et des experts de la santé publique et de l'épidémiologie sur ce que signifie une politique de santé publique ; elle vise également à responsabiliser les individus, les enjoignant d'adopter des comportements bénéfiques à leur santé ; elle est, enfin, l'instrument par lequel un nouveau ministre de la Santé entend se distinguer d'initiatives ministérielles précédentes. Finalement, les processus ...

Writing the law to lay down the law : the public health law of August, 2004The French parliament in August 2004 passed a law "concerning public health policies," labeled by its authors as the "first" public health law since 1904. Grounded in the sociology of Abbott, our analysis based on documentary sources and interviews both with participants in the law's construction and with knowledgeable observers, show that the motives for this law were complex. It was a marker laid down by a new health minister in a competition between professional epidemiologists and administrative elites about what "public health" should be and do. It was intended to mobilize the French population to more actively engage in preventive health behaviors, thereby (by implication) reducing the costs of medical care. It was an opportunity for a new health minister to put his name on a law, on a par with the loi Veil and the loi Evin. We conclude by commenting, first, on what has become a characteristic pattern in France of public health laws created "top-down" by tiny elite networks, and, second, on the question of how public action is legitimated in a neoliberal environment. ; Le Parlement français a adopté une loi en août 2004, considérée par ses promoteurs comme la première loi de santé publique depuis celle de 1902. À partir du cadre théorique défini par Abbott, l'analyse qui suit se fonde principalement sur l'étude d'archives et d'interviews réalisées avec ceux qui ont participé à son élaboration. Elle montre que les raisons au principe de la formation de la loi sont multiples : la loi signe la compétition entre des élites administratives et des experts de la santé publique et de l'épidémiologie sur ce que signifie une politique de santé publique ; elle vise également à responsabiliser les individus, les enjoignant d'adopter des comportements bénéfiques à leur santé ; elle est, enfin, l'instrument par lequel un nouveau ministre de la Santé entend se distinguer d'initiatives ministérielles précédentes. Finalement, les processus ...

Writing the law to lay down the law : the public health law of August, 2004The French parliament in August 2004 passed a law "concerning public health policies," labeled by its authors as the "first" public health law since 1904. Grounded in the sociology of Abbott, our analysis based on documentary sources and interviews both with participants in the law's construction and with knowledgeable observers, show that the motives for this law were complex. It was a marker laid down by a new health minister in a competition between professional epidemiologists and administrative elites about what "public health" should be and do. It was intended to mobilize the French population to more actively engage in preventive health behaviors, thereby (by implication) reducing the costs of medical care. It was an opportunity for a new health minister to put his name on a law, on a par with the loi Veil and the loi Evin. We conclude by commenting, first, on what has become a characteristic pattern in France of public health laws created "top-down" by tiny elite networks, and, second, on the question of how public action is legitimated in a neoliberal environment. ; Le Parlement français a adopté une loi en août 2004, considérée par ses promoteurs comme la première loi de santé publique depuis celle de 1902. À partir du cadre théorique défini par Abbott, l'analyse qui suit se fonde principalement sur l'étude d'archives et d'interviews réalisées avec ceux qui ont participé à son élaboration. Elle montre que les raisons au principe de la formation de la loi sont multiples : la loi signe la compétition entre des élites administratives et des experts de la santé publique et de l'épidémiologie sur ce que signifie une politique de santé publique ; elle vise également à responsabiliser les individus, les enjoignant d'adopter des comportements bénéfiques à leur santé ; elle est, enfin, l'instrument par lequel un nouveau ministre de la Santé entend se distinguer d'initiatives ministérielles précédentes. Finalement, les processus ...