Aug 19, 1999 - demiology) and academic locales (Brooklyn. College and the Joseph L. Mailman School ... charge to open its pages to a wider range of.
Editorials commercially as well. Los Angeles Times. August 19, 1999: 1. 19. Marshall E. Too radical for NIH? Try DARPA. Science. 1997;275:744-746. 20. Piller C, Yamamoto KR. The U.S. biological defense research program in the 1980s: a cri-
tique. In: Wright S, ed. Preventing a Biological Arms Race. Cambridge, Mass: MIT Press; 1990:133-168. 21. Sidel VW, Nass M, Ensign T. The anthrax dilemma. Medicine and Global Survival. October 1998;5:97-104.
22. Tauxe RV. Emerging foodborne diseases: an evolving public health challenge. Emerging Infectious Diseases [serial online]. OctoberDecember 1997;3:1-14. Available at: http:// www.cdc.gov/ncidod/EID/vol3no4/tauxe.html. August 11, 1999.
Why "Public Health Matters" Most readers of the Journal would agree that public health matters. Even within the public health community, however, there are widely divergent views as to what constitutes "public health" and "public health research." We claim no special vantage point. Our world views are undoubtedly influenced by our respective disciplines (anthropology and epidemiology) and academic locales (Brooklyn College and the Joseph L. Mailman School of Public Health of Columbia University), both subtly and sometimes blatantly, as Nancy Krieger recently reminded us.' Yet, as editors of this journal, we have accepted the charge to open its pages to a wider range of public health disciplines and methods than has been considered in recent decades. We intend to return to and build upon the Journal's earlier practice of including descriptions and reviews.2 As the field of public health continues to grow and evolve, so, too, must the Journal.
Fulfilling Our Mission The mission of the Journal, namely, "promoting public health research, policy, and practice," is now stated at the beginning of the page "What AJPH Authors Should Know," which appears in every issue. The mainstay of the Journal in recent years has been original, quantitative research articles. The departments of the Journal provide diversity and balance by featuring other perspectives and types of research not afforded sufficient visibility otherwise. For instance, "Notes From the Field" provides a forum for public health practitioners to highlight work once considered outside the realm of scholarly discourse. We are beginning to publish more original, practicebased research articles. This is especially timely as the Journal forms the basis of a program of continuing education intended primarily for workers in state and local health departments, many of whom have otherwise limited opportunities to solidify November 1999, Vol. 89, No. 11
their public health foundations.3 (See also Fee and Brown's editorial.2)
Introducing "Public Health Matters" Recognizing that a variety of fields and methods are useful, important, and meaningful to public health, we have introduced a new department in the Journal this fall: "Public Health Matters." Although many outside the traditional public health community are unaware of exactly what "public health" entails, we argue here that public health does, in fact, matter not only to the traditional public health community but also to others. We offer our vision for the new department and illustrate the sorts of contributions that are encouraged." By providing a forum for high-quality public health research from disciplines other than epidemiology and clinical medicine, the Journal aims to foster the closer integration of essential disciplines (including anthropology, sociology, economics, planning, communications, and political science) necessary to critically examine and devise solutions to the fundamental public health issues that really matter.
Does Public Health Matter? The Journal is dedicated to the principle that public health matters as a science. Only by studying the health of populations can we begin to understand and hope to ameliorate the most pressing threats to life and well-being. In the interconnected world in which we live, dangers as diverse as ongoing radiation exposure from the Chernobyl disaster and the catastrophic AIDS pandemic forcefully demonstrate that public health problems have the potential to affect millions across political and geographical boundaries. Public health research, surveillance, practice, service delivery, regulation,
and education are essential to safeguard global health. As Paul Farmer passionately and eloquently argued in last month's feature, public health also matters as a human rights and social justice issue.4 People everywhere have the right to lead satisfying, productive lives. We subscribe to the World Health Organization's definition of health as "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity."7 Promoting public health is the right thing to do. According to a recent Harris poll, most members of the general public recognize the importance of the core functions in public health. Lay respondents, however, both misunderstand what public health is and have trouble defining it. Nevertheless, when questioned specifically, the majority value the work of public health. For example, 93% of those surveyed believe that the "prevention of the spread of infectious diseases like tuberculosis, measles, flu, and AIDS is very important," and 82% believe that "conducting research into the causes and prevention ofdisease is very important."8
Enlisting the Sympathizers We suspect that many professionals in other disciplines, including those in the media, are also concerned with public health issues but are largely unaware ofthe varied concerns and key contributions of the field of public health. We want to reach this wider audience by presenting these issues in a format that is intelligible, accessible, and compelling to diverse readers. Useful outcomes of such a venture would include broad-based support for public health initiatives and new avenues for joint research across disciplines. Public health professionals would also benefit from perceptive insights from other fields (e.g., anthropology and communications) that may lead to better conceptualizations of public health problems. Furthermore, experts from other disciplines (e.g., American Journal of Public Health 1631
Editorials economics and planning) are needed to devise workable interventions and meaningful policies to improve the public's health. While some cross-disciplinary work has appeared in other publications (e.g., Social Science and Medicine, International Journal of Health Services, and Medical Anthropology Quarterly), these journals are not readily accessible to many public health workers. As the Journal strives to reach a general public health readership of researchers, practitioners, advocates, and communicators, it has the potential to educate and inform across disciplines. There is ample reason to believe not only that both public health workers and social scientists would be interested in the research findings of related fields, but also that they could meaningfully apply the results to their own work. We did not reach these convictions on our own. What constitutes "valid" public health research is fluid and in large part socially determined.' To those authors who have stretched the limits of what we have previously published in the Journal and who have been actively championing the inclusion of their disciplines and methodologies within its pages, we owe a debt of gratitude. "Public Health Matters" will present high-quality qualitative research on public health topics, critical examinations of research on important public health issues, and analyses that place public health problems in larger social or political contexts.
Qualitative Research Matters Increasing respect is being paid to the ability of qualitative research to supplement and enrich quantitative research. It is also important in its own right. A compelling feature is that qualitative research allows readers to hear the voices of the people affected by, and the actors affecting, public health. It can provide intimacy and depth for readers who fail to be moved by sobering or even encouraging statistics (although an easily understood number often helps to enlist support for public health causes). Qualitative research is apt in a variety of situations. First, it documents and analyzes unique occurrences that cannot be investigated through quantitative techniques. Second, when little is known about a given topic, qualitative research generates and clarifies questions to be investigated using quantitative methods. Third, it helps elucidate the complex interplay of operating factors. Finally, it provides more meaningful interpretation of quantitative research than is possible without it. 1632 American Journal of Public Health
CriticalAnalysis Matters
What Matters Most
Broader societal issues necessarily shape and dictate the research needs and priorities that public health workers address. "Public Health Matters" will feature articles that synthesize findings from a number of different studies (quantitative and/or qualitative); examine the complex interplay of genetic, environmental, economic, political, structural, and cultural factors; and explore the most basic concepts used in public health research (e.g., "race," "community," and even "health"). This includes examining assumptions such as the notion that "White" is a meaningful category9 10 or that it is always desirable to prevent disability, no matter what that prevention entails.5
One of us (M.N.) has participated in the last 6 "Writing for Publication" seminars sponsored by the Journal's editorial board at the annual meetings of the American Public Health Association. Each year, without exception, would-be authors have asked about opportunities for publishing work from related disciplines and using different methodologies (notably qualitative techniques). This year both of us will participate in the seminar. We look forward to telling you more about the new department, hearing your feedback, and discussing submission ideas with you then. We need help to succeed with this new endeavor. Sendus papers of outstanding scholarship, relevance, interest, and immediacy for public health. Let us know of your willingness to serve as critical and supportive peer reviewers in areas that are relatively new for the Journal (e.g., qualitative methods, anthropology, sociology). Spread the word to colleagues that "Public Health Matters" exists. Above all, help guarantee that the scientific work featured in the Journal is timely and relevant to current and future public health research, policy, and practice. Improving the health of the public is what matters most. El Betty Wolder Levin
Scholarship Is Paramount Articles for "Public Health Matters" must constitute solid scholarship. Qualitative research must be well designed and carefully executed; analytic articles must be well developed. This does not mean that publication will be limited to the incontrovertible or the universally accepted. We welcome thoughtful pieces whether or not they challenge prevailing views; we encourage open dialogue and rejoinders, where useful. The level of scholarship must meet the high standards expected of the leading journal in public health. At the same time, the writing must be accessible to nonspecialists. Indeed, we expect that submissions to "Public Health Matters" will be ofinterest to and useful for students, practitioners, and scholars from related fields, as well as those public health professionals who are most knowledgeable about the topics being discussed. Last month, Paul Farmer presented a case study of tuberculosis in Russian prisons.4 He also drew on a wide variety of materials from qualitative and quantitative works to argue that violations of social and economic rights must be considered in addition to abuses of political and legal rights in situations worldwide and that health has a central role in human rights work. In this issue of the Journal, in an article presenting a position sure to startle many in public health, Adrienne Asch uses material from the literatures of a number of disciplines, including genetics, bioethics, and psychology, to challenge the acceptance of prenatal diagnosis and selective termination for disability.5 Also in this issue, C. H. Browner, H. Mabel Preloran, and Simon Cox present the results of a study based on a masterful combination of quantitative and qualitative research techniques.6 The study elucidates Mexican-origin women's decisions to accept or reject amniocentesis.
Contributing Editor Public Health Matters Mary E. Northridge Editor
References 1. KriegerN. Questioning epidemiology: objectivity, advocacy, and socially responsible science. Am JPublic Health. 1999;89:1151-1152. 2. Fee E, Brown TM. A century of progress in public health? Am J Public Health. 1999;89:
1627-1629. 3. New board to expand horizons forAPHA's educational efforts. The Nation a Health. June 1999:3. 4. Farmer P. Pathologies of power: rethinking health and human rights. Am J Public Health. 1999;89: 1486-1496. 5. Asch A. Prenatal diagnosis and selective abortion: challenges to family well-being and social health. Am JPublic Health. 1999;89:1649-1657. 6. Browner CH, Preloran HM, Cox S. Ethnicity, bioethics and prenatal diagnosis: the amniocentesis decisions of Mexican-origin women and their partners. Am JPublic Health. 1999;89:1658-1666. 7. World Health Organization. Constitution of the World Health Organization. Am JPublic Health. 1946;36:1315-1323. 8. Louis Harris & Associates. Harris Poll No.1. Monday, January 6, 1997. Available at: http://
www.harrisinteractive.com. 9. Bhopal R, Donaldson L. White, European, Western, Caucasian, or what? Inappropriate labeling in research on race, ethnicity, and health. Am J Public Health. 1998;88: 1303-1307. 10. Fullilove MT. Abandoning "race" as a variable in public health research-an idea whose time has come. Am JPublic Health. 1998;88: 1297-1298.
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