My first post to this list, after years of avid reading.

Thanks to KT for noting the issue of sheer scale in generalizing how
"Yanks" can be characterized.  I've spent about ten years each in American
academe, health services contract research, and state government.  There is
a broad diversity of opinion in each setting.  My two cents is that:

Many American researchers are eager to incorporate issues of social
gradients and network effects, physical space and multilevel effects.  Race
per se is often reconceptualized this way, although the tradition of
relating race to categorical government mandates often demands priority.
Now Americans (even in government) are talking about the "life course" and
network analysis.  Does that owe nothing to population health concepts
borrowed from elsewhere?

Explicit "exceptionalism" in American analysis is often a reflection of the
political science notion of "incrementalism."  European political and
institutional arrangements are presumably as cumulative as American
arrangements, but the European historical process is much longer and (fair
generalization?) more strongly shaped recently by the World Wars.  Many of
us in the U.S. want to think about getting from from A to B, but that seems
a unique problem for us because other nations got there via X to Y to Z to
Q to R to T ...   Which one of them most resembles our A and B more than
superficially?

So we in the U.S. have our divided national government, our sectarian
Federalism and our extremely varied healthcare funding mechanisms.  IMO
that makes our institutional analysis and our policy aspirations resistant
to comparative-historical generalization.  But I think American researchers
should get more credit for being open to population health ideas when we
move away from institutional issues.  Don't boil us all in the same
Canadian oil!

BTW, how many subscribers to this list are from the U.S., and from other
countries?

Charles Denk
New Jersey Department of Health


      On Nov 2, 2013, at 11:05 AM, Dennis Raphael <[log in to unmask]>
      wrote:

      Interestingly, even when health inequalities research is undertaken
      in the USA there appear to be common perception among researchers
      that drawing upon developments in the UK would have little if any
      value as American policy makers and public see little value in
      considering the experiences of others. This particular form of
      Americans xenophobia is common across a wide range of areas. It is
      therefore not surprising that UK work has been much more positively
      received in Canada, a former colony of the UK with which it maintains
      strong traditions and ties, as compared to the United States.


      dennis

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