Health and the Urban Environment

Joanna Paxton Federico, "Finding the Center(s): Insitutionalizing the Science of Violence Prevention at the CDC (1977-1992)
 
Abstract: My dissertation examines the emergence of violence as an object of public health knowledge at the CDC in the late twentieth century. In 1977, amid an international movement to rationalize public health through an emphasis on prevention (rather than cure), Center for Disease Control director William Foege undertook a major reorganization of the agency. After surveying hundreds of public health experts about the nation’s most pressing preventable health concerns, he developed a new model of several Centers for Disease Control, each focused on a particular cluster of related health risks. Violence, which had only recently been subjected to epidemiologic study, was not a priority for survey respondents initially. Foege nevertheless insisted that the data showed violence was a major and growing cause of preventable premature death and it should therefore be a priority for the CDC. Over the next few years, many of Foege’s advisors came to agree. Yet, exactly where to place violence-related programs within the CDC remained unclear. Did it fit best in the Center for Health Promotion and Education alongside smoking prevention, nutrition, and family planning? In the Center for Environmental Health with chemical exposure programs and accident prevention? Should workplace injury and violence really be siloed in the National Institute for Occupational Health and Safety (NIOSH)? This chapter traces the intersecting epistemological, structural, and social forces at play in violence prevention’s moves through various Centers and considers their effects on the trajectory of the science.