The Politics of Public Health in the United States. By Kent Patel and Mark E. Rushefsky. Armonk, NY: M.E. Sharpe, 2005. 346p. $84.95 cloth, $29.95 paper.

“It is clear,” write the authors, “that the public health system in the U.S. has suffered from political neglect in the last 50 years or so, and the revitalization of the U.S. public health system will necessitate confronting many of the challenges facing it in the twenty-first century” (p. 7). Kent Patel and Mark Rushefsky's survey of the politics of American public health argues that our system emphasizes curative treatment of existing illnesses at the expense of activities aimed at preventing them. Although the United States spends more per capita on health care than any other country, public health activities account for only about 2% to 3% of such expenditures. The low priority given public health, they argue, accounts for America's poor performance relative to other industrialized countries on measures of life expectancy and infant mortality.