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The Affordable Care Act is transforming health care practice nationwide through emphasis on population health and prevention. Health care organizations are increasingly required to address population health needs. However, they may be ill equipped to answer that call.

This study identified ways that health care organizations might better integrate public and population health efforts to better respond to this new emphasis on population health. Employing semi-structured key informant interviews, barriers to and facilitators of integration were explored and implications for health care and public health leaders were developed.

Participants (n = 17) – including senior hospital executives, group practice administrators, and health department officials – identified strategies for health care and public health leaders to more effectively integrate in order to achieve better performance and population health gains. These strategies and their implications are discussed.

The results of this study provide important value to health care administrators leading efforts to integrate population and public health.

This chapter provides a historical contextualisation of health tracking and public health communication from the post-World War Two development of the welfare state, through the birth of neoliberalism, until today’s individualising practices of digital health tracking and quantification of bodies. Through an examination of these three phases of public health quantification of bodies, encompassing the socio-economic, cultural and political shifts since 1948, combined with the development and wide adoption of digital health and self-quantifying technologies, this chapter traces the changing landscape and the dramatic implications this has had for shifting who is responsible for maintaining ‘good’ health. This chapter illustrates how neoliberal free market principles have reigned over UK public health discourse for many decades, seeing health as no longer binary to illness, but as a practice of individual self-quantification and self-care. In turn, the chapter explores how the quantification and health tracking of bodies has become a dominant discourse in public health promotion, as well as individual citizenship and patient practices. This discourse still exists pervasively as we move into the digital society of the 2020s, through the Covid-19 pandemic and beyond; with public health strategies internationally promoting the use of digital health tools in our everyday, further positioning citizens as entrepreneurial subjects, adopting extensive technological measures in an attempt to measure and ‘optimise’ health, normalising the everyday quantification of bodies.

This chapter presents an organizational learning approach to understanding the objectives and challenges of an National Health Service (NHS) Sustainable Development agenda, which involves the integration of social, ecological and economic concerns into organizational functioning, for example the construction and management of buildings, design and delivery of services, and employment of staff.

The approach is used to frame an empirical analysis of 11 Projects conducted by NHS organizations aiming to advance this agenda during a particularly active phase in the mid to late 2000s. The approach helps identify the assumptions of organizational purpose, strategy and practice inherent in proposals for Sustainable Development and expose the challenges these are likely to pose. This framing helps articulate a vision and identify the actor groups, and their guiding assumptions, which need to be engaged if progress is to be made.

The vision of Sustainable Development being promoted was predominantly one of an NHS contributing to the economic and social determinants of health through its procurement, service development and employment activities. Contributions to environmental determinants only took place where financial gains to the NHS organizations themselves made activities, such as investment in renewable energy, viable in the short-term. Within most Projects strategic tools able to predict and measure benefits had to be developed on-the-job and most received help from external agencies to do this work.

Rather than expecting individual NHS organizations to progress this agenda alone, others involved in the shaping of collective assumptions of the NHS' purpose and strategies for growth must be engaged in what can be viewed as a social process of learning.

Epidemiology is often described as “the basic science of public health” (Savitz, Poole & Miller, 1999; Syme & Yen, 2000). This description suggests both a close association with public health practice, and the separation of “pure” scientific knowledge from its application in the messy social world. Although the attainability of absolute objectivity is rarely claimed, epidemiologists are routinely encouraged to “persist in their efforts to substitute evidence for faith in scientific reasoning” (Stolley, 1985, p. 38) and reminded that “public health decision makers gain little from impassioned scholars who go beyond advancing and explaining the science to promoting a specific public health agenda” (Savitz et al., 1999, p. 1160). Epidemiology produces authoritative data that are transformed into evidence which informs public health. Those data are authoritative because epidemiology is regarded as a neutral scientific enterprise. Because its claims are grounded in science, epidemiological knowledge is deemed to have “a special technical status and hence is not contestable in the same way as are say, religion or ethics” (Lock, 1988, p. 6). Despite the veneer of universality afforded by its scientific pedigree, epidemiology is not a static or monolithic discipline. Epidemiological truth claims are embodied in several shifting paradigms that span the life of the discipline. Public health knowledges and practices, competing claims internal and external to epidemiology, and structural conditions (such as current political economies, material technologies, and institutions) provide important contexts in which certain kinds of epidemiological knowledge are more likely to emerge.

Purpose – The purpose of this chapter is to illustrate that when produced through relations of power, West Nile virus (WNV), as it exists on the Public Health Agency of Canada's (PHAC) website, is an effect of the kinds of knowledge, techniques of power, and disciplinary apparatuses that operate on the website and in society.

Methodology/approach – The approach used in the in-depth research project which informs this chapter is an elaboration of Michel Foucault's work on relations of power which offers an effective way of studying the PHAC's website as a collection of authoritative knowledges and as a product of a set of systems, structures, and processes which have helped to assemble and distribute knowledge about WNV.

Findings – The findings discussed in this chapter offer a critical reading of the PHAC's overall production of WNV, focusing particularly on its initial emergence starting in 2001. Cumulatively, this chapter argues that myriad relations of power have produced WNV as a bio-socio-administrative construct.

Contribution to the field – This research illustrates one way that Foucault's theories of power can be used to conduct a critical analysis of both the discursive and material dimensions of the production of contemporary public health issues. Such an approach is useful to scholars who wish to place the emergence of a disease phenomenon within political, institutional, economic, cultural, and social relations of power; thereby drawing attention to how specific spaces, places, individuals, and institutions contribute to the production of contemporary health alarms.

The incipient HIV/AIDS epidemic in Chile poses challenges for responsiveness of the Chilean national health care system, Fondo Nacional de Salud (FONASA) (National Health Funds), especially given the sociocultural forces for inertia in FONASA. Thus, the issue is what is the nature of the forces for change. A grounded theory approach was applied to interview data from two qualitative studies, one with HIV/AIDS advocates and activists as interviewees and the other with Chilean low-income women. The stories of their experiences with and perceptions of FONASA revealed major issues facing FONASA, including quality of care and ethics. Ways in which these issues are being addressed by the activists result in constructed environmental dynamism. A conceptual model of the forces for change was developed including actors, strategies, and targets of change that constitutes organizational environmental dynamism. The construct of environmental dynamism has international applicability, particularly to governmental health systems, which are influenced by strong sociocultural forces.

This chapter is set within global public sector reform processes, as policing is part of public service delivery. It explores the question of who is “vulnerable”, how vulnerability is assessed, and why? It considers the measurement of vulnerability, and how this influences policing practice and the role of the Police in contemporary policing.

The research is qualitative in nature and reliant on interview and documentary source data. It draws on concepts such as resilience, co-production, professionalisation and training as organising themes in which to make sense of how we reimagine the management of Vulnerability and the demands they place at the “core, the heart and the centre” of policing today.

Police management in the UK are attempting to stay true to the Peelian Principle of police efficiency alongside balancing the changing remit of what they have to contend with on a day-to-day basis – this is the paradox. Both Vulnerability and Risk are demonstrated to be increasingly interconnected alongside the developments of public health policing in the UK and elsewhere. Collectively, these concepts help to examine an increasingly complex landscape for the police to manoeuvre within, as they respond to a myriad of competing demands on services.

Vulnerability is the core, the heart and the centre of meaningful human experiences. With increasing pressures on resources, political scrutiny and changing roles and responsibilities, the police as an organisation (both in the UK and internationally) are increasingly responding to competing demands for their service. These demands are represented in this chapter as a paradox of change.

This chapter aims to review evidence of the relationships between dog ownership, dog walking and overall walking and the factors associated with dog walking. It reviews the evidence using a social ecological framework. The chapter finds that dog ownership and dog walking are associated with higher levels of walking. A number of social ecological factors are associated with dog walking. Motivation and social support provided by the dog to walk and a sense of responsibility to walk the dog are associated with higher levels of dog walking. Positive social pressure from family, friends, dog owners and veterinarians is also associated with higher levels of dog walking. Built and policy environmental characteristics influence dog walking, including dog-specific factors such as access to local attractive public open space with dog-supportive features (off-leash, dog waste bags, trash cans, signage), pet-friendly destinations (cafes, transit, workplaces, accommodation) and local laws that support dog walking. Large-scale intervention studies are required to determine the effect of increased dog walking on overall walking levels. Experimental study designs, such as natural and quasi-experiments, are needed to provide stronger evidence for causal associations between the built and policy environments and dog walking. Given the potential of dog walking to increase population-levels of walking, urban, park and recreational planners need to design neighbourhood environments that are supportive of dog walking and other physical activity. Advocacy for dog walking policy-relevant initiatives are needed to support dog walking friendly environments. Health promotion practitioners should make dog walking a key strategy in social marketing campaigns.

Since the 1980s UK government enthusiasm for market reforms has reconfigured the nature and scope of public services. Initially the marketisation of public services changed how public services were provided, increasingly market reforms and pro business policies have also modified the formation and understanding of public policy problematics and how they ought to be resolved. This is particularly noticeable when markets work imperfectly or even fail. UK governments have shown their reluctance to employ regulatory instruments to change the behaviour of companies preferring instead to make use of softer interventions, by focusing on providing advice for consumers and urging individuals to act responsibly. The dilemmas of this approach are explored by discussing the UK's former Labour government's (1997–2010) response to the increase in the incidence of obesity and related health complications.