An Engine, Not a Vessel: Place, Politics, and Health in the United States

Social scientists often treat places as containers for social and economic phenomena that shape health outcomes. Yet this analytic practice conceals more than it reveals. Local governments in the United States should be understood as engines of both health promotion and stratification. As the contributions to this symposium suggest, governments not only occupy a formal place in the U.S. public health system, their decisions on everything from housing to transportation infrastructure can also have profound impacts on health outcomes. Local political economies likewise renegotiate the parameters of acceptable health interventions, public understandings of health disparities, and the status of population health as a public good. By illustrating these linkages, the authors here suggest important future lines of research on both the promise and limits of local health governance, as well as how the allocation of local political power shapes health disparities.