All Health Politics Is Local

Community Battles for Medical Care and Environmental Health

By Merlin Chowkwanyun

352 pp., 6.125 x 9.25, 17 halftones, 15 maps, 1 graph, 3 tables, notes, bibl., index

  • Paperback ISBN: 978-1-4696-6767-6
    Published: July 2022
  • E-book EPUB ISBN: 978-1-4696-6768-3
    Published: May 2022
  • E-book PDF ISBN: 979-8-8908-6215-0
    Published: May 2022
  • Hardcover ISBN: 978-1-4696-6766-9
    Published: July 2022

Studies in Social Medicine

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Health is political. It entails fierce battles over the allocation of resources, arguments over the imposition of regulations, and the mediation of dueling public sentiments—all conflicts that are often narrated from a national, top-down view. In All Health Politics Is Local, Merlin Chowkwanyun shifts our focus, taking us to four very different places—New York City, Los Angeles, Cleveland, and Central Appalachia—to experience a national story through a regional lens. He shows how racial uprisings in the 1960s catalyzed the creation of new medical infrastructure for those long denied it, what local authorities did to curb air pollution so toxic that it made residents choke and cry, how community health activists and bureaucrats fought over who’d control facilities long run by insular elites, and what a national coal boom did to community ecology and health.

All Health Politics Is Local shatters the notion of a single national health agenda. Health is and has always been political, shaped both by formal policy at the highest levels and by grassroots community battles far below.

About the Author

Merlin Chowkwanyun is Donald H. Gemson Assistant Professor of Sociomedical Sciences at Columbia University’s Mailman School of Public Health.
For more information about Merlin Chowkwanyun, visit the Author Page.


“Deeply researched. . . . Chowkwanyun should be commended for capturing the texture of each site in its unique geographies and institutions.”—H-Environment

“Told through engaging, real-world stories, Merlin Chowkwanyun’s examination of the interplay of local and national health policy helps bring to life the complex dynamics that both drive and prevent change. While his lens is trained on health politics, Merlin writes with solidarity, sharing lessons that can benefit all of us who are fighting for a better world.”—Sara Nelson, International President, Association of Flight Attendants

All Health Politics Is Local thoughtfully studies four communities to reveal the relationship between local and national health policy. With careful analysis and clear writing, Chowkwanyun guides the reader to important insights on how to make meaningful progress on difficult and critical issues such as environmental health and better health care for marginalized communities. Drawing on the history of health reforms in New York, Los Angeles, Cleveland, and Central Appalachia, Chowkwanyun has created an important and timely read for our times.”—Risa Lavizzo-Mourey, Former President and CEO, Robert Wood Johnson Foundation

“Riveting, well written, and ambitious, All Health Politics Is Local provides both cautionary tales and a road map through its intensive investigation of health politics in the midcentury United States.”—Lundy Braun, Brown University

“At a time when so many are rethinking the intersections of race, health care, the carceral state, and grassroots activism, this book offers a timely and useful contribution. Rectifying the need for greater attention to localism in the history of U.S. health care, Chowkwanyun uses first-rate archival research and strong writing to delve into how much the fate of policy reforms hinges on local politics and contexts.”—Nancy Tomes, Stony Brook University

“In a striking, diverse, and revealing set of case studies, Merlin Chowkwanyun demonstrates how local leadership and choices can shape health care, environmental risk, and population health. The cases in mid-twentieth-century New York, Los Angeles, Cleveland, and Appalachia are sufficiently far in the past for historical perspective yet recent enough to be enriched by personal recollection. With clear-eyed documentation and balanced analysis, Chowkwanyun shows the achievements, failings, potential, and limitations of local health politics. Anyone interested in health policy and in health progress through community action will gain fresh insights from this work.”—Harvey V. Fineberg, former president, National Academy of Medicine and current president, Betty and Gordon Moore Foundation