Politics and Prevalence: Distributive Justice in U.S. Disability Policy, 1950-2010

Dr. Brosco has used an Arsht Ethics Initiatives Distinguished Faculty Award (2012-13) to work on a book, Politics and Prevalence: Distributive Justice in U.S. Disability Policy, 1950-2010. Abstract:  Each decade over the last century has seen developmental disability (DD) policy driven by what seemed like a new or emerging problem.  From polio in the 1950s and mental retardation in the 1960s through autism in the 2000s, the epidemiology of each specific condition seemed to reveal that it was a critical problem deserving special attention.  It may seem appropriate that prevalence would guide policy: as specific problems affect more children and families, society should respond to address those needs.  When one condition gets so much attention, however, more general policies that might improve the health of all people with DD are neglected.  Indeed, over the last half-century, disability policy has been built in layers, with each generation adding laws and programs in response to perceived immediate problems.  Furthermore, the construction of estimates of prevalence—or other health statistics—is inherently a political process.  The definition of a condition and the methods of determining prevalence occur in a specific historical context: Governors declare epidemics, not statisticians.  By historically reconstructing how prevalence was measured over the last half century, I hope to reveal the specific social and political forces that led to each condition being central to disability policy for a specific period of time.  This history is critical to understanding current dilemmas in distributive justice for all Americans.

The book is forthcoming. In addition, his Arsht award is acknowledged in the following publication:

Impact of Specific Medical Interventions in Early Childhood on Increasing the Prevalence of Later Intellectual Disability  Jeffrey P. Brosco, MD, PhD, Lee M. Sanders, MD, MPH, Monica Dowling, PhD, et al. JAMA Pediatr. Published online April 29, 2013. doi:10.1001/jamapediatrics.2013.1379

Dr. Brosco is Professor of Clinical Pediatrics, Associate Director of the Mailman Center for Child Development, Regional Medical Director of CMS South Region and Chair of the Jackson Health System’s Pediatrics Bioethics Committee.