1993 health guide. Top 10 health stories to watch

A sea change seems likely in the way health care is delivered. In medicine, public health and nutrition, here's what else the year will bring.     

The economics of the women's movement

In recent years, the political process has seemed to become increasingly favorable to issues involving women, as shown by the relatively large number of states which have passed the Equal Rights Amendment. The economic theory of politics would imply that this result would occur if the interests of women in removing labor force sex discrimination had increased. We argue that most sex descrimination in hiring and pay of women is in the form of statistical discrimination where sex is used as a proxy for labor force attachment. If this is so, then, on net, sex discrimination in employment practices would pay in the sense that the gainers from such behavior would gain more than the losers would lose. Married women would share in such gains since they would be compensated for their lower earnings by the higher earnings of their husbands. Single women, however, would receive no such compensation. We therefore hypothesize that the recent increase in legislation benefitting women is related to marriage rates, not to female labor force participation. Using votes in the state legislatures on the ERA as a measure of success by state of the women's movement, we find that our results do hold — number of single women is significant in explaining such voting but female labor force participation is not significant.     

Professionalizing Prison: Primitive Professionalization and the Administrative Defense of Eastern State Penitentiary, 1829–1879

This article describes the process of “primitive professionalization”—the efforts of a small set of actors to claim professional status before their field has professionalized. Using a case study of Eastern State Penitentiary (1829–1879), I examine the strategies by which one prison's administrators claimed status as professionals—those whose command of a specialized knowledge grants authority within their domain. Eastern's administrators deployed a series of evolving discursive strategies aimed at establishing themselves as professionals long before more formal, field‐wide efforts to professionalize criminal justice. These strategies allowed Eastern's administrators to establish their professional status without traditional status markers of national networks, college degrees, or special training, which emerged later. Beyond illustrating a new pathway to professionalization, examining criminal justice professionalization at this early stage illuminates the early prison's precarious position and the internecine warfare among actors competing to control its meaning.     

Altruism and Self Interest in Medical Decision Making

We seem to prefer that medicine and medical care be provided through altruistic motives. Even the pharmaceutical industry justifies its behavior in terms of altruistic purposes. But economists have known since Adam Smith that self-interested behavior can create large and growing social benefits. This is true for medical care as well as for other goods. First, I consider specifically the case of pharmaceutical promotion, both to physicians and to consumers. I argue that such promotion is highly beneficial to patients and leads to health improvements. I consider some criticisms of promotion, and show that they are misguided. I then provide some evolutionary explanations for our erroneous beliefs about medical care.     

The Consequences of Prisoners’ Micro‐Resistance

For more than twenty years, scholars have called for greater attention to the consequences of micro‐resistance to legality. Using archival data from Philadelphia's Eastern State Penitentiary (1829–1875), I examine the consequences of noncompliant prisoner behavior. I find that prisoners’ noncompliance often entailed substantial costs to prisoners, particularly in comparison to the substantial benefits of complying with the prison regime. Despite its cost to prisoners, noncompliance did not have a single set of uniformly negative consequences for the prison regime. In fact, some forms of noncompliance may have actually protected the prison's reputation. Prison administrators, external allies, and critics used episodes of noncompliance for their own goals and to reinforce their preexisting claims about the propriety of competing prison designs, yielding this variable significance of noncompliance. As this study illustrates, connecting prisoner misconduct to power dynamics in the broader field produces a fuller understanding of micro‐resistance's consequences.