This dissertation examines the history of the Public Citizen Health Research Group (HRG)-a small, influential consumer advocacy group established by Ralph Nader and Dr. Sidney Wolfe in 1971-as a means for exploring the effects of the consumer movement on public health policy and practice in the shifting social, political, and economic climate of the late 20th century. It focuses on a series of the issues taken up by the Group over the 31/2 decades of its existence, selected by virtue of their importance to the organization's own internal evolution and/or the ways they reflect, more broadly, the prospects for and limitations on consumer advocacy as a mode of seeking public health reform in this era. In particular, the research centers on HRG's work on several potentially carcinogenic substances in food, consumer products, and workplaces during the 70s;the safety and efficacy of several drug products during the 80s;and alterations to the FDA drug-approval process and the ethics of human subjects research during the 90s. In conducting this investigation, the P.I. will employ three methods of social science research, namely, archival research, oral history, and key informant interviews. Broad Objectives of Proposed Research This research promises to bind together two distinct areas of focus within the literature of American history, drawing on work by 1) economic and political historians who have debated the effectiveness of consumer movements in securing political reforms throughout the 20th century, and 2) historians of public health who have studied the interfaces of industrial development, consumer behavior, and disease. As the history of public health literature has illuminated in recent decades, developments in American political economy, the evolution of science and medicine, and the changing nature and distribution of disease are linked and mutually influential phenomena. But no historians have yet focused explicitly on how reformers in the late 20th century attempted, through consumer politics, to define, exploit, and re-make the connections between these sets of developments. By filling this gap in the historical literature, this dissertation will make an original contribution to debates among scholars, as well as among those engaged with contemporary issues in public health. The research will interest those who study-or work to change-the effect of the U.S. government on the health of its populace, as well as those considering consumer action as a means for preventing and controlling disease, injury, and disability.
The challenges of maintaining America's viability in a rapidly transforming and fiercely competitive global economy continue to alter the framework within which the ends of national economic strength and public health must be reconciled. By retrospectively examining the Health Research Group's diverse efforts to influence public health policy and practice through changing times, this research will inform those involved in meting out the terms of this complex reconciliation today-consumers, public health agencies, community-based organizations, targeted populations, providers, practitioners, administrators, and policymakers. Insights yielded by an historical analysis of HRG are thus directly applicable to the work of the CDC, as CDC is the federal agency with the express mission of preventing and controlling disease, injury, and disability, and because every one of the issues on which the Group has taken its staunch, often controversial stances has fallen within the purview of CDC's articulated health impact goals (see Letter of Career Goals for greater detail).
