New Books In Public Health

Dialysis is a medical miracle, a treatment that allows people with kidney failure to live when otherwise they would die. It also provides a captive customer for the dialysis industry, which values the steady revenues that come from critically required long-term care that is guaranteed by the government. Tom Mueller's six year deep dive into the dialysis industry has yielded his latest book, How to Make a Killing: Blood, Death, and Dollars in American Medicine (W. W. Norton, 2023). It's both an historical account of this lifesaving treatment and an indictment of the industry that is dominated by two for-profit companies that control ~80% of the market. There is a precarious balance between ethical care for patients and the prioritization of profits for the providers, a tension that has led to ethical, political, and legal debates about the rationing and exploitation of life-saving care and quality of life. Dialysis services are desperately needed by patients who require the dangerous, uncomfortable, and exhausting treatments multiple times per week, and pay for it through complex insurance procedures. Tom Mueller’s book includes a vivid account of CEOs who lead their companies with messianic zeal to drive revenues continually up while simultaneously reducing the cost of care. He introduces us to the doctors charged with reducing those costs even at the expense of high-quality care and negative health outcomes. And we meet the patients themselves, who have little choice but to put their lives and well-being at the mercy of this system. How did a lifesaving medical breakthrough become a for-profit enterprise that threatens many of the people it’s meant to save? And who are the brave people -patients, doctors, and employees of the system who are willing to tell their stories despite tremendous pressure to remain silent? And why do we as Americans accept worse outcomes at higher costs than the rest of the world? Tom Mueller's highly readable yet devastating book illustrates the dialysis industry as a microcosm of American medicine. Mueller challenges us to find a solution for dialysis, an approach that could also provide the opportunity to begin fixing our country’s dysfunctional healthcare system and a fighting chance at restoring human health outcomes, rather than the extraction of profits, as its true purpose. To contact Tom Mueller, visit www.tommueller.co Suggested reading: The Body's Keepers by Paul L. Kimmel, M.D. The Occasional Human Sacrifice: Medical Experimentation and the Price of Saying No by Carl Elliott Also mentioned: How to Get Away with Merger by Thomas G. Wollman (NBER working paper, 2020) "How Acquisitions Affect Firm Behavior and Performance" by Eliason, Heebsh et al. (The Quarterly Journal of Economics, 2020) Learn more about your ad choices. Visit megaphone.fm/adchoices

During the COVID pandemic, billions of dollars in relief aid was sent out to help us ride out the storm, although many people who struggled through it might scratch their heads at such a number, having seen little of it make any concrete impact in their own lives. This discrepancy is indicative of the underlying problem with the contemporary care economy, a series of federal and state programs, healthcare facilities and NGO’s, all trying to bend the needs of those under their care to the mechanisms and incentives laid out by capitalism. The result is a massive apparatus that regularly fails to fulfill its supposed intentions, leaving workers and those in need of help in precarious and often dangerous situations. This apparatus is untangled and explained in clear detail by Premilla Nadasen in her book Care: The Highest Stage of Capitalism (Haymarket Books, 2023). Informed by both her work as a historian and as a political activist, she manages to untangle and explain why the massive apparatus regularly fails to fulfill its purpose. She also outlines offramps, forms of resistance that workers and activists have taken to develop alternative anticapitalist forms of care that might someday allow us to truly flourish together. Premilla Nadasen is a professor of history at Barnard College, Columbia University. She is the co-director of the Barnard Center for Research on Women. She is also the author of Welfare Warriors: The Welfare Rights Movement in the United States and Household Workers Unite: The Untold Story of African American Women Who Built a Movement. Learn more about your ad choices. Visit megaphone.fm/adchoices

Global risks present formidable challenges to international law. Although they have long been identified in many other scientific disciplines, they are currently only considered on a sectoral basis in international law in the absence of a legal definition. The aim of Sarah Cassella's book Global Risks and International Law: The Case of Climate Change and Pandemics (Brill/Nijhoff, 2023) is threefold: to identify the main elements that characterise global risks in a legal perspective, to determine the characteristics that make them a new category of risk, and to analyse the changes they bring about in the main mechanisms of international law. Drawing on the relationship between international law and other legal systems, and in particular national law, this book highlights possible responses to the challenges posed by global risks. The study is based on extensive practice related to the examples of climate change and pandemics, but opens up perspectives on conclusions that could be common to other global risks, such as financial risks or cyber risks. Sarah Cassella, Ph.D. (2009), is Professor of International Law at Université Paris. Learn more about your ad choices. Visit megaphone.fm/adchoices

Ryan Reft is a historian in the Manuscript Division at the Library of Congress, where he oversees collections pertaining to 20th and 21st century domestic politics and policies. He received his PhD in U.S. urban history from the University of California San Diego in 2014, and his writing has appeared all over the place, from edited volumes to academic journals, to the Washington Post and Zocalo Public Square. He’s also currently the senior co-editor of the Urban History Association’s blog The Metropole, where he recently authored a great article called “Heroin and Chocolate City: Black Community Responses to Drug Addiction in the Nation’s Capital, 1967-1973.” While it’s not a book, “Heroin and Chocolate City” is a deeply-researched article that offers compelling new insights into how Washington, D.C., responded to heroin use in the late 60s and early 70s, when both D.C., and heroin, were really unique. *Note to listeners: Ryan realized later he connected Julius Hobson with SNCC. Hobson was actually associated with CORE. Emily Dufton is the author of Grass Roots: The Rise and Fall and Rise of Marijuana in America (Basic Books, 2017). A drug historian and writer, her second book, on the development of the opioid addiction medication industry, is under contract with the University of Chicago Press. Learn more about your ad choices. Visit megaphone.fm/adchoices

'A woman, a dog and a walnut tree, the more they are beaten, the better they’ll be.' So went the proverb quoted by a prominent MP in the Houses of Parliament in 1853. His words – intended ironically in a debate about a rise in attacks on women – summed up the prevailing attitude of the day, in which violence against women was waved away as a part and parcel of modern living – a chilling seam of misogyny that had polluted both parliament and the law. But were things about to change? The Walnut Tree: Women, Violence and the Law – A Hidden History (Mudlark, 2024) is a vivid and essential work of historical non-fiction. In it, Kate Morgan explores the legal campaigns, test cases and individual injustices of the Victorian and Edwardian eras which fundamentally re-shaped the status of women under British law. These are seen through the untold stories of women whose cases became cornerstones of our modern legal system and shine a light on the historical inequalities of the law. We hear of the uniquely abusive marriage which culminated in the dramatic story of the ‘Clitheroe wife abduction’; of the domestic tragedies which changed the law on domestic violence; the controversies surrounding the Contagious Diseases Act and the women who campaigned to abolish it; and the real courtroom stories behind notorious murder cases such as the ‘Camden Town Murder’. Exploring the 19th- and early 20th Century legal history that influenced the modern-day stances on issues such as domestic abuse, sexual violence and divorce, The Walnut Tree lifts the lid on the shocking history of women under British law – and what it means for women today. This interview was conducted by Dr. Miranda Melcher whose new book focuses on post-conflict military integration, understanding treaty negotiation and implementation in civil war contexts, with qualitative analysis of the Angolan and Mozambican civil wars. Learn more about your ad choices. Visit megaphone.fm/adchoices

Indonesia is the world's second largest cigarette market: two out of three men smoke, and clove-laced tobacco cigarettes called kretek make up 95 percent of the market. To account for the staggering success of this lethal industry, Kretek Capitalism: Making, Marketing, and Consuming Clove Cigarettes in Indonesia (University of California Press, 2024) moves beyond a focus on the addictive hold of nicotine to examine how kretek manufacturers have adopted global tobacco technologies and enlisted Indonesians to labor on their behalf in fields and factories, at retail outlets and social gatherings, and online. The book charts how Sampoerna, a Philip Morris International subsidiary, uses contracts, competitions, and gender, class, and age hierarchies to extract overtime, shift, seasonal, gig, and unpaid labor from workers, influencers, artists, students, retailers, and consumers. Critically engaging nationalist claims about the commodity's cultural heritage and the jobs it supports, Marina Welker shows how global capitalism has transformed both kretek and the labor required to make and promote it. Marina Welker is Professor of Anthropology at Cornell University and author of Enacting the Corporation: An American Mining Firm in Post-Authoritarian Indonesia. Reighan Gillam is an Associate Professor in the Department of Latin American, Latino, and Caribbean Studies at Dartmouth College. Her research examines the ways in which Afro-Brazilian media producers foment anti-racist visual politics through their image creation. She is the author of Visualizing Black Lives: Ownership and Control in Afro-Brazilian Media (University of Illinois Press). Learn more about your ad choices. Visit megaphone.fm/adchoices

After a storied career as a health policy expert, Stanford Medicine's Dr. Jay Bhattacharya's work became a political focal point during the COVID-19 pandemic, when he advocated against widespread lockdowns. He co-authored the Great Barrington Declaration, an open letter signed by infectious disease epidemiologists and public health scientists which advocated for a focused protection approach to COVID-19, and the Twitter Files revealed that his Twitter account had been placed on Twitter's "black list." In this conversation, he sits down to discuss how the history of American infectious disease affected our COVID response, the mimetic nature of lockdown policy, the importance of freedom of speech to the scientific endeavor, and more. Dr. Jay Bhattacharya is a Professor of Medicine at Stanford University. He is also a research associate at the National Bureau of Economics Research, a senior fellow at the Stanford Institute for Economic Policy Research, a senior fellow at the Stanford Freeman Spogli Institute, and the Director of the Stanford Center on the Demography of Health and Aging. He holds an MD and a PhD in Economics, both from Stanford University. Contributions to and/or sponsorship of any event does not constitute departmental or institutional endorsement of the specific program, speakers or views presented. Annika Nordquist is the Communications Coordinator of Princeton University’s James Madison Program in American Ideals and Institutions and host of the Program’s podcast, Madison’s Notes. Learn more about your ad choices. Visit megaphone.fm/adchoices

Dr. Susan Partovi first experienced poverty medicine volunteering at a dump site in Tijuana during high school. There, she recognized the need for all people to have access to quality medical care. Over the years, she has worked in various facilities around Los Angeles County, incorporating her renegade method of going the extra mile for her patients. As Medical Director of Homeless Health Care Los Angeles, she works to provide a safety net of care for the underserved skid row community and surrounding neighborhoods. Recognized internationally as a leader in street medicine, Dr. Partovi started documenting her patients' stories so that others could hear their voices. By addressing the practical and moral considerations when treating each patient, Dr. Partovi developed her philosophies about what it means to be a "good doctor." Along the way, she began to understand how her personal ethics evolved--from a challenging childhood and complicated relationships with her parents, through professional hurdles--often, she had to push against a system that doesn't always put the patient first. Renegade M.D.: A Doctor's Stories from the Streets (Bookbaby, 2024) is a powerful and inspiring memoir by Dr. Susan Partovi, a renowned street doctor who has dedicated her life to treating the impoverished around the world and people experiencing homelessness on LA's skid row. Through her stories, Dr. Partovi takes us on a journey to the heart of the challenges faced by those living on the streets, and shines a light on her unwavering commitment to advocate for social justice and to provide compassionate care to some of the most vulnerable people in our society. Learn more about your ad choices. Visit megaphone.fm/adchoices

Most of us appreciate the importance of the immune system yet have very little knowledge about how it actually works. If you fall into this camp and are curious to learn more about this intricate system, Bobby Cherayil's book is an excellent resource. The Logic of Immunity: Deciphering an Enigma was published in January 2024 by John Hopkins University Press. It gives a great overview of this complex system, including several findings from the recent years. It also points out the many areas of ongoing research and open questions. The book introduces the actors of the system and the many interactions between them: the various types of immune cells, the pathogens and pathogen-associated patterns they recognize, the cascade of events that ultimately leads to an immune response. The opening chapter explains (and visualizes!) where these cells are located. It explains how they contribute to the immune response, and how we broadly categorize them into innate and adaptive immunity. Chapters 2 and 3 discuss the innate immune system. We get to know the general concepts, like molecular patterns and receptors recognizing them. They describe in detail some well-studied mechanisms, like the LPS-TLR4 interaction. And we also learn the story of their research spanning multiple years and multiple discoveries building upon each other. Chapters 4-6 delve into the mechanisms of adaptive immunity and their main cell types: B- and T-lymphocytes. Have you ever wondered how the immune system is able to "remember" earlier infections? You'll find here both an overview of "immune memory" and a detailed description how B and T cell proliferate and specialize. Chapter 7 shows how these immune reactions are sometimes provoked by harmless substances - that's what we call allergy. Or even by human cells - that's what we call autoimmune diseases. The next chapters put the immune system into a bigger context. They discuss the variability of immunity across different individuals and the many reasons behind it. Genes, environment, past infections, life style. A particularly fascinating part of "the human ecosystem" is the microbiota. Its importance has been recognized only in the last two decades. Chapter 8 introduces really well this emerging field of study. Chapter 11 is dedicated to an immunology topic that affects all of us: vaccines. Building upon the knowledge from previous chapters, it explains how vaccines work. Throughout the book, we learn a lot both about the exciting developments and the open questions in the field of immunology. Chapter 12 gives a summary of some trends of the last decades and an outlook for the next big puzzles to tackle. Learn more about your ad choices. Visit megaphone.fm/adchoices

Our stress response system is magnificent - it operates beneath our awareness, like an orchestra of organs playing a hidden symphony. When we are healthy, the orchestra plays effortlessly, but what happens when our bodies face chronic stress, and the music slips out of tune? The alarming rise of stress-related conditions, such as heart disease, diabetes, and depression, show the price we're paying for our high-pressure living, while global warming, pandemics and technology have brought new kinds of stress into all our lives. But what can we do about it? Explore the fascinating mysteries of our hidden stress response system with Dr. Wulsin, who uses his decades of experience to show how toxic stress impacts our bodies. In Toxic Stress: How Stress Is Making Us Ill and What We Can Do About It (Cambridge UP, 2024), Wulsin gives us the expert advice and tools needed to prevent toxic stress from taking over. Chapter by chapter, learn to help your body and mind recover from toxic stress. Learn more about your ad choices. Visit megaphone.fm/adchoices

From the theatre mask and masquerade to the masked criminal and the rise of facial recognition software, masks have long performed as an instrument for the protection and concealment of identity. Even as they conceal and protect, masks – as faces – are an extension of the self. At the same time, they are a part of material culture: what are masks made of? What traces do they leave behind? Acknowledging that that mask-wearing has become increasingly weaponized and politicised, in Mask (Bloomsbury, 2024) Dr. Sharrona Pearl looks at the politics of the mask, exploring how identity itself is read on this object. By exploring who we do (and do not) seek to protect through different forms of masking, Dr. Pearl's long history of masks helps us to better understand what it is we value. This interview was conducted by Dr. Miranda Melcher whose forthcoming book focuses on post-conflict military integration, understanding treaty negotiation and implementation in civil war contexts, with qualitative analysis of the Angolan and Mozambican civil wars. Learn more about your ad choices. Visit megaphone.fm/adchoices

In The Virus Touch: Theorizing Epidemic Media (Duke UP. 2023), Bishnupriya Ghosh argues that media are central to understanding emergent relations between viruses, humans, and nonhuman life. Writing in the shadow of the HIV/AIDS and COVID-19 global pandemics, Ghosh theorizes "epidemic media" to show how epidemics are mediated in images, numbers, and movements through the processes of reading test results and tracking infection and mortality rates. Scientific, artistic, and activist epidemic media that make multispecies relations sensible and manageable eschew anthropocentric survival strategies and instead recast global public health crises as biological, social, and ecological catastrophes, pushing us toward a multispecies politics of health. Ghosh trains her analytic gaze on these mediations as expressed in the collection and analysis of blood samples as a form of viral media; the geospatialization of data that track viral hosts like wild primates; and the use of multisensory images to trace fluctuations in viral mutations. Studying how epidemic media inscribe, store, and transmit multispecies relations attunes us to the anthropogenic drivers of pathogenicity like deforestation or illegal wildlife trading and the vulnerabilities accruing from diseases that arise from socioeconomic inequities and biopolitical neglect. Professor Bishnupriya Ghosh teaches at the Department of English and Global Studies at UC Santa Barbara. She studies global media cultures, environmental media and critical health studies. Her early research includes two monographs When Borne Across: Literary Cosmopolitics in the Contemporary Indian Novel and Global Icons: Apertures to the Popular, while the co-edited volume exemplifies her current research, The Routledge Companion to Media and Risk. Priyam Sinha is a doctoral candidate in the South Asian Studies Programme at the National University of Singapore. She has interdisciplinary academic interests that lie at the intersection of film studies, disability studies, production cultures, affect studies, anthropology of the body, creative media industries and cultural studies. She can be reached here. Learn more about your ad choices. Visit megaphone.fm/adchoices

Raj Patel, the renowned political economist and New York Times bestselling author of The Value of Nothing, teams up with the physician Rupa Marya to offer a radical new cure: the deep medicine of decolonization. Decolonizing heals what has been divided, reestablishing our relationships with the Earth and one another. Combining the latest scientific research and scholarship on globalization with the stories of Marya's work with patients in marginalized communities, activist passion, and the wisdom of Indigenous groups, Inflamed: Deep Medicine and the Anatomy of Injustice (FSG, 2021) points the way toward a deep medicine that has the potential to heal not only our bodies, but the world. “This book advances a new level of diagnosis that incorporates history and lines of power into our understanding of the root causes of health disparities and the rise of inflammatory disease in industrialized places, offering compelling treatment options for what is ailing people and the planet”. Learn more about your ad choices. Visit megaphone.fm/adchoices

What is a ‘drink map’? It may sound like a pub guide, yet it actually refers to a type of late nineteenth-century British map designed specifically to shock and shame people into drinking less. Drink Maps in Victorian Britain (Bodleian Library Publishing, 2024) by Kris Butler explores how drink maps of particular cities were published in an attempt to fight increasingly rampant alcohol consumption, from Liverpool, Manchester and Sheffield to Oxford, London and Norwich. Featuring red symbols to indicate where alcohol was sold, these special street maps were posted prominently in public places, submitted as evidence, sent to Members of Parliament and published in newspapers to show just how inebriated a neighbourhood could be. They promoted the message that having fewer places to buy alcohol was the answer to reducing widespread crime, poverty and sickness. And they worked – at first. After consulting a drink map in one town, judges decided to close half the licensed shops because even then no one had to walk more than two minutes to buy a beer. Illustrated with original maps, advertisements and temperance propaganda, the story of their brief history is told amidst a tangle of licensing laws, rogue magistrates, irate brewers, ardent temperance organisers and accounts of the complex role alcohol played across all levels of Victorian society. This interview was conducted by Dr. Miranda Melcher whose recent book focuses on post-conflict military integration, understanding treaty negotiation and implementation in civil war contexts, with qualitative analysis of the Angolan and Mozambican civil wars. Learn more about your ad choices. Visit megaphone.fm/adchoices

For decades now, we’ve all heard the refrain – we are in a war against obesity, with perhaps the most important battle being fought over the health of our children. What better place could there be to defeat the enemy of obesity than our schools, where children are fed and educated and educated about being fed on a daily basis? But how did we come to see health promotion in schools as the key solution to solving the problem of obesity? And is obesity really at the root of our problems to begin with? Intertwining policy analysis and ethnography, José Tenorio’s School Food Politics in Mexico: The Corporatization of Obesity and Healthy Eating Policies (Routledge, 2023) examines how, and why now, the promotion of healthy lifestyles has been positioned as an ideal ‘solution’ to obesity and how this shapes the preparation, sale and consumption of food in schools in Mexico. This book situates obesity as a structural problem enabled by market-driven policy change, problematizing the focus on individual behavior change which underpins current obesity policy. Expanding the conversation on the politics of food in schools, obesity policy and dominant perspectives on the relation between food and health, this book is a must-read for scholars of food and nutrition, public health and education, as well as those with an interest in development studies and policy enactment and outcomes. Learn more about your ad choices. Visit megaphone.fm/adchoices

How is India tackling its persistent wage management problems? And, are new infrastructural solutions the way forward? In this episode, Kenneth Bo Nielsen talks to Pamela Das about the new infrastructures that are increasingly being put in place to help Indian cities confront the problem of waste and how to handle it. Estimate suggests that by 2025, India will generate 1.3 billion metric tonnes of municipal solid waste every year. With a recycling rate at below 20 percent, the negative consequences for the environment and for public health are clear and visible in both urban and rural contexts. In policy discussions, the solution is often deemed to be infrastructural – that if only India could get the infrastructure right, the problem of waste would disappear. But infrastructures sometimes produce new and unanticipated social consequences that compound rather than solve existing problems. Pamela Das is an interdisciplinary researcher trained in anthropology, political science, economics, and sociology. Kenneth Bo Nielsen is a social anthropologist based at the University of Oslo and one of the leaders of the Norwegian Network for Asian Studies. Learn more about your ad choices. Visit megaphone.fm/adchoices

Sociologist Neil M. Gong explains why mental health treatment in Los Angeles rarely succeeds, for the rich, the poor, and everyone in between. In 2022, Los Angeles became the US county with the largest population of unhoused people, drawing a stark contrast with the wealth on display in its opulent neighborhoods. In Sons, Daughters, and Sidewalk Psychotics: Mental Illness and Homelessness in Los Angeles (U Chicago Press, 2024), sociologist Neil M. Gong traces the divide between the haves and have-nots in the psychiatric treatment systems that shape the life trajectories of people living with serious mental illness. In the decades since the United States closed its mental hospitals in favor of non-institutional treatment, two drastically different forms of community psychiatric services have developed: public safety-net clinics focused on keeping patients housed and out of jail, and elite private care trying to push clients toward respectable futures. In Downtown Los Angeles, many people in psychiatric crisis only receive help after experiencing homelessness or arrests. Public providers engage in guerrilla social work to secure them housing and safety, but these programs are rarely able to deliver true rehabilitation for psychological distress and addiction. Patients are free to refuse treatment or use illegal drugs—so long as they do so away from public view. Across town in West LA or Malibu, wealthy people diagnosed with serious mental illness attend luxurious treatment centers. Programs may offer yoga and organic meals alongside personalized therapeutic treatments, but patients can feel trapped, as their families pay exorbitantly to surveil and “fix” them. Meanwhile, middle-class families—stymied by private insurers, unable to afford elite providers, and yet not poor enough to qualify for social services—struggle to find care at all. Gong’s findings raise uncomfortable questions about urban policy, family dynamics, and what it means to respect individual freedom. His comparative approach reminds us that every “sidewalk psychotic” is also a beloved relative and that the kinds of policies we support likely depend on whether we see those with mental illness as a public social problem or as somebody’s kin. At a time when many voters merely want streets cleared of “problem people,” Gong’s book helps us imagine a fundamentally different psychiatric system—one that will meet the needs of patients, families, and society at large. Michael O. Johnston, Ph.D. is a Assistant Professor of Sociology at William Penn University. He is the author of The Social Construction of a Cultural Spectacle: Floatzilla (Lexington Books, 2023) and Community Media Representations of Place and Identity at Tug Fest: Reconstructing the Mississippi River (Lexington Books, 2022). His general area of study is in the areas of social construction of experience, identity, and place. He is currently conducting research for his next project that looks at nightlife and the emotional labor that is performed by employees of bars and nightclubs. To learn more about Michael O. Johnston you can go to his website, Google Scholar, Twitter @ProfessorJohnst, or by email at johnstonmo@wmpenn.edu. Learn more about your ad choices. Visit megaphone.fm/adchoices

Brynn Quick speaks with Erin Mulpur about how hospitals can better support patients from linguistic minority backgrounds. The conversation addresses the barriers to both communication and healthcare faced by linguistic minority patients. Drawing on Erin’s 2021 paper “Reducing Barriers to Language Assistance During a Pandemic," the focus is on Houston Methodist Hospital’s innovative use of language assistance technologies during the first waves of Covid-19. For additional resources, show notes, and transcripts, go here. Learn more about your ad choices. Visit megaphone.fm/adchoices

In the middle of the second century AD, Rome was at its prosperous and powerful apex. The emperor Marcus Aurelius reigned over a vast territory that stretched from Britain to Egypt. The Roman-made peace, or Pax Romana, seemed to be permanent. Then, apparently out of nowhere, a sudden sickness struck the legions and laid waste to cities, including Rome itself. This fast-spreading disease, now known as the Antonine plague, may have been history’s first pandemic. Soon after its arrival, the Empire began its downward trajectory toward decline and fall. In Pox Romana: The Plague That Shook the Roman World (Princeton University Press, 2024), historian Dr. Colin Elliott offers a comprehensive, wide-ranging account of this pivotal moment in Roman history. Did a single disease—its origins and diagnosis still a mystery—bring Rome to its knees? Carefully examining all the available evidence, Dr. Elliott shows that Rome’s problems were more insidious. Years before the pandemic, the thin veneer of Roman peace and prosperity had begun to crack: the economy was sluggish, the military found itself bogged down in the Balkans and the Middle East, food insecurity led to riots and mass migration, and persecution of Christians intensified. The pandemic exposed the crumbling foundations of a doomed Empire. Arguing that the disease was both cause and effect of Rome’s fall, Dr. Elliott describes the plague’s “preexisting conditions” (Rome’s multiple economic, social, and environmental susceptibilities); recounts the history of the outbreak itself through the experiences of physician, victim, and political operator; and explores postpandemic crises. The pandemic’s most transformative power, Dr. Elliott suggests, may have been its lingering presence as a threat both real and perceived. This interview was conducted by Dr. Miranda Melcher whose forthcoming book focuses on post-conflict military integration, understanding treaty negotiation and implementation in civil war contexts, with qualitative analysis of the Angolan and Mozambican civil wars. Learn more about your ad choices. Visit megaphone.fm/adchoices

Charlie Hertzog Young became a climate activist in his early teens. His journey led him onto airport runways and into the halls of power, but also to a serious mental health breakdown. He had to rebuild himself physically and psychologically, before focusing his efforts on collective mental recovery in response to a planet in crisis. Spinning Out: Climate Change, Mental Health and Fighting for a Better Future (Footnote Press, 2023) explores how climate chaos and the failure of those in power to tackle it are causing an inevitable mental health crisis across the globe. The relationship between the climate and our emotional wellbeing goes far deeper than eco-anxiety. It goes to the roots of our civilization - its principles, its practices and its false solutions. With testimony from dozens of activists, organizers and researchers across every habitable continent, Spinning Out is a celebration (of other ways to be) and a manual for anyone who wants to fight for a better world, while avoiding burnout and despair. Wedding the needs of the earth with the needs of the human mind, Spinning Out offers a powerful, collective vision for change. Learn more about your ad choices. Visit megaphone.fm/adchoices