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This Article Full Text Full Text (PDF) All Versions of this Article: AJPH.2007.121152v1 98/5/807    most recent Submit a response View responses Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Goldman, J. Articles by Rothman, D. J. PubMed PubMed Citation Articles by Goldman, J. Articles by Rothman, D. J. Related Collections Diabetes Health Policy HIV/AIDS Public Health Practice

Janlori Goldman, JD, Sydney Kinnear, BA, Jeannie Chung, BA and David J. Rothman, PhD

At the time of writing, Janlori Goldman, Sydney Kinnear, and Jeannie Chung were with the Center on Medicine as a Profession (CMAP), the College of Physicians and Surgeons, Columbia University, New York, NY. Janlori Goldman is also with the Health Privacy Project, Washington, DC. David J. Rothman is with the College of Physicians and Surgeons, Columbia University, New York, and with the Institute of Medicine as a Profession, New York.

Correspondence: Requests for reprints should be sent to David Rothman, Center on Medicine as a Profession, College of Physicians and Surgeons, Columbia University, 630 West 168th Street, P&S Box 11, New York, NY 10032 (e-mail: djr5{at}colubmia.edu).

Two recent New York City Department of Health and Mental Hygiene initiatives expanded the mission and scope of public health, with implications for both New York and the nation.

The programs target diabetes and HIV/AIDS for greater systemic and expanded reporting, surveillance, and intervention. These initiatives do not balance heightened surveillance and intervention with the provision of meaningful safeguards or resources for prevention and treatment. The programs intrude on the doctor–patient relationship and may alienate the very patients and health professionals they aim to serve.

Better models are available to achieve their intended goals. These initiatives should be reconsidered so that such an expansion of public health authority in New York City does not become part of a national trend.

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