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The role of public health services in America is generally considered to be the reduction of illness, suffering, and death. But what exactly does this mean in practice? At different points in history, professionals in the field have addressed housing reform, education about sex and illegal drugs, hospital and clinic care, gun violence, and even bioterrorism. But there is no agreement about how far public health efforts should go in attempting to modify behaviors seen as lifestyle choices, or whether the field's mandate extends to intervening in broader social and economic conditions.

The...