Fictitious Colburn University boasts many “amenities” for its students, including cafes, a gymnasium, and U.V. tanning salon Campus Tans. Meredith Tang, a law student originally from Australia, and Barbara Holly, a public health student, cannot believe that this insidious industry has infiltrated campus life and worse yet seems to be promoted by the school, or at least is allowed to advertise on campus. Soon these students turned activists begin a campaign to evict the salon; however, they quickly discover that evicting Campus Tans may not be as easy as they thought. As the story ends, the student activists sit down to a meeting with school officials and the owner of the salon to negotiate an agreement that protects the health of Colburn students while balancing the interests of diverse stakeholders.

Nefertiti Nelson, a senior official at the Columbia Department of Public Health (CDPH) in the fictitious U.S. state of Columbia, has been asked by the governor’s office to examine the cost-effectiveness of administering BMI and eating disorders screenings in schools. To carry out the project, Nefertiti and her team of CDPH colleagues join forces with the consulting firm, Datamon; yet, as the analysis begins questions quickly arise about the logistics and costliness of implementing the screenings, potential outcome measures, and the interests and concerns of respective stakeholders.

Gisele Rodriguez, MPH, moved back to her hometown, East Point, in the fictional U.S. state of Columbia, after graduate school and joined the Columbia Department of Public Health (CDPH). Working with a marketing firm, Gisele and colleagues set out to create an obesity prevention campaign; however, the resulting product is met with community and national backlash for its stigmatizing messages and images. At the end of the story, CDPH releases a request for proposals to invite applications from community agencies to develop a new campaign that is both evidence-based and solicitous of community ideas and input, thus more likely to be effective and engender community-wide acceptance and support.

How does one learn to become an effective advocate on public health issues?  “To Vaccinate or Not to Vaccinate: The Story of Hamilton, Columbia” introduces the reader to the fictional US state of Columbia and its legislature’s dilemma over whether to mandate the HPV vaccine for the state’s young people or simply to educate them and their parents on the importance and availability of the vaccine. On the surface this appears to be a straightforward public health question: Will a vaccine mandate or a voluntary educational effort be more effective in preventing HPV infection and ultimately HPV-related cancers? But as the narrative unfolds, we come to understand that the legislative context is much more complicated and the tensions myriad, complete with financial and political deal making, power contests in anticipation of an upcoming election, and much more. Furthermore, given that the scientific evidence is still incomplete in some aspects and does not necessarily point to a single best option for the state, the ethical concerns at stake become all the more important. What should Columbia do? As the story draws to a close, the state legislature’s Health, Education, and Labor Committee is about to open a public hearing on the dilemma, inviting an array of experts, community leaders, pharmaceutical reps, and government staffers and elected officials to speak on two bills under consideration: one for a mandate and the other for education only. This is where the students will step in to bring the hearing to life, arguing for the course of action they think is most prudent and learning techniques in effective legislative advocacy on important public health issues in the process. 

What is a dedicated, well-intentioned public health practitioner to do when it starts to feel like the science supporting her recommendations is hardly more persuasive to her community partners than the daily horoscope? Pile on more evidence? Not by a long shot, as our case story protagonists find out the hard way in the tale of the town of East Point, a diverse and hard-working community in the fictitious US state of Columbia. East Point and its high school are faced with hard choices at every turn: Offer comprehensive sex ed, but then have to cut afterschool programs to address the town’s budget crisis? Accept serendipitous outside funding for abstinence-only education, but then deprive the town’s youth of effective school-based sexual health education? 

How does one learn to become an effective advocate? “Beauty and the Breast: Mobilizing Community Action to Take on the Beauty Industry” tells the story of protagonist Joe Wendell, known as Wendell, an emergency room nurse and widower raising a teenage daughter in Franklin, a largely working class town in the fictional US state of Columbia. One day his daughter announces she would like to have breast implants. The distressing news prompts Wendell into new, unforeseen directions as he learns all he can about implants and surgery, the “beauty culture” permeating society especially in his community, and the psychological development of teenagers. Though relieved to find out that as long as she is a minor she cannot legally obtain the surgery without his consent (and, no doubt, without his cash), Wendell starts to believe that greater protections for teen girls in Columbia are needed. In this effort he is guided by the confident figure of Anna Pinto, director of a community center in an East Franklin neighborhood with a vibrant Brazilian-American community where cosmetic surgery, especially for girls and young women, is something she perceives to be a particular problem and has some ideas about how to address.

In February 2014, Michael Schrader, chief executive of Vaxess Technologies, Inc., was assessing the startup health care company's 2014 marketing plan. On December 31st, 2013, Vaxess had obtained an exclusive license to a series of patents for a silk protein technology that, when added to vaccines, reduced or removed the need for refrigeration between manufacturing and delivery to the end patient. Schrader and his colleagues had to decide on which vaccines to focus and whether and how to target the drug companies that manufactured the vaccines or the quasi-government organizations (such as UNICEF and PAHO) and nongovernment organizations (such as GAVI) that purchased large quantities of vaccines for the developing world.

In January 2014, Gary Bald, senior vice president of Safety, Environment and Health at Royal Caribbean Cruise Lines (RCL), prepared for a review meeting with the company's chief executive, Adam Goldstein, and chairman, Richard Fain. Prior to joining RCL in 2006, Bald had spent 28 years with the Federal Bureau of Investigation. After seven years of upgrading security for the cruise line, Bald stated, "We've come a long way, but what keeps me up at night is what I don't know." As he prepared for his meeting with Fain and Goldstein, Bald considered whether his department's current initiatives would be sufficient to maintain RCL's position at the cutting edge of cruise industry best practice, and whether RCL could and should differentiate itself in marketing from its competitors in the areas of safety, environment and health.

On April 24, 2013 the Rana Plaza factory building collapsed in Dhaka, the capital of Bangladesh. Over 1,100 people were killed in the worst industrial accident since the Union Carbide plant gas leak in Bhopal, India. Most of the victims worked for garment factories, whose primary clients were European, US and Canadian firms. Export contracts to such firms had helped Bangladesh become the world's second largest clothing exporter. Rana Plaza was not the first tragedy to occur in Bangladesh's garment industry, and without intervention, more might follow. International brand owners, domestic and foreign governments, labor unions and non-governmental organizations (NGOs), stepped up to discuss their responsibilities for improving conditions for Bangladeshi garment workers.

Colorado's 2014 legalization of marijuana for adult recreational (not just medical) use created a new market that entrepreneurs rushed to enter, channeled by regulations that aimed to minimize marijuana's access to minors while not stifling the emergent new industry. The case describes Colorado's initial experience with marijuana legalization and asks students to assess the resulting business opportunities, regulatory efficacy, and public health implications.

To create the world's healthiest workforce, diversified health care giant Johnson & Johnson (J&J) mandated participation in its "Culture of Health" program globally, customized by location, culture, and specific health needs to offer prevention-focused education, rewards for healthy behavior, and workplace environments that encouraged healthy employee behavior. By 2015, 90% of J&J's 128,000 employees would participate in Culture of Health programs; 80% would know their key health indicators (e.g., blood pressure, body-mass index, blood sugar, cholesterol); and 80% would have a "low risk" health profile. To hit these goals, J&J managers in 2014 sought to: 1) reduce national variation in program adoption and popularity, 2) do more to help employees ensure their overall-physical, mental, and spiritual-health, and 3) accurately measure the investments in and return on the program.

In 2014, Social Impact Bonds (SIBs) were quickly gaining popularity as an investment vehicle which joined together private investors and nonprofits to tackle social issues. Although numerous SIB projects and proposals had cropped up across the U.S. following the launch of the first SIB in the UK in 2010, none were explicitly focused on healthcare. Fresno, California announced the first healthcare SIB in 2013 to fund home-based programs to reduce asthma attacks. If successful, the Fresno SIB model would help solve the challenge of delivering preventative care efficiently in at-risk communities.

The case series focuses on Melbourne Trains' viral advertising campaign to improve safe behaviors around trains among young people. This iconic, low budget campaign swept the Cannes Lions advertising awards in 2013 and became a social media sensation.

Since founding CancerScan in 2008, Jun Fukuyoshi and Yoshiki Ishikawa had helped to improve cancer screening rates in Japan. Between 2005 and 2007, awareness of breast cancer in Japan rose from 55% to 70%, but the incidence of breast cancer screenings remained constant. Jun and Yoshiki applied marketing research techniques to increase the screening rate for breast cancer, a disease which killed over 12,000 Japanese women in 2011. Cancer screening initiatives accounted for 60% of the company's 2013 sales of $2.5 million.

At the close of open-enrollment in March of 2014, Kevin Counihan, CEO of Access Health CT, Connecticut's state health insurance exchange, stops to consider the success it has experienced so far and think about how to ensure its long-term sustainability.

In 2014, Pfizer proposed a friendly acquisition of AstraZeneca, but the AstraZeneca board resisted over price and strategy concerns. Was this good for pharmaceutical consumers? Pfizer, like pharmaceutical companies in general, faced difficulties in growing sales due to the challenges of developing new drugs. Over the previous decade or more, Pfizer had pursued acquisitions as a way to acquire new drugs, increase sales, and to reduce costs by combining operations and cutting staff. Pfizer, a U.S. company, was also interested in AstraZeneca, a U.K. company, as a way to reduce its corporate taxes. In recent years, AstraZeneca had significantly strengthened its pipeline of potential new drugs and its board felt it was in a strong position to go it alone. The company's CEO also indicated that an acquisition would be disruptive to its drug development efforts and delay new drugs coming to market. U.K. politicians expressed concerns over downsizing and job losses in the economically important pharmaceutical sector. The case allows readers to explore who benefits from a potential acquisition (shareholders, employees, drug consumers) and which of these stakeholders should be considered when deciding on an acquisition.

Mental illness has been described as an epidemic affecting nearly a quarter of all Americans in their lifetimes, often during their most productive working years. Managers who can design organizations that maximize mental health can minimize these risks and boost productivity. This note serves as a guide to understanding mental health in the American workplace. It provides an overview of the most prevalent mental health conditions among employees and the aspects of the work environment that can exacerbate the issues. It also looks at the costs, both to individuals and to companies, of treating or not treating mental health conditions, and outlines the legal framework, insurance plans, and managerial responses to accommodating employees who struggle with mental health issues. To engage students in a role play, the note includes a vignette featuring a struggling CEO.

This case simulation helps students experience first-hand the challenges of multilateral negotiations in global health policy. In World Health Organization Negotiations on Developing and Financing Health Technologies students participate in negotiations as members of the decision-making body of the World Health Organization (WHO). Representatives from all WHO member states attend planning sessions, which focus on a specific health agenda prepared by the WHO executive board. Students must collectively develop a resolution that the 66th World Health Assembly will adopt at the upcoming meeting in May 2013. The focus of the resolution is the development and financing of new health technologies for those diseases that disproportionately affect developing countries. The resolution must be developed in a group process; individual resolutions are not possible. Students play the role of country member states at the Committee trying to develop a compromise that will be adopted by the WHO Executive Board.