In a way, the theme of this issue—Special Populations—is a bit nonsensical. Labeling some groups as “special” implies that the rest of the population is somehow homogenous and humdrum, of no special interest or requiring no special considerations. We know, of course, that is an illusion, that in fact the populations of the Northwest states are really just a composite of a nearly infinite number of subgroups, each with unique or special characteristics. Globalization, as an ongoing social and economic phenomenon, is rapidly dispelling the myth of a singular, dominant, white, European America.

This reality matters for public health for two reasons. First, to be successful and sustainable, community-level efforts to reduce health threats or to strengthen health assets must be tailored to the specific context and conditions present. Second, it seems true that some segments of our society are always “on the outs,” ignored or disenfranchised by public policy and programs, economic development, or world events (just consider the current raging debate about immigration and immigrants). Since threats to public health, such as drug resistant tuberculosis or a terrorist attack using some biologic agent, don’t necessarily respect race or class boundaries, it is in all of our interests that interventions to protect community health be sensitive and responsive to the special conditions under which marginalized groups live. For these reasons, the construct of  “special populations,” though flawed, may be useful in designing community health initiatives both to bring such groups into the fold of public health and to learn how to better promote well-being in the broader community. That’s the value of this issue of Northwest Public Health.

One characteristic of special populations is that they are, to one extent or another, invisible to society at large or to the powers that be. Take for example, people with autism. How many news stories about victims of Hurricane Katrina did you hear or read that reported on these individuals? Although the news media didn’t focus on them, some folks at Boise State University sure did, and the story of their efforts to support displaced families with autistic members is fascinating and instructive (Reischl, Oberleitner, and Simper).

Another “special” characteristic is being a social outcast, a member of groups the rest of us would rather forget, which are subjects of articles on public health issues concerning inmates (by MPH student Maggie Jones) and homeless people (Wenger). Rink, Zukoski, and Edmunds, discuss a group that is not, generally speaking, ignored or shunned, but whose role in sexual health has been largely ignored: young men. Two other articles focus on issues facing urban Indians (Taualii and Forquera) and people with disabilities (Abdullah and Horner-Johnson). A model for maintaining effective linkages and communications with “special” communities are the subjects of pieces by Tillman and Holmgren, respectively. And, though we tend to shun manuscripts that are primarily about research, we found the study of a simple method to detect dangerous chemicals on farmworkers’ hands intriguing and possibly useful for practitioners (Stoffels, Russell, and Lammers).

Pay attention to the Viewpoint by Saylor, Graves, and Cochran, as they challenge the oft-used deficit approach to community health planning, and to the Northwest Region at a Glance display of data on special populations in our six-state area. Finally, in this issue we present one article that doesn’t quite fit the theme, but whose topic is nonetheless very important: the economics of school soda contracts (Pinson).

Table of Contents

Aaron Katz, Editor-in-Chief
Director, UW Packard-Gates Population Leadership Program