Abstract
Hoppe delivers a compelling critique of criminal justice’s incursion into public health. Examining efforts to criminalize disease through a case study of HIV, Hoppe sheds light on the mechanisms that facilitate the legitimization of criminalization as a disease control strategy and the consequences of that approach. Leaning on the early link made between AIDS and homosexuality, Hoppe outlines the potential for diseases to crystalize a specific set of social anxieties to propagate blame and highlights blame’s powerful role in starting the process through which sickness becomes criminal. Hoppe’s searing analysis forces readers to confront the assumptions embedded in perceptions of public health threats, acknowledge the role of prejudice and power, and uncover the harm perpetuated by punitive approaches to disease control. In Punishing Disease, Hoppe sets out to convince policy makers and the public that the effects of criminalization are predictable, reproducing stigma at the expense of—not in support of—public health. Through astonishingly detailed and varied analyses, Hoppe achieves this purpose, outlines remedial policy options, and proposes a conceptual map to assist stakeholders in recognizing this debilitating response to disease before its effects can be institutionalized in new battlegrounds, such as hepatitis and meningitis.
Punishing Disease outlines the progression from coercion to punishment to criminalization in its two sections: (1) Punitive Disease Control and (2) The Criminalization of Sickness. While Hoppe is careful to contrast coercion and punishment, the book’s formal organization understates the first phase in the progression. Hoppe’s remedial policy options provide a glimpse of what alternatives to HIV punishment and criminalization may have looked like, but Hoppe does not explore alternative state hypotheses in his discussion of coercive (rather than criminal) disease control. Similarly, by ending with a chapter on victim impact, Punishing Disease deemphasizes a class of HIV disclosure law victims for which it exists to advocate. While the impact of criminalizing HIV is peppered throughout from differential advertising and access to treatment to the various sentences listed in relation to the cases’ victim type, Punishing Disease does not present a unified and comprehensive summary of how these laws have increased and perpetuated harm to individuals living with HIV. Such a summary may have enhanced Hoppe’s call to action to prevent the expansion of HIV disclosure laws to other diseases.
The data behind Hoppe’s narrative could not be more powerful. Punishing Disease relies on a comprehensive suite of data that align with each stage of its argument. Hoppe, for example, balances key outcome evaluations with studies of public opinion and content analyses of public policy and ad campaigns. Stressing blame’s role in distinguishing punishment from coercion, Hoppe connects his argument associated with classical coercive disease control to the emergence of a policing role among public health officials through an analysis of the “HIV Stops with Me” ad campaign. This campaign’s promotion of personal (rather than collective) responsibility for disease control introduced compelling information that would likely have been lost in a purely quantitative study. The expert balance Hoppe struck between quantitative and qualitative analyses was critical to supporting the full range of his comprehensive, systemic argument.
Despite its testament to Hoppe’s mastery of various schools of thought, Punishing Disease missed a critical opportunity to explicitly contribute to the wave of federal attention to evidence-based policymaking. Readers familiar with the decision-making perspective will see opportunities for its advocacy interwoven in Hoppe’s contrast between scientific risk and value-motivated criminalization. Punishing Disease provides the information one would need to frame an evidence-based approach to HIV treatment and control but leaves it to the reader to make this connection. Future editions may consider facilitating this connection directly to build on the growing federal attention to policy and practices backed by research.
Punishing Disease adds an HIV case study to a growing body of evidence that shows how much progress remains in the effort to base policy—both public health and criminal justice—on empirical evidence. Perhaps disappointingly for the many criminologists who are more optimistic about research utilization in public health, often leaning on the medical field as an example of how these models can be institutionalized within a practitioner community, Hoppe’s study of HIV shows that both public health officials and criminal justice actors misunderstand the scientific risk associated with HIV transmission. Hoppe’s research, especially his interviews with Michigan public health officials, shows that there is still significant progress needed to base public health policy on science. The conceptual map he derives through his mixed methods research could not be timelier as lawmakers in several states consider extending felony HIV disclosure laws to additional diseases such as hepatitis and meningitis. The breadth and depth of Hoppe’s methodological approach positions Punishing Disease to make a significant contribution to public policy debates as it walks readers through the full cycle of the argument with tangible examples and statistics.
