A difficult but important role for foundations is tackling issues involving important social concerns that are too controversial for the government to fund. In the 1980s, one such concern was sexual behavior and its relationship to public and individual health. The HIV epidemic was emerging, but knowledge of sexual practices influencing the transmission of this and other sexually transmitted diseases was inadequate to shape public health responses.
Despite general agreement among health specialists about the importance of obtaining this information, the government was reluctant to support research that asked people about their private sexual behavior. Although the National Institute of Child Health and Human Development (NICHD) had originally requested a national survey of sexual behavior, the idea was killed when it became known by other parts of the federal government. After that happened, a consortium of foundations stepped forward to fund it. As it turned out, the study engendered little controversy, and the anticipated concerns about respondents' reactions never materialized; rather, Americans were incredibly cooperative.
This chapter of the Anthology describes the experience of fielding the survey and discusses its key public health findings. The knowledge gained from this project exceeded all expectations, and the findings gained widespread attention from the general public as well as public health experts, from cover stories in weekly news magazines to the many articles in academic journals.
- 1. Editors' Introduction
- 2. Reach Out
- 3. A Review of the National Access-to-Care Surveys
- 4. Improving the Health Care Workforce
- 5. Expertise Meets Politics
- 6. The Media and Change in Health Systems
- 7. Addressing the Problem of Medical Malpractice
- 8. Unexpected Returns
- 9. Developing Child Immunizations Registries
- 10. The Homeless Families Program
- 11. The National Health and Social Life Survey