Patchwork Pandemic

Stephen Colbrook completed his PhD in policy history at University College London in 2023. His work has appeared in a range of venues, including Modern American History, the Journal of Policy History, Modern British History, and the Washington Post.

Acknowledgments Introduction 1. The Structure of American Public Health Policy Before the AIDS Epidemic 2. Clandestine Networks and Closeted Bureaucrats: AIDS and the Forming of a Gay Policy Network in California 3. Anti-Feminism, Bisexuality, and the Protean Politics of Child Protection: The Anti-ERA Movement and the Illinois Response to AIDS 4. An Unequal Epidemic: Sodomy, State Legislative Capacity, and the Texan Response to AIDS 5. A New Federal Role is Born: The Genesis and Enactment of the Ryan White CARE Act 6. Public Health Divided: Devolution, Geographic Inequities, and the Mixed Legacy of the CARE Act Conclusion Notes Bibliography Index

"This book is a landmark in our understanding of how states respond to pandemics. Stephen Colbrook shows how the structures of federalism, combined with the varying efficacy of local activism, led to dramatic differences in U.S. states' funding for AIDS care. In its skillful integration of state-centered analysis and study of grassroots social movements, Patchwork Pandemic is a model of how policy history should be written."-Beatrix Hoffman, author of Borders of Care: Immigrants, Migrants, and the Fight for Health Care in the United States "In this painstakingly researched, immaculately crafted book, Stephen Colbrook does far more than provide a comprehensive account of contrasting worlds of policymaking around HIV-AIDS in three US States during the 1980s and 1990s. He uses State-level responses to a public health crisis to shed new light on the workings of American federalism, the politics of pandemic response across the twentieth and twenty-first centuries, and how sexual politics became integrated into state politics in often surprising ways. This book will be required reading for scholars of policy history, public health, US federalism, and the history of sexuality."-Jonathan Bell, author of California Crucible: The Forging of Modern American Liberalism "A bright new voice. This book makes a powerfully written, impeccably documented, horrifying and persuasive argument that state legislatures-far more than Congress or cities-shape the vast majority of health care outcomes in this country. The case-study focus on HIV/AIDS advocacy and policy resistance in California, Illinois and Texas helps link the rights revolution and anti-feminist mobilizations to policy outcomes and health care across these three states and regions. Brilliant."-John McKiernan, author of Fevered Measures: Public Health and Race at the Texas-Mexico Border, 1848-1942 "Offering a new and important perspective on HIV/AIDS policymaking in the United States, Stephen Colbrook's illuminating book highlights the central role of federalism and the states in shaping responses to one of the greatest public health crises of the 20th and 21st centuries. Extending the literature on state-building, American political development, and HIV/AIDS, Colbrook examines how a fractured governing system grappled with an emergent, devastating, and highly stigmatized disease. This book will appeal to a broad audience, including readers interested in the HIV/AIDS crisis, the evolution of state capacity, and the dynamics of policy development."-Daniel Sledge, author of Health Divided: Public Health and Individual Medicine in the Making of the Modern American State