Imagine Doing Better

Why Policies Backfire and How Prevention Thinking Can Change Everything

By: Paul J. Fleming

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Hardcover | 9 December 2025

At a Glance

Hardcover
296 Pages

Dimensions(cm)
16.0 x 23.7 x 2.6

Hardcover

RRP $62.99

$56.75

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A bold vision for reimagining harmful public policies through prevention.

Public policies in the United States are built on certain assumptions: that long-term prison sentences deter crime, that corporate profits benefit everyone, that police are the best way to ensure safety, and that meritocracy ensures equal opportunity. Yet, as public health expert Paul J. Fleming reveals, mountains of evidence show that many of these widely accepted policies cause harm, perpetuate inequities, and even lead to premature death.

In Imagine Doing Better, Fleming offers a bold vision for change thats rooted in public health principles of prevention—addressing problems at their root before they occur. Combining rigorous research, historical analysis, and compelling narratives, he examines the deep flaws in policies governing health care, education, justice, and the environment. Fleming unpacks how these systems were built, why harmful assumptions persist, and how they can be reimagined to promote equity, sustainability, and human dignity. Fleming challenges readers to rethink entrenched ideas by exploring thought-provoking questions like "Are prisons a good investment?" and "Is education a ladder or a sieve?". He highlights how budgets and policies reflect moral choices, and he provides frameworks for advocacy and policymaking grounded in evidence and fairness.

Fleming paints a hopeful—yet urgent—picture of whats possible when societies invest in solutions that prioritize human dignity, equity, and sustainability. Accessible and inspiring, Imagine Doing Better offers a hopeful roadmap to a future where all communities have the resources and opportunities to thrive.

Industry Reviews

Written with precision, passion, and moral clarity. This is a book to help us see our world more clearly and envision the better one we might build.
—Sandro Galea, author of Within Reason: A Liberal Public Health for an Illiberal Time

In Imagine Doing Better, Paul J. Fleming calls for a bold shift from reactive fixes to prevention-focused policy that addresses root causes. He blends research, personal insight, and a call to action. Grounded in evidence and empathy, this is essential reading for changemakers and all who seek a just world.
—Brian C. Castrucci, de Beaumont Foundation

Paul Flemings book is an invitation to reject the status quo and radically right-size systems to minimize harm. Reflection and response are daily practices in how we care for others, building muscle memory for justice movements. This is an excellent guide for chaotic times and a reminder to dream beyond the challenges ahead.
—Linh Song, former City Councilmember, Ann Arbor

If we successfully set a welcoming table for all, what might we do while seated there? How might we set a new agenda, organize a meaningful dialogue, and advance a healing strategy? Dr. Flemings work beckons, and I plan to take a seat and prepare for the courageous journey he offers.
—Renee Branch Canady, author of Room at the Table: a Leaders Guide for Advancing Health Equity and Justice

Paul Fleming forces us to ask big questions. What might the world look like if we invest in understanding why bad things happen and prevent them from happening—rather than waiting until its too late? Flemings thinking is urgent, and we should pay attention.
—Abdul El-Sayed, candidate for U.S. Senate and former Executive Director of the Detroit Health Department

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