Imagine Doing Better: Why Policies Backfire and How Prevention Thinking Can Change Everything

by Paul J. Fleming

A bold vision for reimagining harmful public policies through prevention.

Public policies in the United States are built on certain 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 that's 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 what's 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.

296 pages, Hardcover

Published October 14, 2025

Reviews

[William Lopez · Rating 5 out of 5]

I had the privilege of reading an early draft of this book and I am excited to see it in the world. Cover to cover, it's an engaging read that forces you to ask hard questions about what type of world you want to see--and how you plan to work toward it. Fleming's writing is smooth and easy-to-read, blending stories from his life as a father and professor with reflections on community organizing, public health theory, and activism. This is a great book, and I'd recommend it for other undergrad profs (like me) who want to push their students to think of the future they can build instead of critique what's done.

[Jonathan Heller · Rating 5 out of 5]

More people need to read this book. Given the devastation public health is facing in these times, this is a crucial book. It shows us - in clear and straightforward language and stories - what thinking from a public health perspective can achieve and how that kind of thinking can help us address many of the thorny problems we face.