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Public Health: An Introduction

Lecturer: Christopher Sirrs

This lecture introduces the theme of ‘public health’ and examines how it was transformed in Britain over the 19thand 20thcenturies. What is ‘public health’, and how is it distinguished from ‘medicine’? What activities have come under the rubric of ‘public health’? From a concern with sanitation and infectious diseases in the 19thcentury, to the management of various health services in the inter-war period, and the focus on chronic diseases and lifestyles in the late 20thcentury: the definition and objects of public health have been highly fluid, and subject to significant political contention.

Discussion/Essay Questions:

  1. Who or what is the ‘public’ to which ‘public health’ refers? How did the ‘public’ figure in the changing focus of public health in Britain in the twentieth century?
  2. How did the major reorganisations of health services in Britain in 1948 and 1974 influence the shape, direction and influence of public health?
  3. What was the relative importance of the following to the decline in mortality in Britain in the 19thcentury: improved medical technology, public health measures, or improved nutritional and living standards?

Required Readings:

Mold, Alex, Peder Clark, Gareth Millward, and Daisy Payling. Placing the Public in Public Health in Post-War Britain, 1948–2012. Cham: Springer International Publishing, 2019., [open access PDF], Chap. 2.

Lewis, J. What Price Community Medicine? The Philosophy, Practice and Politics of Public Health Since 1919. Brighton, Sussex: Wheatsheaf Books, 1986

Colgrove, James. ‘The McKeown Thesis: A Historical Controversy and Its Enduring Influence’. American Journal of Public Health 92, no. 5 (1 May 2002): 725–29.

Further Readings:

Berridge, Virginia. Public Health: A Very Short Introduction. 1 edition. Oxford, United Kingdom ; New York, NY, United States of America: Oxford University Press, 2016, especially Chapter 1.

Berridge, Virginia, Martin Gorsky, and Alex Mold. Public Health in History. Maidenhead: Open University Press, 2011.

Hardy, Anne. The Epidemic Streets: Infectious Disease and the Rise of Preventive Medicine, 1856-1900. Oxford: Clarendon Press, 1993.

McKeown, Thomas. The Role of Medicine: Dream, Mirage, or Nemesis? Princeton University Press, 2014 [1979].

Porter, D. The History of Public Health and the Modern State. Amsterdam, Netherlands: Clio medica, 1994.

Porter, D. Health, Civilization and the State: A History of Public Health from Ancient to Modern Times. London: Routledge, 1999.

Szreter, Simon. ‘The Importance of Social Intervention in Britain’s Mortality Decline c. 1850–1914: A Re-Interpretation of the Role of Public Health’. Social History of Medicine 1, no. 1 (1988): 1–38.

Szreter, Simon. ‘Rethinking McKeown: The Relationship Between Public Health and Social Change’. American Journal of Public Health 92, no. 5 (1 May 2002): 722–25.

Welshman, John. Municipal Medicine: Public Health in Twentieth-Century Britain. Studies in the History of Medicine, vol. 1. Berne ; Oxford: Peter Lang, 2000.