Public Health

The Development of a Discipline, Volume 2, Twentieth-Century Challenges, vol. 2

Edited and with an introduction by Dona Schneider and David E. Lilienfeld

Publication Year: 2011

Published in 2008, the first volume of Public Health focused on issues from the dawn of western civilization through the Progressive era. Volume 2 defines the public health challenges of the twentieth century--this important reference covers not only how the discipline addressed the problems of disease, but how it responded to economic, environmental, occupational, and social factors that impacted public health on a global scale. Major illnesses such as cancer, HIV, and tuberculosis are addressed, along with lifestyle concerns, such as tobacco and nutrition. Chapters also explore maternal-child and women's health, dental public health, health economics and ethics, and the role of philanthropy. Each chapter begins with an in-depth introduction, followed by three original articles that illustrate the problem. The volume is enhanced with a detailed chronology of public health events, as well as appendices that contain many of the original documents that ushered public health into the new millennium.

Published by: Rutgers University Press

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The works included in this volume were scanned, dictated, transcribed, or typed in from the originals. Several of the pieces chosen as selected readings have been reprinted in other venues, some more than once. A few of the selections have won awards and, where appropriate, we note this information for the reader in either the source statement following the selected reading or in the suggested readings at the end of...

Acknowledgments

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pp. xi-xii

Introduction

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pp. xiii-xvi

In 1900, life expectancy for whites in the United States was about 50 years; for blacks it was about 35 years. In En gland and Wales, life expectancy in 1900 was about 45 years; in India it was about 23 years. A century later, life expectancy had risen across the globe, though unevenly. Those born in the United States, the United Kingdom, and most of Eu rope in the year 2000 could expect to live into their mid to upper...

Chronology

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pp. xvii-xxxii

List of Abbreviations

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pp. xxxiii-xxxvi

Part I: Population Health Issues

1. Food and Nutrition

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pp. 3-54

Significant efforts were made in improving the quality of food and its nutritional value over the course of the twentieth century, in both developed and developing nations. These efforts included but were not limited to fortifying foods to prevent diseases such as goiter, rickets, beriberi, and pellagra. Many nations passed legislation that would improve food safety and guarantee the accurate labeling of food products. Yet as the century came to a close, problems related...

2. Tobacco

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pp. 55-110

James Albert Bonsack's September 4, 1880, invention of the cigarette rolling machine sparked little interest from the era’s large tobacco companies. Yet one chief executive officer, James Buchanan Duke of W. Duke and Sons, understood the machine’s potential; he purchased a number of them. Within a decade, Duke’s trust, the American Tobacco Company, defined the American industry. Assured a plentiful supply of product after buying the Bonsack patent, Duke focused on...

3. Dental Health

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pp. 111-161

Legend has it that George Washington had a set of wooden dentures, but this is apparently not so. Multiple sources report that although the first U.S. president did have several sets of dentures, they were made of metals, ivory, and various types of reshaped teeth (cow, elk, and perhaps human). Washington was fortunate to be able to afford dental care, such as it was in his day. His wealth made luxury items such as dentures available to him in the eighteenth century, a time...

4. Environmental Health

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pp. 162-215

On December 24, 1968, the three astronauts of Apollo 8, William Anders, Jim Lovell, and Frank Borman, commanded more than the first manned spacecraft to orbit the moon. They commanded our attention as one by one they began their televised reading from Genesis, the story of creation from the Bible. The reading from lunar orbit was done with a backdrop of the earth rising behind the moon, thus creating a striking image depicting the isolation and frailty of...

5. Occupational Health

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pp. 216-257

In the early 1950s, the medical director of one of the leading British asbestos companies, John Knox, approached a young English epidemiologist, Richard Doll, for help with some statistical analyses on the mortality experienced by workers in Knox’s company. Both men were stunned at the extent to which asbestos workers died compared to the general population. Doll was working on a paper reporting their findings when Knox told him to cease because his company did...

6. Women's Health

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pp. 258-298

The twentieth century began steeped in the Progressive Era, with women in many developed nations marching for the right to vote and the right to control their reproductive health (see Volume I, Chapter 22, Margaret Sanger). Everything changed mid century, however. The right to vote had been recognized in many nations, and oral contraceptives fostered an explosion of sexual freedom and women’s pursuit of careers. New demands emerged as views changed...

7. Maternal Child Health

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pp. 299-338

At the dawn of the twentieth century, global statistics for maternal– child health were grim and remained so at century’s end. In 2000, the United Nations estimated more than 1,500 women died daily from complications of pregnancy and childbirth— more than half a million maternal deaths annually. Additionally, about 10,000 babies born each day didn’t take even one breath. Of those born alive, 10,000 more died daily, never living even one month. The WHO reports...

Part II: Diseases, Therapies, and Prevention

8. Tuberculosis

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pp. 341-399

War is expensive, and World War II was no exception— in both lives and money. Although victorious at war’s end, Great Britain was broke. By 1948, Britain no longer controlled India, its fount of wealth, and the nation contemplated how to best fund its national health care system, the National Health Ser vice (NHS). A major consideration was how to deal with tuberculosis (TB). The discovery of streptomycin in 1943 by Selman Abraham Waksman at Rutgers...

9. HIV/AIDS

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pp. 400-432

Gaëtan Dugas, the French-Canadian flight attendant identified as “Patient Zero” in the Acquired Immunodeficiency Syndrome (AIDS) epidemic, suffered the same infamy as did Mary Mallon (“Typhoid Mary”). As an inapparent carrier of the human immunodeficiency virus (HIV), Dugas passed on the infectious agent to others without knowing that he was infected. Such is the tragedy of infectious diseases with long latency periods. Their spread is silent but deadly...

10. Vaccine-Preventable Diseases

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pp. 433-474

When the World Health Assembly made its historic 1980 declaration that the world was free of smallpox, the vast majority of physicians in the developed world had never seen a case of the disease. The announcement came at a time when there was a general belief that many of the vaccine- preventable diseases would soon be eradicated. Indeed, American families had lined up their children to be “Polio Pioneers” in the 1950s, convinced that protection from the scourge was...

11. Cancer

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pp. 475-519

We are here today for the purpose of signing the Cancer Act of 1971. I hope that in the years ahead that we may look back on this day and this action as being the most significant action taken during this administration. It could be, because when we consider what cancer does each year in the United States, we find that more people each year die of cancer in the United States than all the Americans who lost their lives in World War II...

12. Heart Disease and Stroke

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pp. 520-564

Cardiovascular disease (CVD) encompasses many conditions, including coronary heart disease, hypertension (high blood pressure), peripheral artery or vascular disease (PAD, PVD), cerebrovascular disease (stroke), hypertensive kidney disease, congestive heart disease, and valvular heart disease (including rheumatic heart disease). Concurrent with the rise in coronary heart disease mortality were increases in stroke mortality and in the prevalence of...

Part III: Improving Public Health

13. Medical and Preventative Care

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pp. 567-646

Medical and preventative care underwent a revolution during the twentieth century, beginning with great emphasis on public health solutions, such as providing potable water and controlling infectious diseases, and ending with medical attempts to stem the impact of chronic diseases. At the century’s beginning, tuberculosis, pneumonia, smallpox, and typhoid fever presented major infectious disease challenges. Although some public health measures against these diseases...

14. Medical Ethics and Human Research

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pp. 647-689

Professionals involved in medical and preventive care often cite the Hippocratic Oath with the dictum “Do no harm” (see Volume I, Chapter 1) as the beginning of medical ethics, but the evolution of the field usually gets little attention. It was the rise of scientifically focused clinical practice in the late nineteenth century that brought medical ethics, specifically informed consent, to the attention of the medical community as a pressing matter. For example, in 1891 Prussia...

15. Global Health

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pp. 690-736

Although the Greeks were known for hygiene and the Romans for their public works, modern man had a much harder time learning not to foul his nest. The economic engine of the Industrial Revolution needed the balance of the Sanitary Revolution to bring both hygiene and public works back as respectable concepts to maintain the public’s health (see Volume I, Part II). Twentieth- century man’s devotion to technology sometimes blinded him to simple solutions and in...