Medicine, the Market and the Mass Media: Producing Health in the Twentieth Century (review)

Medicine, markets, and the media have all developed dramatically in scope, complexity, and sophistication since the Second World War, and the interactions among these three domains offer rich material for historical analysis. This is nowhere more obvious than in the emergence of the so-called "new public health," especially the media-based "social marketing" approach that is currently flavor of the month in public health circles. Virginia Berridge and Kelly Loughlin, accordingly, offer the present volume as a contribution to a historical understanding of how markets and the media have impinged on the field of public health, chiefly since the 1950s. The papers that make up the volume address this agenda in rather piecemeal fashion, however.

On the media front, Martin Lengwiler uses French posters to document the importation from the United States of a psychological view of accident prevention during the interwar years. Also in France, Luc Berlivet charts the evolution of anti-smoking campaigns during the 1970s, showing how a "rationalist" approach to health education gave way to a more nuanced social-scientific understanding of the causes of smoking. And for Britain, Lesley Diack and David Smith recount how a local public health official's attempts to use the popular news media to mobilize responses to the 1964 Aberdeen typhoid outbreak were subverted by sensationalist reporting.

The role of markets is examined chiefly through analyses of the role of big business in setting health agendas. In three excellent papers, Vivienne Quirke shows how British drug companies' concern at a declining market for antimalarials led them, together with government agencies, to shift their focus to treatments for cardiovascular disease; Virginia Berridge and Penny Starns document how the United Kingdom government colluded with tobacco companies in adopting "safer smoking" campaigns during the 1970s; and Jean-Paul Gaudillière and Ilana Löwy insightfully contrast the recent market-based introduction of genetic tests for breast cancer in the United States with the more medically dominated approach to screening that still prevails in France. This last paper, in particular, is valuable for demonstrating how large-scale configurations of commercial forces, regulatory regimes, medical pressure groups, and consumer-led social movements may determine the kinds of health options on offer in different settings.

It is less clear how the remaining papers in the volume serve to advance the professed aims of the present volume. Studies of hospital accounting and managerial practices in the early British National Health Service, of the politics of the 1956 Clear Air Act, of the evolution of British regulatory responses to the burgeoning expenditure on medicines since the 1950s, and of contrasting institutional approaches to cardiovascular research in postwar East Germany, while interesting in themselves, add little to our understanding of the interactions between markets, the media, and public health. Despite a helpful introductory overview by Berridge and Loughlin, the volume fails to cohere. As a whole, it serves more to illustrate the diversity of topics and approaches that remain to be explored by historians of postwar medicine and health policy than to advance any particular investigative or interpretative perspective.