Student Bodies: The Influence of Student Health Services in American Society and Medicine (review)

It is hard for anyone to know how much college prolongs adolescence and how much it initiates adulthood, and no one is more uncertain than students themselves. Simultaneously chafing against guidelines that represent the university's responsibility in loco parentis and seeking guidance through the maelstrom of decisions and emotions that attend their newfound freedom, college students move through the liminal spaces of ever-changing social norms. Heather Munro Prescott views this fascinating transitional period through the lens of the institutionalization of student health services on college campuses, which she chronicles from the late nineteenth century to the present. Michel Foucault is an implicitly presiding spirit and interlocutor in this work, as Prescott chronicles the roles of a wide range of social actors in their various (and overlapping) roles as consumers and health care providers, students and educators, in shaping the idea of "student health services." Student Bodies is an engaging analysis of how debates surrounding the establishment of health care services on college campuses at once registered and influenced changing ideas about the transition from late adolescence to young adulthood; about education and society; about race, gender, and sexuality; and about disease, medicine, and citizenship.

There are pioneers in this book—Dr. Edward Hitchcock, Jr., who integrated courses in physical education and hygiene into academic course offerings at Amherst College; Dr. Dorothy Ferebee, who directed Howard University's health services and challenged the structures of discrimination against women and non-white men in both medicine and academia—and there are bodies, practices, and institutions that shift in response to changing social terrains. The relationship between institutions and social change is the thread running throughout the book. Student health services had their roots, for example, in the controversies concerning the education of women. While the founding of women's colleges in the second half of the nineteenth century manifested the growing idea that women could and should be educated, many physicians as well as lay commentators worried publicly that intellectual labor could be injurious to women's health. College administrations' responses to such concerns generated the earliest incarnations of health care services on college campuses, and the particular needs addressed by these services affected health care practice in turn. A focus on hygiene and prevention, for instance, helped to make exercise an important medical concern and introduced mandatory physical education in public schools and universities.

Concerns about "race suicide," a term that registered anxieties about the allegedly growing numbers of immigrants and native nonwhite populations and the shrinking sizes of white middle- and upper-class families, exemplified the moralistic strain that permeated the movement to institutionalize student health care services. Historically black institutions were not exempt from these concerns but were equally preoccupied with the goal of fostering a rising black middle class. If colleges had responsibility for the emotional as well as physical well-being of students, for their behavior, and for the shaping of their characters, it fell to student health care services to assume it.

Prescott's focus on student health care services shows how major events in national history (from world wars to civil rights and sexual liberation) and in medical history (from epidemics to the revolution in "mental health") have affected the conceptualization of bodies and health as well as social relations and subjectivity. The insightful tour through a fascinating history led me to anticipate a perceptive engagement with current student health services: specifically, with what we might learn about our own moment through an exploration of where the institution is now. I was disappointed by a conclusion that mostly summarizes the argument of the book, but that is a minor flaw in a book that is rich in detail, historical analysis, and nuanced interpretation. It is well worth the read.