Three decades ago Elizabeth Fee, an eminent public health historian then at Johns Hopkins School of Hygiene and Public Health, published Disease and Discovery, a monograph that detailed the first three decades of the school's history. It was a remarkable effort that met the needs of the school for what might have been in less competent hands a "house history." But what made it remarkable was that in her capable hands it raised a serious foundational question that has haunted public health since: "If public health constituted the study of disease in society, how much attention should be devoted to disease and how much should be devoted to society?" (p. 6). If the former, we can judge Hopkins' success by the enormous number of research grants, epidemiological studies, laboratory discoveries, and technical innovations it has spawned. If the latter, Hopkins' success had to be measured by its engagement with the myriad efforts at social reform that shape the public's health. Sanitation, housing, even income inequality were essential issues that public health should have in its purview. In Fee's telling, there is certain ambivalence, if not disappointment, that Hopkins adopted the "medical [End Page 459] model" in which scientific research trumped social science as the school, and by extension, much of public health's identity ever since. While social science and health education, for example, were incorporated into the curriculum they were in large measure grafted onto Hopkins' established science and research agenda.
I begin with this brief review of the "first volume" ofJohns Hopkins' history as a new edition has been published and because it set the stage for the new effort by Karen Kruse Thomas to bring the story of Hopkins forward another half century to 1985. Health and Humanity builds on Fee's work to trace the evolution of the school from early struggles over public health's core social and research values to its emergence as a center of what is now called "evidence-based" public health research. Today, the Bloomberg School is perhaps the best endowed and financially stable schools of public health in the country and a magnet for federal funding. In her introduction she neatly outlines tensions she experienced as she wrote: a demand to write a "compelling - and marketable" narrative that "would reach a general audience" and "a homage to the trials and accomplishments of the men and women who have built one of the world's oldest and most recognized schools of public health" (p. xiii).
In many ways the book is an admirable attempt to capture the place of the Bloomberg School in the history of public health for it seeks to address Hopkins' ambiguous position in Baltimore, the nation, and the world as public health itself underwent its own redefinition. From its nineteenth century origins in engineering, sanitation, housing reform, and moral suasion, the demands placed on the field have expanded exponentially. Today, there is a bewildering array of social and biological factors that shape our understanding of the field's responsibilities. In addition to traditional functions of stemming infectious disease through the identification of the sources of toxic or microbial dangers, vector control, guaranteeing of pure water and unadulterated food are the added responsibilities to end "epidemics" of non-infectious conditions like diabetes and obesity, as well as gun control, bioterrorism, and police violence, to name a few.
The book traces the history of public health through the lens of Hopkins' expanding research agenda in both the local, national, and international contexts. It begins by tracing what Thomas calls "the Southern Roots of Public Health," identifying the deep roots many of the early deans and administrators had in traditions and attitudes that would quickly come into conflict with the very real demographic change...