Be Wise! Be Healthy! Morality and Citizenship in Canadian Public Health Campaigns by Catherine Carstairs, Bethany Philpott & Sarah Wilmshurst (review)

The recent unveiling of the new Canada Food Guide reminds us that the Canadian government has a vested interest in keeping its citizens healthy. One has to wonder: has it always been this way? In this important new book, historians Catherine Carstairs, Bethany Philpott, and Sara Wilmshurst show us that over the last century, health has become inexplicably tied up with notions of responsible citizenship. In the initial absence of a comprehensive public health department in Canada, nongovernmental organizations had a critical role in shaping contemporary views on health. These efforts have received little historical attention. This book starts to fill this gap by examining one such organization. Between 1920 and 1970, the Health League of Canada, under the leadership of Dr. Gordon Bates, played an important role in educating the public about new health initiatives. Underlying the league's mandate was a belief that individuals needed to take more responsibility for their health. Utilizing an impressive array of primary sources, the authors trace the rise and decline of the league's influence on public health.

What began as a council to combat venereal disease (VD) eventually grew to include a wider range of proposals aimed at improving the overall health of Canadians. As the authors show, the league began advocating for the implementation of many initiatives that have since become ingrained as everyday notions of healthy living. Pasteurization, nutrition, fluoridation, and immunization were all movements that were championed by the league. These campaigns were different because they moved away from blaming environmental factors like inadequate housing or contaminated water for illness and disease. In doing so, the behavior of the individual became paramount to new health movements. This shift relied on the rise of health experts and their considerable effect on new public health initiatives. The authors make it clear, however, that this role was not clear-cut, as the social hygiene roots of the league heavily influenced its policy recommendations. Interestingly though, immigrants and Indigenous peoples were largely ignored by the league's appeals. Other studies have shown that during this period there was a concerted effort to get both Indigenous and immigrant populations to subscribe to a preferred 'Canadian' way of life that encompassed diet, health, and household habits. Instead, as this book demonstrates, the league's approach focused on an audience that was assumed to be white and middle class. The Health League ignored factors such as poverty or accessibility that contributed to ill health. People who did not adhere to the league's vision, rhetoric at the time held, were either ignorant or lazy, and shirking their duties as good citizens.

Although the book focuses on a case study of one organization in Toronto, the in-depth examination of the Health League's history allows us to see a broader picture of how health policy was created and disseminated in modern Canada. The tactics that were employed often cultivated fear and judgment, but the league did offer sound advice for many of the issues it took on. While the league exerted more influence at the local level, it did help shape the national discourse on public health. This kind of case study also provides a valuable tool of comparison. Why did the Health League fail while other voluntary health organizations created during the period survive? Rather than adopt new mandates, after the 1950s the league remained committed to "fighting battles they had already largely won" (p. 17). This problem stemmed from the composition of the league at the executive level. The authors argue that studying the history of the league "teaches us how important it is for voluntary groups to renew their leadership over time" (p. 208).

Gordon Bates is a figure that looms large in the history of venereal disease, but sexual health was not...