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

Be Wise! Be Healthy! Morality and Citizenship in Canadian Public Health Campaigns is a well-written, well-organized, and well-researched monograph. Although the title suggests a national study of public health campaigns across the provinces and territories, Carstairs, Philpott, and Wilmshurst instead provide a case study of a local Toronto public health organization that had national ambitions, rather than a national presence. While the Health League (HL) went on to open branches in other provinces, it always remained a “Toronto-centric” organization.

At the turn of the twentieth century in North America, the “New Public Health” approach shifted the focus from environmental factors towards individual responsibility for good health. Indeed, good health responsibility was directly tied to civil responsibilities, creating an image of the ideal health citizen in Canada. Pulling from British historian Dorothy Porter’s work, the authors argue that the HL espoused a “health citizenship” rhetoric that engrained in Canadians the belief that if they followed doctors’ advice, had regular checkups, ate well, and exercised, they would be healthier and more productive members of society. The Canadian National Council for Combatting Venereal Disease (CNCCVD) was established based on these ideals in 1919 by Gordon Bates (1885–1975), a Toronto physician who specialized in treating venereal disease (VD). However, Bates and his organization continually ignored the realities of poverty and the unique hardships placed on minorities and immigrants in Canadian society. His ideal health demographic was middle- and upper-class white Canadians. The organization went through two name changes; in 1922, it became the Canadian Social Hygiene Council (CSHC), and in 1935, the HL.

Heavily influenced by positive eugenics and social hygiene theories, the CNCCVD’s initial mission was to eradicate VD in Canada, and the organization was largely successful at educating the public on prevention and treatment through films, radio, public talks, travelling exhibits, and reading materials, all with a major emphasis on prevention through good morals and open discussion. The number of soldiers coming out of the First World War with VD paved the way for physicians like Bates to discuss and destigmatize sexually transmitted diseases. One of the more prominent aspects of Bates’ anti-VD campaign in the 1920s was the feminist angle, whereby the sexual double standard was challenged in the CNCCVD’s material and pressure was applied on young men to avoid premarital relations. When Bates renewed his anti-VD campaign in the late 1930s and 1940s, however, he changed his tune, and instead began warning men about “dangerous” women in society.

Funding for the HL significantly increased during and after the Second World War, at the same time that infectious diseases were declining and chronic illnesses were growing in both number and national attention. This lead the HL to diversify and broaden its health education programs, incorporating: Toxoid Week (against diphtheria), an industrial health division, renewed anti-VD programs, immunization programs, nutritional programs, milk pasteurization, and municipal water fluoridation campaigns. The HL also launched National Immunization Week (1943–71) and National Health Week (1944–80), arguably two of its most successful projects, and the closest it came to having a national influence.

The HL emerged at a time when volunteer organizations held more influence, funding, and roles in Canadian society. Bates, exemplifying his generation, was uneasy with governments conducting public health campaigns, as he thought they placated the population rather than fought for controversial health issues. When the CNCCVD began, the federal and provincial departments of health did not have the resources to organize and conduct public health campaigns on a large scale. Organizations like the HL had large networks of influential members in the business, medical, and political spheres, as well as in churches and schools. They also had working relationships with service clubs. As the state became more involved in the day-to-day lives of citizens, and national...