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Reviewed by:
  • Public Health: The Development of a Discipline, Twentieth-Century Challenges ed. by Dona Schneider and David E. Lilienfeld
  • Max Michael, M.D., Dean
Keywords

public health, twentieth-century healthcare

Dona Schneider and David E. Lilienfeld, eds. Public Health: The Development of a Discipline, Twentieth-Century Challenges. New Brunswick, New Jersey, Rutgers University Press, 2011. xxxiii, 873 pp., illus. Includes bibliographical references and index, $45.95 [End Page 323] .

Across the globe during the twentieth century, life expectancy increased dramatically, if unevenly. In the United States, life expectancy increased thirty years with twenty-five of those years coming from public health interventions and advances. Public Health: The Development of a Discipline traces the remarkable events of the twentieth century from the perspective of public health, giving the reader an unusual perspective on the history of our civilization.

Public Health begins with a chronology of sentinel events that collectively define advances in health and well-being during these one hundred years. The chronology is followed by three sweeping sections— "Population Health Issues," "Diseases," "Therapies," "Prevention," and "Improving Public Health"—that serve as the backbone for chapter headings selected to capture the seminal advances critical to public health. Each chapter begins with an absolutely perfect introduction to place it in its historic context. Following the introduction are several original articles and book chapters that highlight the work and the thinking of the men and women central to this part of the story of public health.

The sections are straight out of Forrest Gump, "Life was like a box of chocolates. You never know what you're gonna get." In "Population Health Issues," the fascinating history of dental caries and fluoridation reads like a Burton Rouché medical detective story beginning at the turn of the century with the observation of mottled teeth by a young dental graduate Fredrick McKay in his new practice in Colorado Springs. Almost a half century later, municipal water fluoridation started in Grand Rapids, Michigan, but remains a sometimes controversial policy. The path from that initial observation to municipal water fluoridation and fluoride tooth pastes highlights the often slow, circuitous way by which an important public health intervention become a part of our cultural fabric.

In "Diseases, Therapies, and Prevention," the HIV/AIDS retrospective brought back chilling memories of personally caring for several of the earliest victims of the epidemic at our county hospital. I well remember the fascination with trying to unravel a new disease, grapple with what to tell my patients and how best to allay my own anxieties about this mysterious illness; and even now I marvel at the breathtaking reality of how public health efforts to quickly understand the sociobiology of HIV/AIDS and mount massive educational campaigns against a backdrop of social stigma converted a death sentence to a chronic disease in less than a generation.

Finally, in "Improving Public Health," the huge challenges of medical care, medical ethics and human research, and global health round out this thoroughly engaging book. The section on medical care explores the relative imbalance in developed countries of our massive investments in a system focused on sickness relative to health promotion and disease [End Page 324] prevention. The implications of this imbalance gets played out in how the developed nations invest in improving the health and well-being in developing nations and how private philanthropy is beginning to shape global health policy in an era of global economic disruption.

As the authors note, you can quibble with the chapter topics and the selection of the original papers, and I found myself thinking of other potential chapter topics or paper selections—e.g., malaria instead of TB, or pellagra instead of Vitamin A, or obesity instead of cardiovascular disease— only to realize how effectively the authors were able to focus a massive sweep of history into something manageable and digestible. This is a book to be savored, to be picked up, and sampled from time to time to help keep some of the daily tedium in its proper historical perspective. We all want the work we do in public health to matter; we want to be part of that seminal breakthrough that changes the dynamics between health and...

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