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The politics of the healthy life: an international perspective
  1. John Powles

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    Edited by E Rodríguez-Ocaña. Sheffield: European Association for the History of Medicine and Health Publications, 2002, £37.92, pp 288. ISBN 0-9536522-5-4

    The first part of the 20th century is a fascinating period in the history of public health. In the north Atlantic countries mortality decline accelerated and social gradients in survival chances steepened. The pace of health improvement was set not by technical advance but by social reorganisation.

    The essays gathered together in this book mostly centre on this period with the six essays of the second part, on “the international theatre and the locus of expertise”, being of special interest. Paul Weindling deals with the transition from “moral exhortation to the new [sic] public health, 1918–45”, instancing especially the Rockefeller medicine men who “advanced holistic initiatives in community health, and generated a wave of radical experimentation on how to measure health and produce the healthy life in the modern mass society” (page 127). Moser and Fleischacker show how the intellectual response among German hygienists to the demographic shock of the first world war prepared the ground for the German medical profession’s embrace of “racial hygiene” in the 1930s. Murard and Zylberman present a dense and colourful account of the French “public health map” in the 1930s—including the “road not taken” to socialist medicine. The public health leader Hazemann, although a member of the Communist Party, heaped “praise on planning by, not Soviet, but American hygienists”: “Some day, mathematical formula will replace social relations”. Gillespie offers a fascinating account of the creation of the WHO after the conflagration of the second world war, concentrating on the central roles of the US and the UK. Hostility to international agencies was rising in the US and they were especially determined that medical insurance should not be a topic of international deliberation. The US Congress had still not relaxed its opposition to full US participation in the WHO on the eve of the first World Health Assembly in 1948. The WHO played it safe and “spent its first two decades absorbed in disease eradication campaigns and technical work on standards and nomenclature” (page 234). A consolidated bibliography and an introductory essay by the editor add further value to this work.