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WITHOUT IT, WE ARE CONDEMNED TO REPEATING OURSELVES
It’s a cliché, that without a knowledge of history we’re condemned to repeat it. This is especially true of health policy and public health. Remarkably, despite the renaissance of public health over the past 20 years, our history has remained all but invisible. The journal intends to change all that, and, beginning this month, we will be carrying regular historical contributions. To kick us off, Virginia Berridge and Martin Gorsky contribute an Editorial on the importance of the past in public health linked to a paper by Scally and Womack, which includes some good signposts for the beginner. The recently established Centre for History in Public Health at the London School of Hygiene and Tropical Medicine should help to provide us with a focus, but clearly it is important that a historical capacity should be built in all those academic institutions that lay claim to educating the next generation of practitioners at both undergraduate and postgraduate levels. This point is further elaborated in a veritable manifesto for public health history by Gabriel Scally. See pages 728, 751
The humanities are further represented in this issue by several contributions in Continuing Professional Education. Mackenbach reflects on the streets of Paris, sunflower seeds, Nobel Prizes and the quantitative paradigm of public health, while two further papers in the same section launch our commitment to exploring the contribution of literature to epidemiology and public health. This series was inspired by a course on social epidemiology delivered by Professor Ichiro Kawachi at the Summer School of Public Health on Menorca, where it was agreed that some novels could be of particular utility for students of social epidemiology. The inclusion of literary studies in medical schools has shown a continued growth in recent years, and there is a wide recognition that the study of literature can make relevant contributions to the practice of medicine. For example, it has been recognised that literature, among other potentialities, can help doctors understand what happens in patient’s lives and develop empathy. Epidemiologists and public health practitioners are usually more distant than doctors from their object of inquiry and work, the human population. Although epidemiologists regularly manage phenomena like social stratification, working conditions, or perinatal risks as variable categories in their analysis, their real knowledge of these facts could be limited. Furthermore, because of their population approach, epidemiologists also need a thorough insight into people’s environments, including families, neighbourhoods, social milieu, working conditions, and allied factors. The narrative knowledge stimulated by reading literary texts facilitates the understanding of these subjects, but the links between literature and epidemiology have been apparently scarce in the related scientific production. The first two pieces in our series on Literature and Epidemiology are published in this issue. Ichiro Kawachi proposes that we travel back to the end of the 19th and beginning of the 20th centuries as viewed by five American authors, while Naomar Almeida-Filho portrays the parallels between the central topic of the book All the Names by the Portuguese writer Saramago and epidemiological methodology. Although with different approaches, both papers remind us of the commitment of epidemiology to the foundations of public health: human rights and social justice. In the words of Naomar Almeida-Filho, “the new epidemiological dream is having our young science deeply committed to human emancipation and social equity and justice”. Contributions to this series are most welcome. See pages 734, 738, 743
Staying with continuing education for a moment, and also with history, Virginia Berridge and Sarah Mars provide a Glossary on the history of addictions. Note the use of the term “addictions”—a contested term that the World Health Organisation sought to replace by the word “dependence” in 1964. It is interesting that the word “addiction” continues to enjoy such currency. Perhaps we could have some debate on this subject? Note also that Berridge and Mars’ first names are used in full, this in response to Debbie Lawlor’s complaint that our journal policy on naming was resulting in women being given male identities. In Speakers’ Corner this month, Lawlor expands on her theme. See pages 747, 726
All three Gallery contributions have a historical spin in one way or another. From Glasgow and Gaza a comparison of housing in slum areas separated by almost 100 years, and from Fes an occupational and environmental hazard related to tanning (not the type that we are now familiar with in England, where healthy young women subject their skin to the rapid aging caused by sun beds). Deborah Salerno draws to our attention the hazards of an industry that used to exist in other parts of the world, but whose public health consequences have now been largely exported to less fortunate parts of the world. Will occupational health standards trickle down any more successfully than economic development? And from New York, photos of the City Public Health Department, a building from the early 20th century and reminiscent of the London School of Hygiene with its own pioneer hall of fame, where the surnames of (all male?) public health pioneers are displayed loud and clear within a few blocks of the World Trade Centre site. See pages 727, 733, 778
Discussion about the appropriate methodologies for evaluating complex public health interventions seem to have moved on to a new level. This is reflected in Helen Roberts’ Editorial exploring some of the issues. Surely we also now need narrative and case studies to be included in the repertoire—something touched on in a paper in Theory and Methods by a group from the Social Science Research Unit at London University in their examination of systematic reviews and peoples’ views. See pages 729, 794
Behind the scenes, many of our Board members continue to make important contributions to this journal, and this month one of them, Ana Garcia, provides a thoughtful Editorial on the Uniform Requirements for Manuscripts produced by the International Committee of Medical Journal Editors. This might seem like a very dry topic, but in seeking to serve both our public and our authors, it is something that we as an Editorial Board must take very seriously, and about which all parties to publication have a duty to keep themselves informed. We would also like to express our thanks to Ana for her assistance with the revamp of our “Guidelines for authors and reviewers” at http://jech.bmjjournals.com/misc/ifora/ See page 731
Other points this month include:
a report of mercury contamination at unsafe levels in women of reproductive age in a Caribbean island;
two valuable explorations of the use of capture-recapture techniques for service planning in relation to problem and injecting drug misuse;
a neighbourhood comparison of self rated health between London and Helsinki (high rates of single parenthood were associated with health impact in London, but not Helsinki);
and an analysis of social position and minor psychiatric morbidity in Britain between 1991 and 1998 (the impact of unemployment and minor psychiatric morbidity was higher for those who were previously in a more advantaged social class position;
and finally, in Theory and Methods, a further discourse on methods for exploring variation in implementation in local contexts, including the use of written and oral narratives.