Looking Forward to the Past? The Politics of Public Health

Abstract

This article explores the role of political agents, institutions, circumstances, and ideas in the development of public health policies in Britain. The first part attempts to define public health. The second section of the article looks at the experience of the Victorian public health movement. The final part considers the re-emergence of the public health perspective. The underlying theme of the article is that an awareness of the political dimension, both contemporary and historical, improves our understanding of developments in the field of public health. The main conclusions reached are: first, that given the formidable political obstacles which exist, public health reform will only succeed if the reformers themselves operate with full awareness of the political dimension; second, that the modern public health debate is unlikely to be resolved in the short term.

Features of Evolved Adaptive Responses (FEAR): an evolutionary-developmental model of psychological trauma and common psychological conditions

“…the science and art of preventing disease, prolonging life, and promoting health through the organised efforts of society 205 Public health is a whole-of-society endeavour concerned with the health of populations. Notwithstanding its elegant definition, the historical reality of public health is neither simple nor straightforward -in fact public health is an ideological and political battleground 206,207 . In the orthodox narrative, public health is modelled as a function of biomedical healthcare, however the weight of historical and contemporary evidence indicates that the contribution of biomedical healthcare to public health is marginal to limited.…”

Housing as an instrument of health care

“…This gradual separation of housing policies from health policies was eventually reflected in the establishment of the Ministry of Housing in 1951, independent of the Ministry of Health. The public health movement has become fragmented, with responsibilities divided between a wide range of government departments, making coordination of policy difficult (Baggott 1992). Similarly, at the local level, housing and health have been separated by a series of administrative changes.…”

“…Since the early 1970s the effectiveness of health services has been questioned, with an increasing interest in preventive medicine (Baggott 1992). A 'new public health' movement has emerged which is once again emphasizing the importance of social aspects of health (Green 1993 Seymour 1988).…”

The I-frame vs. S-frame: how neoliberalism has led behavioral sciences astray

“…A trend toward individual health promotion has been observed since the 1980s ( Baggott, 1991 ; Burrows et al, 1995 ) and has coincided with the rise of neoliberal political ideology in the Global North. We propose that this is not accidental, but that the individualization of health research might be the result of neoliberalism.…”

“…Understanding the political ideology shaping health research today is an important first step toward designing impactful interventions on the systemic level. As Baggott (1991) argues “public health reforms will only succeed if the reformers themselves operate with full awareness of the political dimension” (p. 191). It seems that behavioral scientists, especially in the health sciences, pay little attention to the political context in which health behaviors are shaped and researched.…”