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This Article Figures Only Full Text Full Text (PDF) All Versions of this Article: AJPH.2009.163956v1 100/1/54    most recent Submit a response View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Fairchild, A. L. Articles by Fried, L. P. Search for Related Content PubMed PubMed Citation Articles by Fairchild, A. L. Articles by Fried, L. P. Related Collections Health Professionals Health Education History Public Health Practice Surveillance

Amy L. Fairchild, PhD, MPH, David Rosner, PhD, James Colgrove, PhD, MPH, Ronald Bayer, PhD and Linda P. Fried, MD, MPH

All of the authors are with the Mailman School of Public Health, Columbia University, New York, NY.

Correspondence: Address correspondence to Amy L. Fairchild, PhD, MPH, Columbia University, Mailman School of Public Health, 722 W 168th St, New York, NY 10032 (alf4{at}columbia.edu). Reprints can be ordered at http://www.ajph.org by clicking the "Reprints/Eprints" link.

We trace the shifting definitions of the American public health profession's mission as a social reform and science-based endeavor. Its authority coalesced in the late nineteenth and early twentieth centuries as public health identified itself with housing, sanitation, and labor reform efforts. The field ceded that authority to medicine and other professions as it jettisoned its social mission in favor of a science-based identity. Understanding the potential for achieving progressive social change as it moves forward will require careful consideration of the industrial, structural, and intellectual forces that oppose radical reform and the identification of constituencies with which professionals can align to bring science to bear on the most pressing challenges of the day.