Rethinking McKeown: The Relationship Between Public Health and Social Change
Simon Szreter, PhD
Simon Szreter is with the Faculty of History, University of Cambridge, a fellow of St John's College, Cambridge, England, and is a Research Fellow of the British Economic and Social Research Council.
Correspondence: Requests for reprints should be sent to Simon Szreter, PhD, St John's College, Cambridge CB2 1TP, England (e-mail: srss{at}cam.ac.uk).
Thomas McKeown was a rhetorically powerful critic, from theinside, of the medical profession's mid-20th-century love affairwith curative and scientific medicine. He emphasized insteadthe importance of economic growth, rising living standards,and improved nutrition as the primary sources of most historicalimprovements in the health of developed nations.
This interpretation failed to emphasize the simultaneous historicalimportance of an accompanying redistributive social philosophyand practical politics, which has characterized the public healthmovement from its 19th-century origins. Consequently, the currentgeneration of public health practitioners are having to reconstructsuch a politics and practice following its virtual dismantlementduring the last 2 decades of the 20th century.
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