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This Article Extract Full Text (PDF) All Versions of this Article: AJPH.2007.122770v1 97/10/1736    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 Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Fee, E. Search for Related Content PubMed Articles by Fee, E. Related Collections Community Health Contraception Mental Health History Public Health Practice Other Child and Adolescent Health

Elizabeth Fee, PhD, Contributing Editor

American Journal of Public Health

The historical articles in the Journal are intended not only to inform but also to offer a means of reflection—on the past, the present, and by extension, the future. Knowing more about the past gives us perspective on the issues of our times: sometimes by showing us changes and transformations of which we may not have been aware; at other times by confronting us with a startling lack of progress despite decades of effort. By making the acquaintance of strong voices from the past, we enlarge the community of public health and benefit from new ideas—or from old ideas expressed with particular clarity and conviction. We can find kindred spirits from times past and thus develop a rich and energizing sense of our heritage.

Above all, history shows us that the immediate reality we face is far more unstable than we might imagine. Everything changes and often in ways that we may not predict. However, change is not merely something that happens; it is the result of human agency, human effort, and human organization. Human progress, although not guaranteed, is always a possibility and is worthy of our passion, energy, and commitment. History can thus stimulate our imaginations, show us alternate realities, and enhance our sense of agency—the idea that we can make a difference and that it is worth trying to do so even, and perhaps especially, when the immediate conditions in the world around us seem discouraging.

Three historical essays grace this issue of the Journal. In the first, Rajakumar et al. inform us of the reappearance of an old disease: childhood rickets. The authors carefully trace the growth of scientific knowledge and the development of public health practice around this once prevalent disabling disease. Characteristic of children growing up in sunless industrial slums in the early 20th century, the disease was banished once sunlight and vitamin D–fortified foods were made part of popular experience. The article by Rajakumar et al. thus celebrates a past public health triumph—the control of rickets—but warns of the need for continuing vigilance.

Temkin provides another historical narrative relevant to a contemporary public health issue, in this case, the refusal of some health insurance companies to cover prescription contraceptives. She explains that the International Workers Order was the first insurer to include contraceptive services in its benefit package in the 1930s and 1940s. For $4 per year, a woman could receive a general examination, a gynecological examination, contraceptive supplies, and a year’s worth of follow-up visits. The International Workers Order also offered prepaid primary care, discounted medications, and free preventive health screening programs, as well as cultural programs—a mandolin orchestra, a dramatic competition, and dances (see the cover of this issue).

The third historical contribution is a Voices from the Past column by Hans Pols, a historian of psychiatry. He provides an excerpt from Hollingshead and Redlich’s classic study of Social Class and Mental Illness, published almost 50 years ago. This study showed that the mentally ill of the higher social classes were more likely to receive the best therapeutic interventions, including analytic psychotherapy than were the lower social classes, who were more likely to receive electroshock therapy, lobotomy, and drugs. Pols notes that one thing has changed in the interim: the poor, who previously received lower-quality treatment, now often receive no treatment at all.

Taken together, these three historical contributions seem to provide a rather sobering assessment of public health progress. Yet all are engaged histories, turning the past to present use. Rajakumar et al. see unquestioned advances, both scientific and social, despite a continuing hazard; Temkin uses a progressive historical example to reinforce the case for contraceptive equity today; Pols reminds us that social class is still determinative of the experience of and therapy for mental illness. Together, historians of public health are contributing their knowledge and their voices to the mission we all share, of improving the public’s health, reducing health disparities, and enhancing the quality of life for all.

This Article Extract Full Text (PDF) All Versions of this Article: AJPH.2007.122770v1 97/10/1736    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 Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Fee, E. Search for Related Content PubMed Articles by Fee, E. Related Collections Community Health Contraception Mental Health History Public Health Practice Other Child and Adolescent Health