2 A HISTORY OF PUBLIC HEALTH May the rich remember during the winter, when they sit in front of their hot stoves and give Christmas apples to their little ones, that the ship hands who brought the coals and the apples died from cholera. It is so sad that thousands always must die in misery, so that a few hundred may live well. Rudolf Virchow during the 1848-49 cholera epidemic in Berlin, quoted in Waitzkin, 2006, p. 7 KEY CONCEPTS Introduction Era of Indigenous control Colonial legacy Theories of disease causation Public health legislation and sanitary reforms Australian responses Status quo or radical change? Relearning the nineteenth-century lessons: Mckeown and Szreter Nation-building era Affluence, medicine, social infrastructure Conclusion INTRODUCTION Contemporary public health approaches in Australia and many other countries reflect practices that came from nineteenth-century Europe and were spread around the globe through the processes of colonisation. An appreciation of their history, and of the crucial philosophies and practices that have been representative of public health at different times, are important to understanding why the new public health was labelled as such and how it is both a continuation of the past and a departure from it. Copyright @ 2015. Oxford University Press. All rights reserved. There have been seven distinct periods in the development of public health thinking and practice in all countries. These are summarised in table 2.1 based on Australian history, but the history has resonance for other countries too. In practice there is some overlap between the different eras. This chapter describes the first four eras-the era of Indigenous control, the colonial era, the nation-building era and the promise of medicine era. The final three eras are discussed in chapter 3. Baum, Fran. The New Public Health, Oxford University Press, 2015. ProQuest Ebook Central, http://ebookcentral.proquest.com/lib/latrobe/detail.action?docID=4786467. Created from latrobe on 2022-08-07 01:37:05.
CHAPTER 2: A HISTORY OF PUBLIC HEALTH 19 TABLE 2.1 HISTORY AND DEVELOPMENT OF PUBLIC HEALTH IN AUSTRALIA Period Era of Indigenous Strong links with land, traditional control (estimated healers, emphasis on spirituality to be in excess of and integration of health and life. 40 000 years) Colonial era (from white invasion until 1890s) Nation-building era [1890-1940s) Affluence, Economic affluence and medicine and infrastructure (1950s-early 1970s) Lifestyle era (late 1960s-mid-1980s) New public health era (mid-1980s- mid-1990s) Copyright @ 2015. Oxford University Press. All rights reserved. Dominant policies and ideologies Control of infectious disease main aim. Strongly influenced by British practices. Emphasis on sanitary measures. State action to improve the health of the nation. Seeking to 'improve the race'. Health linked to ideas of vitality, efficiency, purity and virtue. interventionist governments committed to improving quality of life. Considerable developments in clinical medicine, which led to a belief that finally medicine would conquer disease. Focus on effects of affluence in terms of chronic disease. Rediscovery of philosophy of prevention reflecting a desire to control costs of health services. Focus on individual behaviour. Epidemiological methods developed. Influenced by World Health Organization policies, especially the Alma Ata Declaration of