There is no definitive history of the population health approach. In living memory, the important epidemiological research published during World War II by Jerry Morris and Richard Titmuss is invoked as a seminal model of population health analysis.¹ Morris and Titmuss carefully demonstrated that the incidence of such “individual” afflictions as juvenile rheumatism, rheumatic heart disease, and peptic ulcer all varied according to changing social conditions, such as the rate of unemployment. Along with others, they sought to widen the scope of traditional public health beyond disease prevention toward social medicine, anticipating to some extent the philosophy of the Lalonde...

This chapter’s main aim is to contribute to the study of fertility change through analyzing certain intellectual and institutional aspects of the field of study since World War II. The principal focus is the intellectual history of the idea of demographic transition: the idea that has provided students of changing fertility throughout the postwar era with the dominant collective definition of the phenomenon they are seeking to understand and explain. “Demographic transition” has been confusingly invoked at different times by different authors—or even by the same author at the same time—as theory (“the” demographic transition), historical model, predictive...

Dr John Tatham of the General Register Office (GRO), looking back in 1905 over more than half a century’s achievements by the public health movement since the passing of the first Public Health Act of 1848, found it necessary deprecatingly to remind his readers that “it will be well to utter a caution at this stage against the prevalent tendency to attribute to the results of sanitary administration alone the whole of the life-saving which has taken place. . . .”² As most undergraduates today in medicine or modern history will know, it is now widely considered that this confidently...

In 1988 I argued that a careful reappraisal of the nineteenth-century historical epidemiological evidence, which Professor Thomas McKeown derived from the Registrar-General’s decennial supplements, showed that it did not, after all, support the view that he had championed.¹ I demonstrated that for the purposes of the argument McKeown was making, it was invalid to combine together all the airborne infectious diseases as a single category as evidence in favor of the principal conclusion that McKeown drew, that rising living standards and per capita nutritional intake was the single most important source of falling mortality in nineteenth-century Britain. I then argued...

The modern standard of living debate has been conducted throughout the last forty years predominantly in the absence of any direct, detailed, and empirically based consideration of the mortality experience of the British working population during the industrial revolution era.² This is somewhat surprising in that, when setting out the basis for a “pessimistic” view in his seminal contribution to the debate of 1957, Hobsbawm gave pride of place to evidence bearing on mortality and health, which he envisaged as ideally including “mortality rates . . . morbidity rates and anthropometric data.”³ The last category of evidence, in particular, has...

Over the long term the processes of rapid economic growth seem to be strongly correlated with improvements in the prosperity and health of a society. Hence derives the commonplace notion that economic growth results in development. This essay argues that contrary to this widely held opinion, economic growth entails critical challenges and threats to the health and welfare of the populations involved and does not, therefore, necessarily produce development.

Since the 1940s economic and demographic historians, social scientists, and policymakers have broadly accepted that each national trajectory of sustained economic growth has always been attended by a “demographic transition,” a...

From its earliest years the General-Register Office (GRO) developed a twin-pronged publication strategy to maximize both its political and scientific impact in promoting the environmentalist policies of the public health movement. Through its weekly and quarterly bulletins of comparative death-rates the GRO fought a relentless campaign to heighten local awareness of the extent of preventable death. The government’s chief medical officer also used this information to investigate negligent local authorities. A parallel series of annual and decennial reports offered a more rigorous and scientific analysis of the incidence of the nation’s fatal diseases.

A relative decline in the GRO’s leading...

By the beginning of the twentieth century Fabian socialists had been advocating collectivist social legislation for well over a decade, on grounds of functional efficiency, national defense and, increasingly, congruence with the lessons of evolutionary science. In this respect their analysis and aims coincided to a considerable extent with those of the eugenicist and biometrician Karl Pearson. Both shared a nationalist interpretation of evolutionary theory: “social Darwinism” as it has come to be termed. The specific form of social Darwinism espoused by the Fabians and by the biometricians would be more accurately termed “nationalist Darwinism,” since there were so many...

This chapter will present some historical evidence that indicates a long-standing geographical dimension to what we call class differentials in health and inequality. It will also offer some initial thoughts on how these influences of place and region may assist in understanding the long-run sociopolitical history of health inequalities during the last two centuries. These cannot be explained through any straightforward account. A number of important studies have shown both a remarkable persistence of health inequalities during the twentieth century and also no linear pattern of either gradual decline or gradual improvement.¹ Thinking about the interactions between class and place...

In the ongoing quest to improve our understanding of the conditions that make for improved public health and wellbeing, scholars, practitioners, and policymakers have recently returned in earnest to a theme with a long and distinguished history in the social sciences—namely, following Durkheim, the importance of social circumstances in shaping the quality of life one enjoys.¹ This has been fueled in part by the indifferent performance of a series of high-profile public service delivery reforms, the widening rhetorical appeal of communitarian and neo-liberal policy discourse,² and a growing recognition that ever-more sophisticated medical interventions and media campaigns have had...

Historians of globalization have identified two modern forms of global economic growth in history (following two premodern forms—archaic globalization and proto-globalization—antedating the emergence of nation-states and the onset of the first industrial revolution in the eighteenth century).² Of the two modern forms, the first refers to the period from the late eighteenth to the early twentieth centuries, in which nation-states industrialized and colonized; while the second comprises the current postcolonial phase, following the period during which most colonies gained their independence between 1945 and 1975. Along with the ending of the Cold War and deregulation of international financial...