Primary Submission Category: History of Population Health
Who killed Social Medicine (and should Population Health be worried)?
Authors: Quinn Valier
Presenting Author: Quinn Valier*
Population Health has a past. Hopes for a more equitable, thriving world span time and place. The intimate weaving of individual and social, suffering and healing, is as fundamentally human as it is profoundly humane. And yet all this we struggle to remember in the insistent face of the now. Now; always evolving, forever new and novel, is an artefact of the European Enlightenment, a preoccupation with chronology as progress, category as hierarchy, sorting the self from the other. This is, broadly, a worldview at home in biomedicine; chronology as progress manifest in the insatiable creep of medicalization. An unerringly linear view of technologically-enabled healthiness as the spoils of a self-styled ‘war’ against disease. What if the ascent of biomedicine can be shown to have been contested not by cranks and quacks, but by an established (proto-population health movement of) Social Medicine? Histories of Social Medicine are few despite the historical records being plentiful (historians are – somewhat ironically — as prone to the chronology as progress narrative as anyone else when it comes to science, technology, and medicine). Social Medicine as a multi-generational movement is very poorly understood as is the fact that its existence cannot be explained as the last gasp of old-style Sanitarians fussing over archaic theories of miasma and contagion. Contemporaneous scientific elites and institutions were amply represented. The c20th ascent of the biomedical model – coming on the heels of the laboratory and bacteriological revolutions of the late c19th — was as much a choice as a certainty and involved more coercion than consensus. Here now is a call to community reflection and community action. Social Medicine did not fizzle and die of its own accord, it was targeted and slain at the hands of others. As the field of Population Health grows and matures we have the choice now to learn this history, our own longevity may well depend upon it.