In the early 21st century, public health is subject to complex tensions and conflicting impetuses. This new book by Professor Virginia Berridge traces the history of public health in post-war Britain and the evolution of those tensions.
Background
The post-war history of public health and the role of smoking within that history epitomises the tensions which surround taking health to the public. Public health history has concentrated on the nineteenth century sanitary period or on the years before the Second World War, often concentrating on the environmental advances, or on the professional and occupational history of public health as an activity.
Focus
This book has a different focus: change in the outlook of public health after the war. From a focus on services, vaccination, and dealing with health issues at the local level, it reoriented itself around the concept of risk and targeted individual behaviour. Centralised campaigns directed at the whole population replaced local campaigns, and politicians started speaking directly to the public on health matters. Early worries about the nanny state gave place to a desire to inculcate new norms of behaviour.
Approach
Identifying debates between those believing in 'systematic gradualism' and those who advocated a more coercive approach, Virginia Berridge uses smoking as a model. Such debates brought into play tensions over the relationships between public health and industrial interests. Health campaigning by new style pressure groups like ASH, which were part state-funded, was an important motivating force behind the change. In the 1980s and 1990s, public health changed again. Passive smoking and HIV/AIDS brought environmental concerns, which had disappeared after the 1950s, back into public health. The 'rise of addiction' for smoking demonstrated the power of pharmaceutical interests to define a new 'pharmaceutical public health' in which treatment and 'magic bullets' were also tactics for prevention.
Publication
Marketing Health: smoking and the discourse of public health in Britain, 1945-2000 is published by Oxford University Press.