Public Health: The Development of a Discipline - Vol. 1

Public Health: The Development of a Discipline - Vol. 1

Public Health: The Development of a Discipline - Vol. 1

Public Health: The Development of a Discipline - Vol. 1


Public health as a discipline grew out of traditional Western medicine but expanded to include interests in social policy, hygiene, epidemiology, infectious disease, sanitation, and health education. This book, the first of a two-volume set, is a collection of important and representative historical texts that serve to trace and to illuminate the development of conceptions, policies, and treatments in public health from the dawn of Western civilization through the Progressive Era of the early twentieth century.

The editors provide annotated readings and biographical details to punctuate the historical timeline and to provide students with insights into the progression of ideas, initiatives, and reforms in the field. From Hippocrates and John Graunt in the early period, to John Snow and Florence Nightingale during the nineteenth-century sanitary reform movement, to Upton Sinclair and Margaret Sanger in the Progressive Era, readers follow the identification, evolution, and implementation of public health concepts as they came together under one discipline.


Those who do not study history are doomed to repeat it.

—GEORGE SANTAYANA, The Life of Reason, 1905

History will die if not irritated. The only service I can do to my profession is to
serve as a flea.

—HENRY ADAMS (1838–1918), U.S. historian, journalist, and novelist

Life expectancy, or the mean age of survival of population groups, has risen over the millennia. For early humans, a nomadic lifestyle, small populations, and the absence of domestic animals originally limited the spread of disease. These early hunters and gatherers suffered from high mortality rates, mostly from trauma, infected wounds, or zoonoses, diseases acquired from eating infected animals or their excreta. Archaeological evidence tells us that the life expectancies of these early populations were short, with the average person living perhaps 20 years.

Around 12,000 years ago, large wild mammals became extinct, and the nomadic lifestyle became less practical. By necessity, food sources shifted from hunting and gathering to small-scale agriculture. Early domesticated plants were poor in nutritional value, and human mortality remained high. It was not until around 8,000 years ago that improvements in agriculture allowed for food production large enough to support increases in both average family and overall population sizes. Villages and towns emerged as places for the exchange of surplus food and goods. Density increased, with people and animals living side by side, often sharing the same living quarters. Humans became widely infected with parasites, food-borne and waterborne diseases, and respiratory diseases. Life expectancy remained, on average, short.

By the time of Hippocrates (c. 400 BCE), the average life span had risen to about 28 years, with significant variation based on class, gender, and geographic region. Improvements included access to water in sufficient quantities for personal hygiene and of adequate quality to reduce waterborne diseases. Well-established overland trade routes reached across the Middle East and into Asia. Cargo ships routinely sailed across the Mediterranean. As travelers returned home, they brought stories about new lands and peoples with them, including tales of strange lifestyles and diseases. As scrolls were fragile and books nonexistent during this period, oral tradition . . .

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