The Deadly Truth: A History of Disease in America

The Deadly Truth: A History of Disease in America

The Deadly Truth: A History of Disease in America

The Deadly Truth: A History of Disease in America

Excerpt

This book is a product of nearly three decades of teaching and research. When I first became interested in the relationship between health and the environment in American history, I accepted many of the explanations about the etiology of disease and changing epidemiological patterns. Over time, however, I became more skeptical of contemporary theories that purportedly explained why people became sick and why they died. At present much of medical theory is based upon the belief that risk factors are responsible for cardiovascular diseases, cancer, and diabetes, and that behavioral and environmental changes provide the basis for their prevention. As will become clear in the following pages, I have serious doubts about the validity of these claims, which are seldom supported by empirical evidence. Indeed, we know very little about disease processes and mechanisms. This is not to disparage clinical medicine, which does yeoman work in managing and alleviating the symptoms of disease and thus contributes to the prolongation of life. Nevertheless the cure of most chronic or long-duration diseases, whether infectious or noninfectious in origin, remains only an ideal.

There are two ways of approaching the history of disease. The first (and dominant one) involves the study of the ways in which people have constructed and interpreted the meaning of disease. The second deals with the biological reality of disease. Both approaches are legitimate. The first (social construction) attempts to reconstruct past experiences, past meanings, and past perspectives. The second involves an effort to trace morbidity and mortality trends over time and to relate them to changing social, environmental, and behavioral factors. I

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