An Era of Change,
Medical sociology, as a general rule, followed a path parallel but slightly behind national trends in science and higher education. At the same time, relations between mainstream science, medicine, and social science were unstable. During the century prior to World War II, there was a certain consistency in the objectives they shared: social science actually played a larger role in medical research than is generally known, and both took it as their overriding objective “to use quantified data to illuminate the relationship between morbidity and mortality patterns … and broad environmental factors. ” 1 From 1945 onward, the pace of research development quickened and diversified. Guided by strong leaders, the relationship between medicine and social science intensified, but the pattern of its interests split the next fifty years in half. The first half was dominated by several quests: for a scientific epidemiology, for a viable theory of the social psychology of interpersonal relations in therapeutic institutions, and for analysis of the sociology of the professions. The second half, beginning in the seventies, turned in focus toward socioeconomic and sociopolitical explanations of health services delivery and the organization of both the traditional and new health care institutions.
For those who were part of these shifting developments, however, the feeling and meaning of what was happening are not captured by such generalizations. Henry Riecken, speaking from his view as the first head of the Office of Social Sciences at the NSF 2 from 1958 to 1965, described how “the winds of change” affected all of science in the postwar's first quarter-century. From its beginning orientation toward basic “pure” science, Riecken wrote, a decided shift occurred toward demands for proof of utility, accompanied by often angry criticism of the purity, even the truthfulness, of the methods and purposes of the scientific establishment. Riecken strikes a nostalgic, sometimes poetic, note about these changes:
The comfortable assumptions of the sixties about federal support for scientific research; about the dedication of professors and graduate students to the life of the mind; about the fundamental importance of the pursuit of