Health and Wealth

Health and Wealth

Studies in History and Policy

Simon Szreter

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Essays seeking to bring an historical perspective to bear on today's national and international policy concerns and to present original historical research that challenges conventional assumptions and viewpoints.
Today's complex policy problems cannot be understood by the social, medical, and policy sciences, alone. History is also required to interpret the present and to inform attempts to mold the future. The essays in this volume seek to bring an historical perspective to bear on today's national and international policy concerns and to present original historical research that challenges conventional assumptions and viewpoints.
The essays in part I of Health and Wealth offer an historian's reappraisal of several of the most influential ideas dealing with the relationships between health and economic development in the post-war international policy sciences, such as demographic transition theory, the McKeown thesis, and the population health approach.
Part II presents a distinctive interpretation of the course and causes of mortality change in Britain during the "long century" of industrialization, c.1780-1914. British history shows that rapid economic growth is a highly disruptive process, unleashing potentially deadly challenges. The key to life and death in Britain lay less in medical science or rising living standards than in the changing electoral politics of the nation's industrial cities. Class relations, political economy, ideology, religion, and the public health movement were all significant elements in this story. A late-Victorian flowering of vigorous municipal government was the precursor to central state activism in the twentieth century.
Part III reflects on history to make direct contributions to contentious current policy issues. The persistence of social and health inequalities today in developed nations and debates over the new concept of social capital are addressed, along with the economic and health problems of today's less developed countries. The lessons of history are awkward and heterodox, indicating the importance of establishing state-sanctioned institutions to ensure social security, legal identity, and civic freedoms in advance of measures to stimulate and open these countries' economies to global trade.

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Table of Contents

The Population Health Approach in Historical Perspective
The Idea of Demographic Transition and the Study of Fertility Change: A Critical Intellectual History
The Importance of Social Intervention in Britain's Mortality Decline c.1850-1914: A Reinterpretation of the Role of Public Health
Mortality in England in the Eighteenth and Nineteenth Centuries: A Reply to Sumit Guha
Urbanization, Mortality, and the Standard of Living Debate: New Estimates of the Expectation of Life at Birth in Nineteenth-Century British Cities
Economic Growth, Disruption, Deprivation, Disease, and Death: On the Importance of the Politics of Public Health for Development
The Silent Revolution in Nineteenth-Century Government: The Rise of Local Government Expertise
Health, Class, Place, and Politics: Social Capital, Opting In and Opting Out of Collective Provision in Nineteenth-Century and Twentieth-Century Britain
Health by Association? Social Capital, Social Theory, and the Political Economy of Public Health
Public Health and Security in an Age of Globalizing Economic Growth: The Awkward Lessons of History


These essays are an intellectual delight. They also have profound implications for policy. Szreter arrays persuasive evidence that the preconditions for economic growth include economic and social security that is initiated and sustained by effective governments in collaboration with autonomous civic institutions. --Daniel M. Fox, Milbank Memorial Fund

Health and Wealth is applied history at its most perceptive and most timely. Simon Szreter deploys his profound knowledge of the history of mortality to critique Britain's welfare policies, and to argue that in poorer countries government provision for pubic health should be developed before, not after economic modernisation. This book is essential critical reading for policy-makers. --John Tosh, Professor of History, Roehampton University, UK

To understand Brazil in the 21st century, study the English city of Birmingham in the 19th. The powerful insight at the heart of this nuanced and highly readable account of health and social change is that the lessons of history are fundamental to understanding the relation of economic growth to health. --Professor Sir Michael Marmot, Director International Institute for Society and Health

Simon Szreter has been prepared to grapple with some of the big issues in history, health and economic growth, and their implications for the present. This book is a vivid and outspoken contribution to the necessary relationship between history and policy. --Virginia Berridge, Professor of History, London School of Hygiene and Tropical Medicine

Health and Wealth presents a unified and coherent intellectual argument, developed over time and here assembled, for a new interpretation of the causes of the decline in mortality in Britain and for the relevance of that interpretation to current national and international policy. JOURNAL OF THE HISTORY OF MEDICINE AND ALLIED SCIENCES, 2006

Author Bio

Simon Szreter teaches at the University of Cambridge

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