Abstract
Throughout the course of the 20th century, many observers have noted important tensions and antipathies between public health and medicine. At the same time, reformers have often called for better engagement and collaboration between the 2 fields. This article examines the history of the relationship between medicine and public health to examine how they developed as separate and often conflicting professions. The historical character of this relationship can be understood only in the context of institutional developments in professional education, the rise of the biomedical model of disease, and the epidemiologic transition from infectious disease to the predominance of systemic chronic diseases. Many problems in the contemporary burden of disease pose opportunities for effective collaborations between population-based and clinical interventions. A stronger alliance between public health and medicine through accommodation to a reductionist biomedicine, however, threatens to subvert public health's historical commitment to understanding and addressing the social roots of disease.
Full Text
The Full Text of this article is available as a PDF (725.5 KB).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Antler J., Fox D. M. The movement toward a safe maternity: physician accountability in New York City, 1915-1940. Bull Hist Med. 1976 Winter;50(4):569–595. [PubMed] [Google Scholar]
- Bayer R. Public health policy and the AIDS epidemic. An end to HIV exceptionalism? N Engl J Med. 1991 May 23;324(21):1500–1504. doi: 10.1056/NEJM199105233242111. [DOI] [PubMed] [Google Scholar]
- Duffy J. The American medical profession and public health: from support to ambivalence. Bull Hist Med. 1979 Spring;53(1):1–22. [PubMed] [Google Scholar]
- Epstein A. Performance reports on quality--prototypes, problems, and prospects. N Engl J Med. 1995 Jul 6;333(1):57–61. doi: 10.1056/NEJM199507063330114. [DOI] [PubMed] [Google Scholar]
- Fee E., Krieger N. Understanding AIDS: historical interpretations and the limits of biomedical individualism. Am J Public Health. 1993 Oct;83(10):1477–1486. doi: 10.2105/ajph.83.10.1477. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Freymann J. G. The origins of disease orientation in American medical education. Prev Med. 1981 Nov;10(6):663–673. doi: 10.1016/0091-7435(81)90032-3. [DOI] [PubMed] [Google Scholar]
- Krieger N. Epidemiology and the web of causation: has anyone seen the spider? Soc Sci Med. 1994 Oct;39(7):887–903. doi: 10.1016/0277-9536(94)90202-x. [DOI] [PubMed] [Google Scholar]
- McDermott W., Deuschle K. W., Barnett C. R. Health care experiment at Many Farms. Science. 1972 Jan 7;175(4017):23–31. doi: 10.1126/science.175.4017.23. [DOI] [PubMed] [Google Scholar]
- McDermott W. Medicine: the public good and one's own. Perspect Biol Med. 1978 Winter;21(2):167–187. doi: 10.1353/pbm.1978.0048. [DOI] [PubMed] [Google Scholar]
- McKinlay J. B., McKinlay S. M., Beaglehole R. A review of the evidence concerning the impact of medical measures on recent mortality and morbidity in the United States. Int J Health Serv. 1989;19(2):181–208. doi: 10.2190/L73V-NLDL-G7H3-63JC. [DOI] [PubMed] [Google Scholar]
- Pearce N. Traditional epidemiology, modern epidemiology, and public health. Am J Public Health. 1996 May;86(5):678–683. doi: 10.2105/ajph.86.5.678. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Rose G. High-risk and population strategies of prevention: ethical considerations. Ann Med. 1989 Dec;21(6):409–413. doi: 10.3109/07853898909149231. [DOI] [PubMed] [Google Scholar]
- Rosenberg C. E., Rosenberg C. S. Pietism and the origins of the American Public Health movement: a note on John H. Griscom and Robert M. Hartley. J Hist Med Allied Sci. 1968 Jan;23(1):16–35. doi: 10.1093/jhmas/xxiii.1.16. [DOI] [PubMed] [Google Scholar]
- Rosenberg C. E. Social class and medical care in nineteenth-century America: the rise and fall of the dispensary. J Hist Med Allied Sci. 1974 Jan;29(1):32–54. doi: 10.1093/jhmas/xxix.1.32. [DOI] [PubMed] [Google Scholar]
- Schroeder S. A., Zones J. S., Showstack J. A. Academic medicine as a public trust. JAMA. 1989 Aug 11;262(6):803–812. [PubMed] [Google Scholar]
- Susser M. Epidemiology in the United States after World War II: the evolution of technique. Epidemiol Rev. 1985;7:147–177. doi: 10.1093/oxfordjournals.epirev.a036280. [DOI] [PubMed] [Google Scholar]
- Thier S. O. Academic medicine's choices in an era of reform. Acad Med. 1994 Mar;69(3):185–189. doi: 10.1097/00001888-199403000-00003. [DOI] [PubMed] [Google Scholar]
- Winslow C. E. THE PLACE OF PUBLIC HEALTH IN A UNIVERSITY. Science. 1925 Oct 16;62(1607):335–338. doi: 10.1126/science.62.1607.335. [DOI] [PubMed] [Google Scholar]