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March 2003, Vol 93, No. 3 | American Journal of Public Health 421-431
© 2003 American Public Health Association


PUBLIC HEALTH THEN AND NOW

The Population Health Approach in Historical Perspective

Simon Szreter, PhD

Simon Szreter is with St John’s College, University of Cambridge, England. He is also co-editor of www.historyandpolicy.org.

Correspondence: Requests for reprints should be sent to Simon Szreter, PhD, St John’s College, Cambridge CB2 1TP, United Kingdom (e-mail: srss{at}cam.ac.uk).

The origin of the population health approach is an historic debate over the relationship between economic growth and human health.

In Britain and France, the Industrial Revolution disrupted population health and stimulated pioneering epidemiological studies, informing the early preventive public health movement. A century-long process of political adjustment between the forces of liberal democracy and propertied interests ensued.

The 20th-century welfare states resulted as complex political mechanisms for converting economic growth into enhanced population health. However, the rise of a "neoliberal" agenda, denigrating the role of government, has once again brought to the fore the importance of prevention and a population health approach to map and publicize the health impacts of this new phase of "global" economic growth.




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