Stigmatized ethnicity, public health, and globalization

The prejudicial linking of infection with ethnic minority status has a long-established history, but in some ways this association may have intensified under the contemporary circumstances of the "new public health" and globalization. This study analyzes this conflation of ethnicity and disease victimization by considering the stigmatization process that occurred during the 2003 outbreak of Severe Acute Respiratory Syndrome (SARS) in Toronto. The attribution of stigma during the SARS outbreak occurred in multiple and overlapping ways informed by: (i) the depiction of images of individuals donning respiratory masks; (ii) employment status in the health sector; and (iii) Asian-Canadian and Chinese-Canadian ethnicity. In turn, stigmatization during the SARS crisis facilitated a moral panic of sorts in which racism at a cultural level was expressed and rationalized on the basis of a rhetoric of the new public health and anti-globalization sentiments. With the former, an emphasis on individualized self-protection, in the health sense, justified the generalized avoidance of those stigmatized. In relation to the latter, in the post-9/11 era, avoidance of the stigmatized other was legitimized on the basis of perceiving the SARS threat as a consequence of the mixing of different people predicated by economic and cultural globalization.     

Governing population, public health, and malaria in the early Turkish republic

In the early Turkish republic of the 1920s, population was a central question of concern for the leadership of the Kemalist state. This article focuses on how a demographic discourse concerning population – in terms both numerical and medical – provided a basis for emerging programs in public health, confronting the very real threats posed by disease. Employing the example of the nascent republic’s anti-malarial campaigns, this study thus examines the discursive, cartographic, and legislative measures employed in combating this widespread disease in the wider contexts of nation-building. In doing so, it traces one vital trajectory of the development of modern governmentality (i.e., that of public health) in the case of Turkey during the 1920s and 1930s, prior to the wartime slowing of state investments (due to national defense priorities), the post-World War II infusions of foreign aid and the incorporation of DDT in confronting malaria.     

Cities without cavities: democracy, risk, and public health

This essay examines the history of fluoride debates in four Canadian cities. It argues that fluoride's opponents were primarily motivated by what they saw as the health and environmental risks of adding fluoride to the water supply. They also believed that fluoridating the public water supply was a fundamental violation of civil liberties. The fluoride debates have much to teach us about how people evaluate potential health risks and how they respond to state interventions in the field of public health.     

Becoming public: public pedagogy,citizenship and the public sphere

This paper explores the question what kind of educational work can be done in attempts to reclaim or reinvigorate the public sphere. Through a discussion of the intersection of public sphere and public space, it engages with the work of Hannah Arendt in order to outline a conception of the public sphere as a space for civic action based on distance and the conservation of a degree strangeness rather than on commonality and common identity. The discussion of the educational work that can be done to support the public quality of common spaces and places focuses on three interpretations of the idea of public pedagogy: that of public pedagogy as a pedagogy for the public, that of public pedagogy as a pedagogy of the public and that of public pedagogy as the enactment of a concern for the public quality of human togetherness. The latter form of public pedagogy neither teaches nor erases the political by bringing it under a regime of learning, but rather opens up the possibility for forms of human togetherness through which freedom can appear, that is forms of human togetherness which contribute to the ‘becoming public’ of spaces and places.     

Prelude to the plague: public health and politics at America's Pacific gateway, 1899

San Francisco played a crucial in the formulation of American immigration policy vis-à-vis Asia in the late nineteenth and early twentieth centuries. During this period, it was often difficult to differentiate political struggles over the exclusion of Asians from other conflicts. This article examines one such arena: an acrimonious, well-documented argument in 1899 between Federal and various State and local authorities over the arrival of a Japanese passenger liner that may--or may not--have been carrying bubonic plague. Six months later, the plague unquestionably arrived, resulting in the well-known San Francisco plague epidemic of 1900 in which more that 110 people died. Reviewing the 1899 prelude, the public attitudes of the various health authorities, and the way the press reported health issues, collectively give some sense of that historical space where the regulation of public health, politics, and the immigration industry intersected and were fiercely contested.     

Legislating fear and the public health in gilded age Massachusetts

Between 1876 and 1881 Massachusetts experienced an outbreak of human rabies (hydrophobia). The entire state--the Governor, the legislature, the State Board of Health, newspapers, and the citizenry and elected officials of every town and city--reacted to the disease. Central to the response was the Commonwealth's legislature--called the General Court. Through public hearings, their own debates, and the passage of legislation, it resolved widespread fear and anger, mediated conflicting concepts of disease, and promoted social solidarity in the face of an epidemic. This article first narrates the General Court's legislative actions; it then examines the conflicting understandings of disease causality; finally, it explores the social and political rituals the legislature drew upon to deal with this public health crisis. Arguing that public health legislation is simultaneously instrumental and symbolic, this article demonstrates that attention to both enriches the study of epidemics, historical and yet to come.     

Infection, contagion, and public health in late medieval and early modern German imperial towns

From today's point of view, the concepts of "miasma" and "contagion" appear to be two mutually exclusive perceptions of the spread of epidemic diseases, and quite a number of historians have tried to discuss the history of public health and epidemic diseases in terms of a progression from the miasmic to the contagionist concept. More detailed local studies, however, indicate how extremely misleading it may be to separate such medical concepts and ideas from their actual historical context. The article presented here, based on local studies in late medieval and early modern imperial towns in southern Germany, demonstrates to what extent the inhabitants of these towns had notions of both "miasma" and "contagion." Furthermore, a contextual analysis of language shows that they did not see a necessity to strictly distinguish between these different concepts relating to the spread of diseases. Tracing the meaning of "infection" and "contagion," we find that these terms were used in connection with various diseases, and that a change in the use of the expressions does not necessarily imply a change of the corresponding notion. Moreover, a coexistence of differing perceptions cannot--as some historians have suggested--be attributed to a divergence between the academic medicine and the popular ideas of that period. A survey of measures and actions in the public health sector indicates that a coexistence of--from our point of view--inconsistent concepts helped the authorities as well as the individuals to find means of defense and consolation during all those crises caused by epidemic diseases--crises that occurred very frequently in these towns during the late medieval and early modern periods. As the article demonstrates, the interaction during such crises reveals the continuity of ancient rituals and concepts as well as the adoption of new insights resulting from changes in the economical, political, scientific, religious, and social structures.     

Post-war smoking policy in the UK and the redefinition of public health

Current analyses of UK smoking policy within two frameworks--the 'heroes and villains' view of journalist accounts and a political science emphasis on rival 'producer' and 'issue' networks in policy making. It is often assumed that the US experience provides a universal historical model. This paper sees smoking policy in the UK as a case study in the relationship between 'scientific fact creation' and policy, which has also been emblematic of wider changes in public health ideology. The issue of smoking and lung cancer symbolized the post-war shift from infectious to chronic disease and the rise of a new 'lifestyle'-oriented public health. In the 1980s passive smoking brought a revival of environmentalism; in the 1990s the rediscovered concept of addiction symbolized developments in public health in which curative and preventive initiatives were entwined. Despite the rise of a militant 'healthism' within both anti-smoking and public health since the 1970s, British policy retained a dual focus, an emphasis on risk reduction as well as risk elimination in which policy networks were entwined rather than distinct. Some public health scientists worked in policy milieux, notably the expert committee, which crossed this apparent divide and which linked with industry. Connections between government and industry changed as public health 'treatment' brought the pharmaceutical industry into the picture.