HIST 373: Politics of Health and Medicine in the Americas: From Historical Roots to Contemporary Developments (Crosslisted: LAS)

In this course we will examine the history of health - and health care - as well as the political dimensions of scientific research and medicine. Based on the understanding that health and health care are subject to political competitions on the nation state level and are mediated by changing global paradigms, we will use readings and class discussions to draw conclusions about citizenship rights in the Americas. We will start with a number of broad questions to make specific links: When did the responsibilities for citizens' health shift from being rooted in notions of charity to a sense of citizens' entitlement to state services? When, and under what circumstances, can people put pressure on their political leaders and make states accept increased responsibility for citizens' health? How can we best understand the links between global paradigm shifts and nation-state policy changes that protect public health as citizens' entitlement and a human right? And what are the historical reproductions of inequality that we find as we trace health policies in specific regions or nations?
In 1946, the World Health Organization (WHO) defined health to be "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity." The WHO also provided a definition of public health, referring to "all organized measures (whether public or private) to prevent disease, promote health, and prolong life among the population as a whole. Its activities aim to provide conditions in which people can be healthy and focus on entire populations, not on individual patients or diseases." The WHO's definition of health has been praised for its holistic vision; simultaneously it was condemned for being unrealistic, or, in the words of historian Robert Hughes, for being "more realistic for a bovine than a human state of existence." What are the political, economic, and social factors that make holistic approaches to disease (and to the protection of health) so difficult? Why would it be unrealistic to protect the health of all humans, and to assure that all populations have access to appropriate and cost-effective care, including health promotion and disease prevention services? How are the difficulties of protecting human health linked to competing definitions of disease, and how have the definitions of disease changed over time?
We will explore how outcomes of scientific and medical research - as well as health policies, and the practice of medicine -- are shaped by historical subjectivities and are linked to such categories as race, class, gender, age, experience, and ability. Subjects will include (but are not limited to) social and socialized medicine, epidemics and diseases as "unequal killers," racial profiling, the projects of "missionaries of science" and "health internationalists," definitions of madness and sanity, competitions between traditional medicine and "modern" medical practice, and power struggles and political rivalries over the role of the state in welfare and the protection of public health.