Raj Bhopal and John Last (eds), Public health: past, present and future: celebrating academic public health in Edinburgh, 1902–2002, London, The Nuffield Trust, 2004, pp. xxi, 213, £25 (paperback 0-11-703264-6).

Abstract

One of the best things about this post-conference publication is a fascinating overview of the next epidemiological transition in the Asia Pacific. What, you may ask, has that got to do with academic public health in Edinburgh? Not a lot, and neither has the bulk of this book. My hackles first rose when reading in the Preface that no other British university can match Edinburgh's claim to have founded academic public health. In fact Liverpool created a professorship in public health in 1897—a year before Edinburgh—and earlier post-graduate courses had been established by both Dublin and Cambridge. Although this is a personal whinge, it highlights one of the main weaknesses of the book: its attempt at history is vague, muddled and at times plain wrong. This is not helped by delegating the section on ‘The Past’ to non-historians. There is a sketchy chapter on general ‘Landmarks in the history of public health’;‘Some historical notes on health and public health in Edinburgh’ and ‘Edinburgh's contribution to public health’. No one appears to have given any thought to how these would fit together, so they read like verbatim conference presentations, where the speakers have subjected the audience to a sequence of repetitious anecdotes. They are all keen on “gardyloos” but not so keen on analysing (or even describing) how academic public health in Edinburgh has developed with reference to the local or national changes in scientific knowledge, or socio-economic structures. There are already comprehensive accounts of the work of the nineteenth century MOH Henry Littlejohn, his successors, and the development of health in Edinburgh. These disparate hagiographical reminiscences add nothing new. The section entitled ‘The Present’ actually contains reviews of late-twentieth-century developments. Anthony Hedley (Professor of Community Medicine in Hong Kong) presumably features because he at one time worked in Edinburgh, which is fortunate for this volume. His chapter on emerging problems such as SARS and tobacco control in the Asia Pacific is well written and useful. Yet, we are then thrown back again to Littlejohn (and an erroneous claim that he carried out the first epidemiological survey of a city in Britain), and further regurgitations of the history of diseases such as smallpox. There is actually very little about the contributions of Edinburgh academics, if that is what this volume sets out to achieve. Much more could have been said about people like Mary Fulton, who pioneered research on coronary heart disease and lead poisoning in children. Sheila Bird's chapter is a welcome relief, and an example of how oral history can illuminate the interface of academic and practical public health. Her account of the development of the CD4 database during Edinburgh's HIV crisis in the 1990s is what I had hoped to find in a volume with such an enticing title. She provides an excellent case study in the politics of epidemiology. Helen Zealley's autobiographical approach to Scotland's post-devolution struggle to produce joined-up public health policy is also worthwhile. This volume, produced to celebrate the centenary of academic public health in Edinburgh, unfortunately obscures some of the most interesting aspects of its development in a mire of second-rate historical anecdotes. Despite the claims of Bhopal and others that twenty-first-century public health is now truly inter-disciplinary, it sadly illustrates the pitfalls of failing to engage with historians in a meaningful way. Let's hope that this lesson is learnt in time for the bicentenary.