Susan Gross Solomon, Lion Murard and Patrick Zylberman (eds), Shifting boundaries of public health: Europe in the twentieth century, Rochester Studies in Medical History, vol. 12, Rochester, NY, University of Rochester Press, 2008, pp. viii, 338, £50.00, $90.00 (hardback 978-1-58046-283-9).

Abstract

This volume is a collection of ten papers written by eminent scholars within the field of public health history. Through the introduction’s analysis of twentieth-century public health historiography, the editors present the book’s agenda as an investigation into “the shifting boundaries between [the international, national and local] levels in the making of policy, the design of structures and instruments, and the refinement of expertise in European public health” (p. vii). These “levels” may be geographical or administrative. However, they also refer to the “porous boundaries” between government and private agencies, as well as those separating knowledge claims of a general, global validity from those referring to the health challenges of a local setting—e.g., a particular field, a social group, or an individual state. Interestingly, several papers address fluctuations and changes in the meaning of the basic concepts “international”, “national” and “local” in relation to health policy throughout the century. The papers are organized into four parts: in the first part, ‘Place as politics’, papers by Peter Baldwin and Dorothy Porter discuss collective and individual responsibilities in the light of recent debates on preventive health care. Baldwin analyses the diverging strategies chosen by democratic societies during the early phase of the AIDS epidemic, as a transmittable disease caused “in some measure by our own voluntary habits” (p. 29). The second part, ‘Carving out the international’, includes papers by Paul Weindling and Iris Borowy on the internationalization of public health in the interwar period, as well as a paper by James A Gillespie on post-war international agencies in the field. Here, the “shifting borders” move between the international and the local, as well as between the different American agencies of philanthropic support and their benefactors (Weindling), between the League of Nations Health Organization’s lack of operational space during the Second World War and the manoeuvres preserving some of its key features in the World Health Organization (Borowy); and between sets of meaning attached to the concept of international health (Gillespie). In the third part, ‘Preserving the local’, papers by Lion Murard, Sabine Schleiermacher and Graham Mooney further elaborate on how “the local” has been intimately connected to both national and international levels. Schleiermacher’s comparison on health polices in the occupation zones of post-war Germany presents an intriguing story of continuation and discontinuities of past policies. In the last part, ‘Navigating between international and local’, Susan Gross Solomon delivers a strong paper, comparing strategies for cross-border “fact-finding” by Soviet and American public health experts in the inter-war period. Patrick Zylberman elaborates on malaria prevention in southern Europe, arguing that “American malariology was profoundly different from social malariology of a European ilk”(p. 269). Most papers appear to be based on original research, quoting contemporary printed sources as well as archival documents. The book gives no pretence to be a general reader of European public health history, with the slight exception of its sub-title. Rather, this can be seen as a collection of papers with a shared agenda to investigate a range of “border-crossings”. Seven out of the ten papers concentrate on the years 1920 to 1950. As all the four parts contain papers addressing the local or individual as opposed to more general entities, the organization of papers may appear somewhat random. Therefore, it is unfortunate that even obvious connections and explicit contrasts between papers are not discussed, or, at least, noted in cross-references. For example, Weindling and Murard present quite diverging interpretations on the basis of a similar range of sources, but are placed in different parts of the book. As the contributions, in general, follow up the aim of investigating the “shifting boundaries” and not the “shifting manifestations” of public health, the collection presents itself as a consistent whole. Combined with the thought-provoking introduction and the excellent quality of several papers, this makes the book a valuable contribution both to public health history, and to the history of “shifting boundaries” within other knowledge and policy fields.