Abstract
The decline of coronary heart disease mortality in the United States and Western Europe is one of the great accomplishments of modern public health and medicine. Cardiologists and cardiovascular epidemiologists have devoted significant effort to disease surveillance and epidemiological modeling to understand its causes. One unanticipated outcome of these efforts has been the detection of early warnings that the decline had slowed, plateaued, or even reversed. These subtle signs have been interpreted as evidence of an impending public health catastrophe. This article traces the history of research on coronary heart disease decline and resurgence and situates it in broader narratives of public health catastrophism. Juxtaposing the coronary heart disease literature alongside the narratives of emerging and reemerging infectious disease helps to identify patterns in how public health researchers create data and craft them into powerful narratives of progress or pessimism. These narratives, in turn, shape public health policy.
Highlights
The decline of coronary heart disease mortality in the United States and western Europe is one of the great accomplishments of modern public health and medicine
This paper traces the history of research on coronary heart disease decline and resurgence and situates it in broader narratives of public health catastrophism
Late twentieth century public health narratives about communicable and non-communicable disease have both exhibited oscillations between narratives of progress and doom. Their juxtaposition, read in light of the sociology of expectations, helps to identify patterns in how researchers create and respond to data. Recognizing these patterns is crucial as the international community increasingly acknowledges the need to shift the goals of global health beyond HIV, tuberculosis, and malaria to meet the challenge of cardiovascular disease, cancer, diabetes, and mental illness
Summary
Abstract: The decline of coronary heart disease mortality in the United States and western Europe is one of the great accomplishments of modern public health and medicine. This paper traces the history of research on coronary heart disease decline and resurgence and situates it in broader narratives of public health catastrophism.
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