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11 - Public Health Confronts Modernity in the Shadow of the Pandemic

Published online by Cambridge University Press:  30 April 2022

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Summary

Abstract

Empirical science in the eighteenth and nineteenth centuries transformed public health. Improvement in nutrition and living conditions were the driving forces, linked to basic sanitation. The principles of public health also proved highly effective in prevention of chronic disease, such as cardiovascular disease and cancer. However, the dominant force in biomedicine has become genomics and “precision medicine,” both of which ignore the role of environmental exposures, and focus on individual, not collective risk. Genetic determinism and technological solutions have narrowed the scope of research aimed at improving population health, and reduced the benefits that biomedical science and public health could provide. The COVID-19 pandemic is the same story in bold print.

Keywords: public health; COVID-19; genomics; prevention.

What is a good society? How do we measure progress toward a more fulfilling and healthy life? From the early stages of the Western philosophical tradition in Greece every society has sought to define goals and criteria to answer these questions as the basis for an intellectual and spiritual framework that can give meaning to their collective social experience. Historical context and first principles handed down by an ideological or religious tradition inevitably constrain the metrics that are used, and those metrics are in turn subject to endless debate and revision. Population health has unique advantages when choosing the critical measures of a good society and the basis on which to assert that progress is being made. Accepting for the moment a division between physical and mental health, a very substantial proportion of all public health outcomes that are considered desirable across cultures are objective and universally accepted. Successful reproduction, low infant mortality, long life expectancy, and freedom from disability are prized above all of life's other gifts. Of course, there is more to human self-actualization than good physical health, but the desire for a “sound mind in a sound body” has been articulated under some guise in all cultural traditions. This chapter will focus on physical well-being. While this focus is not intended to dismiss the importance of mental and spiritual health, an assessment of the hierarchy of metrics that should be given to the needs of the spirit and the mind, and a comprehensive definition of good mental health and emotional fulfillment would take us far beyond the intended limits of this discussion.

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Global Modernity from Coloniality to Pandemic
A Cross-Disciplinary Perspective
, pp. 257 - 276
Publisher: Amsterdam University Press
Print publication year: 2022

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