The McKeown Thesis: Rethinking McKeown: The Relationship Between Public Health and Social Change

Szreter, Simon PhD

About the Author: Simon Szreter is with the Faculty of History, University of Cambridge, a fellow of St John's College, Cambridge, England, and is a Research Fellow of the British Economic and Social Research Council.

Requests for reprints should be sent to Simon Szreter, PhD, St John's College, Cambridge CB2 1TP, England (e-mail: [email protected]).

This commentary was accepted October 26, 2001.

American Journal of Public Health 92(5):p 722-725, May 2002.

Thomas McKeown was a rhetorically powerful critic, from the inside, of the medical profession's mid-20th-century love affair with curative and scientific medicine. He emphasized instead the importance of economic growth, rising living standards, and improved nutrition as the primary sources of most historical improvements in the health of developed nations.

This interpretation failed to emphasize the simultaneous historical importance of an accompanying redistributive social philosophy and practical politics, which has characterized the public health movement from its 19th-century origins. Consequently, the current generation of public health practitioners are having to reconstruct such a politics and practice following its virtual dismantlement during the last 2 decades of the 20th century.