Health activism in a globalising era: lessons past for efforts future

Author: 
Ronald Labonté
Publication date: 
22 June 2013

Health activism in a globalising era: lessons past for efforts future

In 1848 the Prussian pathologist Rudolf Virchow famously described medicine as a social science, and politics as medicine writ large. Virchow's medicine today is better recognised as public health, writ large by our evidence of the political, social, and economic determinants of health. Virchow's then-radical theory of social medicine was built upon his own youthful investigation of typhoid among Silesian coal miners. His revolutionary prescription ranged from increased democracy and female suffrage, to improved wages and working conditions and progressive taxation. His government employers thanked him for his report and fired him. A few weeks later, a committed activist, he joined Berlin's public protests and street barricades of the short-lived 1848 populist revolution.
Few major social advances in public health have been achieved without health workers taking political risks. Virchow's British contemporary, John Snow, similarly faced censure from those supporting the prevailing miasma theory of disease in the face of his fastidious evidence-gathering. In 1854 Snow's careful work led to the removal of the handle of the choleric Broad Street pump, an archetypal moment in 19th-century public health. These two past approaches capture to some extent the dynamics that underpin health activism today: Snow had a singular focus in response to a particular problem; Virchow was aligned with a broad movement aimed at overturning a pathological political order.