Insights into the origin and identity of the discipline of public health

Public health: a very short introduction. Virginia Berridge. Oxford University Press, 2016 (£7.99; 160 pp). ISBN 9780199688463

When I am introduced to non-medical friends as a respiratory physician, there is often a look of confusion, which is resolved with the explanation “lung doctor”. However, even when introduced to other doctors as a public health physician, there is often a similar moment of confusion, which is less easily resolved. In Public health: a very short introduction, Virginia Berridge — who is professor of History and director of the Centre for History in Public Health at the London School of Hygiene and Tropical Medicine, University of London — paints a picture of a discipline that is often uncertain of its own identity. Is it a medical specialty, or should it have a broader professional membership? Is it a single component of our health system, or should public health principles guide all aspects of our approach to health? Should it focus on proven interventions for specific conditions, or should it recognise that equity and social inclusion are fundamental determinants of health?

The book presents a British perspective on public health, and much of the focus is on its historical emergence from origins in Europe and the industrial revolution. This means that areas such as Indigenous health are absent and that references to public health in Australia and non-Western countries are largely confined to comparisons with the United Kingdom. However, it must be acknowledged that the Australian discipline of public health owes much to its British roots and the international comparisons are instructive. For example, it is fascinating that within the past century, public health medicine in the UK has swung from sitting at the pinnacle of the health system to working alongside it, either from local government or the health department.

Moreover, the outsider’s perspective on Australian public health is sobering. Although Australia’s leading role in plain packaging legislation is recognised in the book, the profession of public health medicine in our country is dismissed as “weaker with fewer public health posts in health systems”. With no national equivalent to the public health bodies found in the United States, Europe and the UK, and still relatively few training positions in most states, it is hard to dispute this claim.

Overall, Public health: a very short introduction packs an amazing amount of absorbing content into its 160 pages, but from a distinctly British and historical perspective.