Thomas McKeown, Professor of social medicine, and Simon Szreter, demographer and social historian, discuss the possible reasons for the decrease of mortality in Britain during the 19th/20th century.
McKeown argues that we have to look in other areas to conclude about the determining factors for the decrease of mortality, instead of the medical and environmental field. He states that an expansion in medical services such as dispensary, midwifery and hospitals plus advances in anatomy, physiology and the introduction of vaccines did not have a big impact on health. From his point of view the conclusion lacks the distinction between the interest of the medical world and of the population.
Szeter argues that the public health …show more content…
He explains that the exponential growth of cities, due to industrialization, reflected in a staggering decline of mortality. When the Public Health acts such as Clean Water Act, Adulteration & Food Act and Sale of Food & Drug Act was introduced in 1872 which, among other things, meant clean water for the population, and a sewer system was put in place, the cities and hence the living standards changed for the better. He points out that the last part of the 19th century was the time were the effort of government officials showed a result and took effect. These combined efforts of council men, health officials and politicians, which brought about change, are to be credited for the decline of mortality.
McKeown presents his life work of 20yrs of empirical studies, which, by definition, means collecting data from experience and observation. He interprets and analyses the evidence and statistics gathered, and draws his conclusions without offering a bias opinion. It seems he doesn't have compassion for the medical world because, even though he spent two decades on his research, he gives us an unemotional analysis of his …show more content…
Szreter on the other hand engages in a straw man argument to discredit McKeowns work, and states that McKeown credits improved living standards and nutrition to the decline in mortality in the late 19th and early 20th century, which is not true. He continues analysing the data, presented by McKeown, in his own fashion and looking at social demographic reasons which he thinks are responsible for the shift in mortality, e.g. public health regulations, improved wages, management of the living space. Being a historian and demographer Szreter evaluates and analyses from a different point of view. It seems he is passionate about the general public and the work of the government and therefore claims that achievements by local officials and the government are the power behind the decline of mortality.
Szreter’s life work encompasses the study of history of public health and he was awarded the Viseltear Prize for his contributions in that field. This award honours historians who had an impact in the interpretation of the history of public