Rethinking McKeown: the relationship between public health and social change

Am J Public Health. 2002 May;92(5):722-5. doi: 10.2105/ajph.92.5.722.


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.

Publication types

  • Historical Article

MeSH terms

  • Developed Countries
  • England / epidemiology
  • History, 18th Century
  • History, 19th Century
  • History, 20th Century
  • Humans
  • Mortality
  • Politics*
  • Population Growth
  • Private Sector / economics
  • Public Health / economics*
  • Public Health / history
  • Social Change*
  • Social Responsibility
  • Social Welfare / economics*
  • Social Welfare / history