The EXODUS of public health. What history can tell us about the future

Am J Public Health. 2010 Jan;100(1):54-63. doi: 10.2105/AJPH.2009.163956.


We trace the shifting definitions of the American public health profession's mission as a social reform and science-based endeavor. Its authority coalesced in the late nineteenth and early twentieth centuries as public health identified itself with housing, sanitation, and labor reform efforts. The field ceded that authority to medicine and other professions as it jettisoned its social mission in favor of a science-based identity. Understanding the potential for achieving progressive social change as it moves forward will require careful consideration of the industrial, structural, and intellectual forces that oppose radical reform and the identification of constituencies with which professionals can align to bring science to bear on the most pressing challenges of the day.

Publication types

  • Historical Article

MeSH terms

  • Health Policy / history
  • Health Policy / trends
  • History, 19th Century
  • History, 20th Century
  • Humans
  • Occupational Health / history*
  • Occupational Health / legislation & jurisprudence
  • Public Health / history*
  • Public Health / trends
  • Public Health Administration / history
  • Social Change*
  • United States