publichealth-3 C

Transcriber:	Chen Li-Chen
Brief Bio:
Date finished:	04-06-2006
Proofreader:	Paula Trever
Brief Bio:
Date finished:	04-06-2006

The History of Public Health

Lecture 3: The Sanitary Idea

Part C

Welcome back.  Having looked into urbanization and industrialization as social processes that prompted social reform, what I'd like to do now, in this section, is to look at some philosophical and political underpinnings of the sanitary idea.  And to do that, we have to look at what was known as the Enlightenment and a particularly unique form of Enlightenment thinking that emerged in Britain in the late 18^th and early 19^th century, and that was utilitarianism. The Enlightenment period, around about 1750 to 1830, had as its central idea democratic citizenship.  French philosophers began to challenge in this period, tradition and authority of sources of knowledge. And they began to assert the primacy of reason and rationality.  French philosophers, such as Rousseau, argued that there was a social value to intelligence. And when we talk about intelligence here, we mean, in part, the value of information and intelligence gathering. Philosophers argued that humans--and, as you can see here that I've put in inverted commas around [the word] ‘man' because that is how it used to be framed during this period--human beings could design and guarantee social progress by evaluating systematically, analyzing in a formal way, information and intelligence that was gathered.  And they also believed, the philosophers of the Enlightenment, that education and free institutions, such as hospitals and schools, could lead to human perfectibility.  And these ideas and theories provided an underpinning for public health intervention.  Rousseau again emphasized that health was a natural state of humans, and it was a desirable goal, and it was a goal that could be achieved not only by individuals and physicians, but also by the state. 

A particular form of Enlightenment thinking emerged in Britain in the early 19^th century.  The intellectual optimism and daring of the Enlightenment was combined with a practical outlook by Jeremy Bentham. And his disciples, who formed a theory of utilitarianism, were known as philosophical radicals.  And as I've said in the previous slide, they provided a theoretical underpinning for health policy but also wider social policies.  And this was known as utilitarian political economy.  And the central theme of utilitarianism was the belief that the reduction of mortality and the improvements of health had an economic value to expanding industrial societies.  If you removed disease and ill-health, you provided workers who were able to contribute to the economy of the society.  And implicit in this idea, was that it was possible to measure moral evil or vice of particular actions by the degree of misery that it created and for the number of sufferers who endured that misery.  So there was an imperative to the political-economic outlook that required measurements and information, and this links back to the basic philosophies of the Enlightenment.  And so for Bentham, the welfare of both the poor and the wealthy was a necessary goal of utilitarian government.  And actions that were best were those which accomplished the greatest good for the greatest number.  And you can see that what is also crucial to achieving this greatest happiness for the greatest number, for Bentham, was the role of government and the state.  He argued that subsistence, abundance, security, and equality could be achieved and secured more efficiently and more economically under the auspices of good government.   

So that provides you with a brief, a very brief, overview of the Enlightenment and utilitarianism, and the intellectual origins of public health in Britain in the early 19^th century.  What I'll do when we come back is to have a look at the role of statistics and epidemiology in the emergence of the sanitary idea, and how statistics and epidemiology also link back to these philosophical theoretical underpinnings of the Enlightenment and utilitarianism.