This session, in combination with other blocks in population health will analyze changing disease patterns over time to develop a fuller understanding of the impacts of medicine, public health and wider environmental changes on the health of populations. Historical accounts of great moments in public health need to be placed in context with changes in mortality within a historical era of great social change and the emergence of the contemporary practice of preventive medicine. The epidemics, developments in public health measures developed in the Victorian era are documented in both media accounts and statistical records of mortality. Historical epidemiology also enables us to examine the impact of the conquest of infectious diseases, and broader changes in environment, income and nutrition. This perspective on changes in population health is important because medical history is often presented as an account of the impact of individual heroes.
Most heroic biographies focus on discoveries, which improved treatment of individuals.
However, the history of public health also celebrates the work of pioneers such as Pasteur and Koch who developed the basis for modern microbiology and influenced the health status of whole populations. Both historical and epidemiology research demonstrate that social, economic and related environmental conditions serve to explain much of the pattern of illness and disease in modern and traditional societies. It also includes a time line showing the dates of some of the major historical events demarcating the time period in which these significant discoveries in the knowledge base of public health and microbiology were made. The work of the historical epidemiologist, Thomas McKeown identified the factor contributing most significantly to improvements in population health status in each of the three historical eras. Rather than trying to comprehensively cover many of the significant events in the history of microbiology and epidemiological understanding of infectious disease, we will concentrate on the period of the middle of the 19th century when the understanding and control of infectious diseases like cholera showed dramatic changes.