Course Content: The purpose of this course is to provide the student of public health a clear understanding of health history as a key component of the environment in which the health care administrator must function. The course content will begin in prehistory and have a world wide perspective through the 1700s. It will then shift to the history of the United "States. In the historical, social, economic, and political context that the US. health care system evolved are lessons and understandings that are necessary for this generation of health administrators and health policy makers to advance health for all. The course will provide an understanding of the development of the health care system in the United States. The first part of the course will examine the impact of disease on world history through the 18th century. The second and third parts of the course will present, from a historical perspective, the evolution of the modern health care system in the United States.
 

Course Objectives: Upon successful completion of the course the student will:

(1) Understand the impact of disease on the historical, social, economic, and political history of the world through the 18th century.

(2) Understand the historical, social, economic, and political context that the United States health care system has evolved in.

(3) Understand the social history of medicine in the United States and how it has shaped the current health care system.

(4) Be able to apply the deductive methods of history to contemporary health care issues.

(5) Be able to apply the deductive methods of history to administrative decision in health administration.

(6) Understand the major issues in the US. health care system.

Texts:

McNeil, William H., Plagues and Peoples, Anchor Books, Anchor Press/Doubleday, Garden City, NY, 1976.

Paul Starr, The Social Transformation of American Medicine, Basic Books, Inc., NY., NY, 1962.

Selected Journal Articles.
 

Course Conduct: The course will be conducted as a seminar with lectures provided by the instructor. Lectures and discussion will be based on the assigned readings. Student achievement of the course learning objectives will be demonstrated by: student presentations that analyze assigned readings on a particular health topic, a mid-term examination, and major paper or annotated bibliography. Each student will present two assigned readings in class. Presentations should be brief and cover the most important issues in the article in order to facilitate class discussion.

The mid-term examination will be in essay form ( 3-5 questions ) covering lectures and reading assignments. It will be handed out at the end of class on Sunday, September 27, 1998 and is to be mailed to the instructor by October 15, 1998. A major paper is required for the course and is to be mailed to the instructor by December 1, 1998. The topic for the major paper should be approved by the instructor prior to the end of class on Sunday, September 27, 1998.

Course Requirements Include:

- Completing all reading assignments

- Class room participation including discussion leadership

- Student presentation on assigned readings.

- A mid-term examination (take home)

- A major research paper.

There is no page requirement on the research paper (average = 30 pages). The emphasis will be on quality research of narrow scope drawing on large numbers of source articles.
 

Grades will be computed as follows:
 

Classroom participation and oral presentation	30%
Mid-term examination	30%
Paper or bibliography	40%
	100%

CLASS SCHEDULE
 

DATE: TOPIC:

July 29 Introduction to HADM 710-Health History, Policy, and Issues

July 30 Introduction to HADM 710-Health History, Policy, and Issues
 

Readings:

Stevens, Rosemary, "History as Part of Management Education", The Journal of Health Administration Education, 4:3, Summer, 1986, pp. 447-452.
 

September 18 PM Disease and Environment - Pre-History

Readings:

McNeil, William H., Plagues and Peoples, Anchor Books, Anchor Press/Doubleday, Garden City, NY, 1976, pp. 1-68.

Penfield, Wilder, "Ur of the Chaldes and the Influence of Abraham on the History of Medicine", Bulletin of the History of Medicine, Vol. XIX, No. 2, February, 1946, pp. 133-147.

Wong, K. Chimin and Lien-Teh, History of Chinese Medicine, pp. 1-21.

Thorwald, Ju rgen, Science and Secrets of Early Medicine, pp. 233-246.

September 19 PM Civilization and Disease - 500 BC. to 1500 AD.

Readings:

McNeil, William H., Plagues and Peoples, Anchor Books, Anchor Press/Doubleday, Garden City, NY, 1976, pp. 69-175.

Lee, T'ao, "Medical Ethics in Ancient China", Bulletin of the History of Medicine, Vol. XI, No. 5, May, 1942, pp. 268-277.

Hillier, S.M. and Jewell, J.A., "Chinese and Western Medicine in China, 1800-1911", Health Care and Traditional Medicine in China, 1800-1982, pp. 3-27.

Hillier, S.M. and Jewell, J.A., "Development of Chinese Health Care, 1911-49", Health Care and Traditional Medicine in China, 1800-1982, pp. 28-65.

September 20 AM The New World-1500 AD to the Present

Readings:

McNeil, William H., Plagues and Peoples, Anchor Books, Anchor Press/Doubleday, Garden City, NY, 1976, pp. 176-257.

Unschuld, Paul U., Medicine in China: A History of Pharmaceuticals, pp. 11-16.

Unschuld, Paul U., Medicine in China: A History of Ideas, pp. 229-249..

Rutherfurd, Edward, Sarum: The Novel of England, Ivy Books, pp. 578-583.
 

September 20 PM Medicine and Culture 1760 - 1850

Readings:

Starr, The Social Transformation of American Medicine, pp. 3 - 59

Carmichael, Ann G., "Plague Legislation in the Italian Renaissance", Bulletin of the History of Medicine, 1981, pp. 508-525.

Deutsh, Albert "Historical Inter-Relationships Between Medicine and Social Welfare", Bulletin of the History of Medicine, Vol. XI, No. 5, May, 1942, pp. 485-502.

Preston, Richard, "Crisis in the Hot Zone", The New Yorker, October 26, 1992. pp. 58-81.
 

September 25 PM Rise of Professionalism 1850 - 1930

Readings:

Starr, The Social Transformation of American Medicine, pp. 60 - 144.

Barlow, William and Powell, David O. "To Find a Stand: New England Physicians on the Western and Southern Frontier 1790-1840", Bulletin of the History of Medicine, Vol. 54, 1980, pp. 386-401.

Thielman, Samuel B. "Madness and Medicine: Trends in American Medical Therapeutics for Insanity", 1820-1860", Bulletin of the History of Medicine, Vol. 61, 1987, pp. 25-46.

Ransom, John E. "The Beginnings of Hospitals in the United States" Bulletin of the History of Medicine, Vol. 13, 1943, pp. 514-539
 

September 26 PM Reconstruction of the Hospital

Public Health

Readings:

Starr, The Social Transformation of American Medicine , pp. 145 - 179, pp. 198 - 234.

Terris, Milton "An Early System of Compulsory Health Insurance in the United States", Bulletin of the History of Medicine, Vol. XV, No. 5, May, 1944, pp. 433-444.

McCandles, Peter "A House of Cures: The Ante-bellum South Carolina Lunatic Asylum" Bulletin of the History of Medicine, Vol. 62, No. 2, May, 1988, pp. 220-242.

Rosenkrantz, Barbara G. "Cart before Horse: Theory, Practice and Professional Image in American Public Health, 1870-1920", Journal of the History of Medicine, January, 1974, pp. 55-73.
 

September 27 AM Reform and Accommodation 1915 - 1945

The Liberal Era 1945 - 1969

Readings:

Starr, The Social Transformation of American Medicine, 235 - 334, pp. 335 - 378.

Mc Farland, Deborah R., Meier, Kenneth J. "Restructuring Federalism: The Impact of Reagan Policies on the Family Planning Program", Journal of Health Politics, Policy, and Law, Vol. 18, No. 4, Winter 1993, pp. 821-850.

Fan, David P., Norem, Lois "The Media and the Fate of the Medicare Catastrophic Act", Journal of Health Politics, Policy, and Law, Vol. 17, No. 1, Spring 1992, pp. 39-70.

Schorr, Lisbeth B. "Successful Health Programs for the Poor and Underserved", Journal of Health Care for the Poor and Underserved, Vol. 1, No. 3, Winter 1990, pp. 271-277.

September 27 PM End of the Mandate 1970 - 1980

Readings:

Starr, The Social Transformation of American Medicine, pp. 379 - 449.

Stoskopf, Carleen H., Samuels, Michael E., Ciesla, James R., "Findings From a Demonstration Outreach Project at a Community Health Center", Journal of Health Care for the Poor and Underserved, Vol. 4, No. 1, 1993, pp. 51-64.

Colby, David C., Cook, Timothy E. "Epidemics and Agendas: The Politics of Nightly News Coverage of AIDS", Journal of Health Politics, Policy, and Law, Vol. 16, No. 2, Summer 1991, pp. 215-249.

Wilensky, Harold L., "Social Science and the Public Agenda: Reflections on the Relation of Knowledge to Policy in the United States and Abroad", Journal of Health Politics, Policy, and Law, Vol. 22, No. 5, October, 1997, pp. 1241-1265.
 

• The topic for the major paper should be approved by the instructor prior to the end of class on Sunday, September 27, 1998.

• The mid-term examination will be handed out at the end of class.

Stevens, Rosemary, "History as Part of Management Education", The Journal of Health Administration Education, 4:3, Summer, 1986, pp. 447-452.

Penfield, Wilder, "Ur of the Chaldes and the Influence of Abraham on the History of Medicine", Bulletin of the History of Medicine, Vol. XIX, No. 2, February, 1946, pp. 133-147.

Wong, K. Chimin and Lien-Teh, History of Chinese Medicine, pp. 1-21.

Thorwald, Ju rgen, Science and Secrets of Early Medicine, pp. 233-246.

Lee, T'ao, "Medical Ethics in Ancient China", Bulletin of the History of Medicine, Vol. XI, No. 5, May, 1942, pp. 268-277.

Hillier, S.M. and Jewell, J.A., "Chinese and Western Medicine in China, 1800-1911", Health Care and Traditional Medicine in China, 1800-1982, pp. 3-27.

Hillier, S.M. and Jewell, J.A., "Development of Chinese Health Care, 1911-49", Health Care and Traditional Medicine in China, 1800-1982, pp. 28-65.

Unschuld, Paul U., Medicine in China: A History of Pharmaceuticals, pp. 11-16.

Unschuld, Paul U., Medicine in China: A History of Ideas, pp. 229-249..

Rutherfurd, Edward, Sarum: The Novel of England, Ivy Books, pp. 578-583.

Carmichael, Ann G., "Plague Legislation in the Italian Renaissance", Bulletin of the History of Medicine, 1981, pp. 508-525.

Deutsh, Albert "Historical Inter-Relationships Between Medicine and Social Welfare", Bulletin of the History of Medicine, Vol. XI, No. 5, May, 1942, pp. 485-502.

Preston, Richard, "Crisis in the Hot Zone", The New Yorker, October 26, 1992. pp. 58-81.

Barlow, William and Powell, David O. "To Find a Stand: New England Physicians on the Western and Southern Frontier 1790-1840", Bulletin of the History of Medicine, Vol. 54, 1980, pp. 386-401.

*Thielman, Samuel B. "Madness and Medicine: Trends in American Medical Therapeutics for Insanity", 1820-1860", Bulletin of the History of Medicine, Vol. 61, 1987, pp. 25-46.

Ransom, John E. "The Beginnings of Hospitals in the United States" Bulletin of the History of Medicine, Vol. 13, 1943, pp. 514-539

Terris, Milton "An Early System of Compulsory Health Insurance in the United States", Bulletin of the History of Medicine, Vol. XV, No. 5, May, 1944, pp. 433-444.

McCandles, Peter "A House of Cures: The Ante-bellum South Carolina Lunatic Asylum" Bulletin of the History of Medicine, Vol. 62, No. 2, May, 1988, pp. 220-242.

Rosenkrantz, Barbara G. "Cart before Horse: Theory, Practice and Professional Image in American Public Health, 1870-1920", Journal of the History of Medicine, January, 1974, pp. 55-73.

Mc Farland, Deborah R., Meier, Kenneth J. "Restructuring Federalism: The Impact of Reagan Policies on the Family Planning Program", Journal of Health Politics, Policy, and Law, Vol. 18, No. 4, Winter 1993, pp. 821-850.

Fan, David P., Norem, Lois "The Media and the Fate of the Medicare Catastrophic Act", Journal of Health Politics, Policy, and Law, Vol. 17, No. 1, Spring 1992, pp. 39-70.

Schorr, Lisbeth B. "Successful Health Programs for the Poor and Underserved", Journal of Health Care for the Poor and Underserved, Vol. 1, No. 3, Winter 1990, pp. 271-277.

Stoskopf, Carleen H., Samuels, Michael E., Ciesla, James R., "Findings From a Demonstration Outreach Project at a Community Health Center", Journal of Health Care for the Poor and Underserved, Vol. 4, No. 1, 1993, pp. 51-64.

Colby, David C., Cook, Timothy E. "Epidemics and Agendas: The Politics of Nightly News Coverage of AIDS", Journal of Health Politics, Policy, and Law, Vol. 16, No. 2, Summer 1991, pp. 215-249.

Wilensky, Harold L., "Social Science and the Public Agenda: Reflections on the Relation of Knowledge to Policy in the United States and Abroad", Journal of Health Politics, Policy, and Law, Vol. 22, No. 5, October, 1997, pp. 1241-1265.

John Snow, a creative if unassuming London physician, achieved prominence in the mid-nineteenth century as an obstetrician who was among the first to use anesthesia. It is his work in epidemiology, however, which earns him his position as a prototype for CDC's Division of Bacterial and Mycotic Diseases epidemiologists.

During the 1830s and 1840s, when severe cholera epidemics threatened London, Snow had become interested in the cause and transmission of the disease. In 1849, he published a brief pamphlet, On the Mode of Communication of Cholera, suggesting that cholera is a contagious disease caused by a poison that reproduces in the human body and is found in the vomitus and stools of cholera patients. He believed that the main, although not only, means of transmission was water contaminated with this poison. This differed from a commonly held theory that diseases are transmitted by inhalation of vapors. The pamphlet caused no great stir, and Snow's argument was only one of many hopeful theories proposed during a time when cholera was causing great distress.

Snow was able to prove his theory in 1854, when another severe epidemic of cholera occurred in London. Through painstaking documentation of cholera cases and correlation of the comparative incidence of cholera among subscribers to the city's two water companies, he showed that cholera occurred much more frequently in customers of one water company, the Southwark and Vauxhall.

This company drew its water from the lower Thames, where it had become contaminated with London sewage, whereas the other company obtained water from the upper Thames. Snow's evidence soon gained many converts.

A striking incident during this epidemic has now become legendary. In one particular neighborhood, the intersection of Cambridge Street and Broad Street, the concentration of cholera cases was so great that the number of deaths reached over 500 in 10 days. Snow investigated the situation and concluded that the cause was centered around the Broad Street pump. He advised an incredulous but panicked assembly of officials to have the pump handle removed, and when this was done, the epidemic was contained.

The pump handle has remained a symbol of effective epidemiology, and today the John Snow Pub, located near the site of the former pump in London, boasts of having the "original" handle. A John Snow Society has been formed to honor the memory of the epidemiologist (the only requirement being that one visit the John Snow Pub while in London). Snow was a skilled practitioner as well as an epidemiologist, and his creative use of the scientific information of his time is an appropriate example for those interested in disease prevention and control.

1.Rosenberg, Charles E. The Cholera Years. Chicago: The University of Chicago Press.
1962.

2.Snow, John. Snow on Cholera. New York: The Commonwealth Fund; London: Oxford
University Press. 1936.
 
 

Stevens, Rosemary, "History as Part of Management Education", The Journal of Health Administration Education, 4:3, Summer, 1986, pp. 447-452.

McNeil, William H., Plagues and Peoples, Anchor Books, Anchor Press/Doubleday, Garden City, NY, 1976, pp. 1-68.

Starr, Paul The Social Transformation of American Medicine, pp. 3 - 59