Antagonism and accommodation: Interpreting the relationship between public health and medicine in the United States during the 20th century
Antagonism and accommodation: Interpreting the relationship between public health and medicine in the United States during the 20th century
复制标题
DOI：
10.2105/ajph.90.5.707
复制
发表时间：
2000-05-01
影响因子：
12.7
通讯作者：
Gardner, M
中科院分区：
文献类型：
--
作者：
Brandt, AM;Gardner, M
在整个世纪，许多观察家都注意到公共卫生和医学之间的重要紧张关系和反感。与此同时，改革者经常呼吁这两个领域之间更好的接触和合作。本文探讨了医学和公共卫生之间的关系的历史，以研究它们是如何发展为独立的，往往相互冲突的专业。这种关系的历史特征只能在专业教育的制度发展，疾病的生物医学模型的兴起，以及从传染病到系统性慢性疾病的流行病学转变的背景下理解，当代疾病负担中的许多问题为基于人群的干预和临床干预之间的有效合作提供了机会。然而，公共卫生和医学之间通过适应简化论生物医学而建立的更强有力的联盟有可能颠覆公共卫生对理解和解决疾病社会根源的历史承诺。
Throughout the course of the 20th century, many observers have noted important tensions and antipathies between public health and medicine. At the same time, reformers have often called for better engagement and collaboration between the 2 fields. This article examines the history of the relationship between medicine and public health to examine how they developed as separate and often conflicting professions. The historical character of this relationship can be understood only in the context of institutional developments in professional education, the rise of the biomedical model of disease, and the epidemiologic transition from infectious disease to the predominance of systemic chronic diseases.Many problems in the contemporary burden of disease pose opportunities for effective collaborations between population-based and clinical interventions. A stronger alliance between public health and medicine through accommodation to a reductionist biomedicine, however, threatens to subvert public health's historical commitment to understanding and addressing the social roots of disease.