From Cradle to Grave: Introduction • Hilary Marland, Office H315 • Office Hours Mon 2-3 and Weds 11-12 • Email email@example.com
Feb 25, 2016
From Cradle to Grave: IntroductionHilary Marland, Office H315Office Hours Mon 2-3 and Weds 11-12Email firstname.lastname@example.org
Objective of moduleExplore medicine in modern Britain through the lens of the life cycle, examining how health care and medical interventions impinge on individuals and families from birth, through adolescence, maturity and aging, and death
Lectures 3-4pm S0.19Seminars 4-5pm H102I expect you all to do the required reading on a weekly basis and also to lead some of the seminar discussionsLecture topicsGeneral introductionDemographic change and shifts in medical anxieties over 200 years e.g. problem of agingLiterature/themes and medicalisation of societyLinking past with presentAge, time and bodies - temporalityState medicine/role of institutionsAccess, entitlement, expectations and consumptionMedia watching seminarCurrent debates in health service!
Demographic increase18002000Population9 million58 millionWealth per capita1,50021,000Life expectancy4079The UK in 1800 and 2000: some comparisonsAverage mortality per year per million England and WalesCause of death1851-601891-1900Smallpox221 (1.0%) 13 (0.07%)Scarlet fever876 (3.9%) 158 (0.9%)Fevers908 (4.1%) 182 (1.0%)Tuberculosis 2,679 (12.1%) 1,391 (7.6%)Cancer317 (1.4%) 758 (4.2%)Circulatory diseases1,247(5.6%)1,657(9.1%)All causes22,16518,194 Demographic changes and concernsRoughly speaking the modern period (1800-2000) has been marked by:19thC concern about everybody dying, but notably those dying too young or of working age/childbearing age most deaths resulted from a wide range of usually epidemic disease, made worse by poor public health provision, dire working and living conditionsby late 19thC deaths from most major diseases were in decline attention shifted to concerns about infants and young children, given the extremely high rates of infant mortality for every 1,000 live births, 154 babies died in 1900 before their first birthday, 30 in 1950 and 9 in 1985moving into mid to late 20thC preoccupation with chronic diseases often of middle life, notably heart disease and cancer, which began to impact significantly on death ratestowards end of 20thC great concern not about people dying too young but living too long. Living longer does not necessarily equate with living healthier. Anxieties about the aging population and how to support them into an ever longer old age.
Problems of aging populationIn words of WHOpopulation ageing can be seen as a success story for public health policies and for socioeconomic development, but it also challenges society to adapt, in order to maximize the health and functional capacity of older people as well as their social participation and security
This week, Health Secretary Jeremy Hunt announced a new cap - 75,000 - on the amount that individuals will be expected to pay towards their own social care.. This, he claims, is designed to readjust the balance of responsibility between the individual and the state, and prevent the 'scandal' of older people having to sell their homes to pay for their care. In an interview given to Andrew Marr this weekend, he particularly mentioned the plight of those suffering from dementia, a condition which has become a prominent cultural repository of our darkest fears about the challenges, losses and burdens of old age. Hunt alluded to the figures at the heart of the Prime Ministers Challenge on Dementia, launched last year, which suggested that the number of people living with this condition will double in the next 40 years, to reach 1.7 million by 2050.
http://www2.warwick.ac.uk/knowledge/culture/oldage/ 12 Feb. 2013Dementia and societyRelationship between historical work and current issues
Medicalisation/psychologisation of society
Linking past and present?Although the historical method is concerned primarily with the past, that is with opening up new ways of understanding how health and disease have been experienced and managed in past times, the scope and meanings of medical history are also overtly shaped by, and contribute to, present debates. (Mark Jackson, Oxford Handbook, p.13)
Anti-vaccination TemporalityChanging markers of birth and death See David Armstrong, The temporal body in Roger Cooter and John Pickstone (eds), Medicine in the Twentieth Century (2000). 247-59. Relationship between time, age and bodies has changed significantly in the modern period. Birth and death are the traditional outer markers of the temporal space of the life span. But this temporal space has been remapped, and sub-divided in the 19th and 20th centuries.
The division of infancy1857 that the Registrar-General reported the number of deaths of children under the age of one (deaths first registered in 1838) giving formal recognition to the infant morality statistic and highlight high number of infant deaths.In 1926 stillbirths (after 28 weeks of pregnancy) began to be recorded in (Births and Deaths Registration Act), giving a new starting point to infancy after 28 weeks. In 1938 neonatal mortality was recorded separately, the first four weeks of an infants life. In the 1950s perinatal mortality deaths in the first week of life came into general use (now deaths after 24 weeks of gestation according to WHO).State medicine and responsibility
NHS and access to careThe creation of the NHS in the reconstruction years following World War II was based on William Beveridges 1942 report, which argued that universal access to health care was necessary in order to fight the five giants (want, disease, squalor, ignorance and idleness). Beveridge believed that the government should provide its citizens with social security from the cradle to the grave.
From spectacles and dentures to the perfect smile
Consumption and innovation
Ideas of healthWHO 1948, Health Not merely the absence of disease and infirmity but complete physical, mental and social wellbeing