Emily K. Abel shows how the association of the disease with “tramps” during the 1880s and 1890s and Dust Bowl refugees during the 1930s provoked exclusionary measures against both groups. In addition, public health officials sought not only to restrict the entry of Mexicans (the majority of immigrants) during the 1920s but also to expel them during the 1930s. 

            Abel’s revealing account provides a critical lens through which to view both the contemporary debate about immigration and the U.S. response to the emergent global tuberculosis epidemic.

Drawing upon statistical data and in-depth interviews with over five hundred families in Oregon, Karen Seccombe and Kim Hoffman assess the ways in which welfare reform affects the well-being of adults and children who leave the program for work. Representative of poor communities nationwide, the vivid stories recounted here illuminate the critical relationship between health insurance coverage and the ability to transition from welfare to work.

The history of medicine is much more than the story of doctors, nurses, and hospitals. Seeking to understand the patient’s perspective, historians scour the archives, searching for rare personal accounts. Bringing together a trove of more than 400 family letters by Charles Dwight Willard, Suffering in the Land of Sunshine provides a unique window into the experience of sickness.

Severe and persistent mental illnesses are among the most pressing health and social problems in contemporary America. Recent estimates suggest that more than three million people in the U.S. have disabling mental disorders. The direct and indirect costs of their care exceed 180 billion dollars nationwide each year. Effective treatments and services exist, but many such individuals do not have access to these services because of limitations in mental health and social policies.

In our rapidly advancing scientific and technological world, many take great pride and comfort in believing that we are on the threshold of new ways of thinking, living, and understanding ourselves. But despite dramatic discoveries that appear in every way to herald the future, legacies still carry great weight. Even in swiftly developing fields such as health and medicine, most systems and policies embody a sequence of earlier ideas and preexisting patterns.

In History and Health Policy in the United States, seventeen leading scholars of history, the history of medicine, bioethics, law, health policy, sociology, and organizational theory make the case for the usefulness of history in evaluating and formulating health policy today. In looking at issues as varied as the consumer economy, risk, and the plight of the uninsured, the contributors uncover the often unstated assumptions that shape the way we think about technology, the role of government, and contemporary medicine. They show how historical perspectives can help policymakers avoid the pitfalls of partisan, outdated, or merely fashionable approaches, as well as how knowledge of previous systems can offer alternatives when policy directions seem unclear.

Together, the essays argue that it is only by knowing where we have been that we can begin to understand health services today or speculate on policies for tomorrow.