Jointly organised by the Centre for the History of Medicine at University of Glasgow and the Centre for the Social History of Health and Healthcare, Glasgow (a research collaboration between Glasgow Caledonian University and the University of Strathclyde), this conference should be of interest to all medical humanities scholars.
The focus of the conference is an engagement with historical perspectives on how health has been defined, by whom, and- importantly- the motivations and objectives informing these choices of frame. An important aim of the conference is to “engage with and critique ‘governmentality’ as a tool of analysis in the history of medicine.” The idea of medicine as an instrument of social control is of course familiar to social historians of medicine, and, as evidenced by conferences like this, continues to be both provocative and informative. By contrast, most doctors are likely to have never, at least knowingly, encountered this way of thinking about the nature and purpose of medicine.
If the contents of newspapers, popular magazines, television programmes, internet sites, medical journals and reports from health departments around the world, are anything to go by, it would seem to me that a passing familiarity with the concept of ‘governmentality’ would be of great value to health care professionals, managers and policy makers alike. Consider, for example, contemporary discourse about obesity, smoking, alcohol and drug use and government drives to address these perceived public health and social problems through public health initiatives.
The relatively poor impact of medical approaches to these issues is, finally, beginning to raise questions about the suitability of a medical frame. Are people who are fat/ smokers/ drink too much alcohol/take illegal (recreational?) drugs simply making lifestyle choices, albeit ones that increase their risk of health related problems, or are they in some way ill? To paraphrase the leader of the UK’s political opposition party, David Cameron, is a person who eats a poor diet and takes little physical exercise ‘at risk’ of obesity (in much the same way that all men, especially as they get older, are at risk, say, of prostate cancer)? If so, then primary and secondary prevention strategies, already widely employed within health care, might well seem a rational approach for a government to take. If however a person who eats a poor diet and takes little physical exercise is simply an autonomous individual, making choices with predictable consequences, then a very different ‘solution’, whereby better and more attractive choices are made available, might be more appropriate.
For example, in places and societies where it is safe to cycle and to walk, and where active recreational facilities such as swimming pools and other sport facilities are cheaper and easier to access, people are less sedentary and more active. When cheap and easily available food is inherently unhealthy- think trans fats and corn syrup- those with limited resources and information will consume it. Likewise, when healthy and affordable food is cheap and easily available more of it gets eaten. Of course, not everyone will use even the most well designed cycle lanes, and not everyone prefers fresh veg to chips, but medicalising lifestyle choices will do no favour to those ‘at risk’ if it means that addressing the limitations on inidivual choice gets neglected.
Which is a rather longwinded way of saying this sounds like a fascinating and highly relevant conference, and a tacit admission that I look forward to receiving more submissions to Medical Humanities from social historians of medicine.