January 11, 2024 – A potentially deadly virus is spreading, and there’s a vaccine that could help save people’s lives. But a lot of people don’t want it.
This is what happened during the COVID-19 pandemic. But this is not a new phenomenon. The same thing happened in the late 1800s when many people refused to be vaccinated against smallpox.
The history of vaccine hesitancy is one of several long-standing issues in public health, a new course debuted last fall at the Harvard T.H. Chan School of Public Health. The course, titled “Reimagining Public Health—Historical Dimensions of Emerging Issues,” discusses topics such as how life expectancy is measured and used, tensions between the fields of public health and medicine, and evolving methods for determining the causes of disease.
The past is prologue
“The problems we have today in public health did not appear suddenly,” said Emily Harrison, lecturer in the Department of Epidemiology and lead instructor for the course. “They evolve from choices made by individuals and organizations and are influenced by historical context. So to understand the public health problems we’re trying to solve, it’s very helpful to understand what caused them over time. .” She added, “Having a historical perspective allows us to remain humble as we address these issues.”
Co-instructors for the Harrison course include Allan Brandt, professor of history of science in the Harvard Graduate School of Arts and Sciences and professor of global health and social medicine at Harvard Medical School; Jesse Bump, global department of global health and population, Harvard Chan School of Business Lecturer in Health Policy; Evelynn Hammonds, Professor of History of Science and African and African American Studies, College of Arts and Sciences, and Professor, Department of Social and Behavioral Sciences, Harvard Chan School of Business; David Jones ), Professor of Medical Culture at the School, Doctor of Arts and Sciences at Harvard Medical School, and Professor in the Department of Epidemiology at Harvard Chan School.
Jones points out that some of the most basic questions of epidemiology are historical in nature. “Why do disease patterns change over time? For example, why was tuberculosis a major disease in the 19th century?th The 20th Century and Heart Diseaseth? ” he asked. “Answering these questions can provide insight into the nature of disease and the power and limitations of public health and medical interventions. “
“Historical perspective can also help us solve some of our current thorny issues,” he said. “Many people are very frustrated with the politicization of COVID-19 control plans such as vaccines, masks, social distancing, school closures, etc. It’s important for everyone to realize that this resistance is not new. Anti-vaccination Sentiment and Vaccination As old as the 1918 flu pandemic, masks were controversial. Studying these historical precedents can gain perspective and understanding that are valuable to us today. Ideally, this would lead to solutions, but some of these issues do It’s tricky.”
For Harrison, one of the main takeaways from the course is that it helps students understand how the field of public health has developed. “The field is really built around the physical and life sciences,” she explains. “But because of the particular priorities of early 20th-century institution buildersth century, there has been relatively little support for the political, social and cultural dimensions of public health. “
The framework in this area has persisted over time, she said. “This way [public health] Funding received by researchers remains subject to this life sciences framework. Most schools and colleges of public health rely on federal grants to stay afloat, primarily for life science research. Far less is allocated for social and political approaches. “
Students who took the course mentioned some of the discussions that stood out to them.
Betsy Osborn, director of the Asia Program in the Department of Global Health and Population at the Harvard Chan School of Business and Graduation this year with a master’s degree in global health, discovered that understanding American sociologist and historian WEB Du Bois’ collection and analysis of information The effort is meaningful regarding health outcomes for Black Americans. “He believes the collection and availability of this information is one of the things that stands in the way of social justice,” Osborne said. “Yet his work has been largely ignored. It’s very moving to think of the almost glacial pace of social change we’ve experienced since then. I’m thankful we’re in a better place now, but sadly What’s wrong is that we couldn’t have benefited from his work sooner.”
For Sarah Boese, a first-year biostatistics doctoral student, a class discussion about who should make important public health recommendations in a democracy—public health experts or politicians—stands out. “Are we moving away from democracy if we say Congress can’t make these decisions?” she asked. Osborne agreed that the discussion raised challenging questions. “Individuals, countries, and medical markets are creating [public health] Information and incentive options? It’s not clear and it never will be clear,” she said.
“For me, this course emphasized the importance of historical inquiry in public health,” noted Hebatalla Mohamed, a master’s student in global health and population. “This course challenges us to scrutinize not only health measures but also the success of controversial strategies, the delicate balance between health expertise and democratic governance, and the critical role of the environment in medicine and public health.”
“We have a lot of very rich discussions. We don’t have enough time in each class to finish them,” Harrison said. At student request, Harrison added an extra discussion time each week. “It’s great,” she said. “It’s great to feel these conversations come to life.”