Health Care and Social Change in the United States A Mixed System, A Mixed Blessing

Abstract

or most of human history, the health of any society did not depend much on its biomedical healing system. Physicians could cure or assuage a limited number of conditions, but not until the late 19 century did medicine have a sufficient grounding in experimental science to allow the systematic treatment of disease. Indeed, in 1880, when the United States entered what is commonly known as the mortality transition, its biomedical establishment was weaker than those of most nations in Western and Central Europe. In order to understand changes in the health of Americans, one must consider medical factors as well as political and cultural ones. Indeed, the importance of non-biomedical considerations has persisted to the present in American health. This essay will analyze the relationship between health and society in the United States over two long periods, from 1880 to 1930 and from 1930 to the present. It will identify those forces that contributed to better health and longer life as well as those problems that had to be addressed. The paper will also consider inequalities in health among Americans. On the basis of these generalizations, the U.S. experience can be made comparable to that of other countries.