The American Roots of Social Epidemiology and its Transnational Circulation. From the African-American Hypertension Enigma to the WHO’s Recommendations

In 2008, the Commission on Social Determinants of Health at the World Health Organisation published a report demonstrating the existence of a socio-economic gradient for health. Though health inequalities had been apparent since at least the 19th century, the report introduced a bio-psycho-social aetiological model that was absent from 19th century social medicine, as well as from former WHO documents. To bio-psycho-social epidemiologists stress associated with social status is the main cause of morbidity and death. Here I begin by noting that the history social epidemiologists have written for their fi eld tends to inscribe their work in continuity with 19th century social medicine. This contributes towards minimizing the epistemological and contextual transformations that led bio-psycho-social epidemiology to initiate a profound transformation in international health policy. Adopting an epistemological and transnational perspective, I fi rstly argue that bio-psycho-social epidemiology emerged from René Dubos’ historical and epistemological critique of the foundation of 19th century social medicine. I secondly show how the political and epistemological research program elaborated by Dubos developed in the US context, which was characterized both by a growing concern for chronic diseases and for racial inequalities. Finally, I show that through its transnational circulation in the United Kingdom, bio-psycho-social epidemiology was “de-racialized”. This step was a prerequisite for its aetiological model to be integrated into international public health strategies and to transform them.

The stethoscope goes digital: Learning through attention, distraction and distortion

For centuries, those training doctors have been faced with the challenges of standardising subjective experiences and constructing “the universal body” in learning situations. Various technologies have been introduced to address these challenges, with varying degrees of success. In this article we focus on the stethoscope, specifically the electrical and digital stethoscope models. Historical and social studies of medicine have already underlined the sociomateriality of learning in medicine. In this article we underscore the per formative nature of teaching and learning in the sociomaterial context. We do so by juxtaposing ethnographic and historical events that stage electrical and digital stethoscopes. These are not documentations of everyday practices but rather reconstructions of choreographed performances for learning about the body. In these stagings, the novice is taught to focus attention and avoid distraction, when learning the sounds of “the body”. Through engaging with, and comparing, different ethnographic and historic materials and artefacts, and through methodological reflection, we examine the importance not only of attention and distraction in learning a bodily skill, but also of dealing with distortion. We argue that these ethnographic and historic insights into distortion illuminate a neglected aspect of medical training, and more generally, in shaping sensory perceptions.

Assurance-maladie et libéralisme économique: l’échec de l’initiative populaire du Parti socialiste suisse de 1974

In 1974, the Swiss citizens voted against a popular initiative aimed at reforming the health insurance, launched by the Swiss Socialist Party. They refused as well a less ambitious counter-proposal elaborated by the government. This failure of the left-wing reformers is worthy of interest. This was, indeed, the main attempt until now to implement a healthcare subsidization based on social funding that would provide a wide risk coverage. In fact, shortly after the vote, the emerging economic crisis rather reinforced the advocates of a limitation of social welfare benefits. This durably hindered the political Left’s hopes of transforming in depth the Swiss healthcare system. The 1974 failure of the socialist initiative thus contributed to strengthen the conservative model, which received support from right-wing forces and the business community.

Les méthodes d’évaluation de nouveaux remèdes dans la première moitié du 19ème siècle: l’exemple des médecins genevois

Recent research on the history of medicine has shown that during the 18th century, the pharmacological market has steadily expanded. For medical practitioners, this influx of novelties triggered constant challenges to the process of cure assessment. This study analyses six historical controversies surrounding new remedies in Geneva during the first half of 19th century. The overview of fifty years of therapeutic questioning shows how Genevan practitioners managed to judge the usefulness of a specific remedy on the basis of observations – usually quite numerous – and how they started to elaborate methodological principles underlying a populational approach.

Avant-gardes et expérimentations des formes dans les revues pharmaceutiques suisses: le cas Sandorama (1962–1965)

This article reports on formal experimentation (literary, graphic and cinematographic) in Swiss pharmaceutical journals in the 1960s based on a case study: the Sandorama journal of Laboratoires Sandoz. It looks at the relationship between arts, medicine and commerce, showing that the public trust of the doctors who read the journal is built up through forms. The inventiveness of the latter is part of the more global process of a reorganization of pharmaceutical marketing after the Second World War, due in particular to the arrival of psychotropic drugs on the market.