Public Health Transitions and the “New Public Health”

Abstract

Beginning in the 1940–1950s, public health has suffered a major transition to a New Public Health focused on acknowledging socioeconomic risks to health, at the same time internalizing them to the individual who now is seen as a risk carrier. Population-based prevention became Preventive Medicine incorporated in the clinical encounter, developing diagnostic tests and explorations to detect risk-laden predispositions, preclinical conditions, even suspicious genetic markers. Individuals are medicalized into “healthy patients,” subjected to routine control check-ups, preventive medication, indications to lead healthy life style and show correct comportment. Public health prevention becomes an individual responsibility aimed at avoiding risk and preventing disease. Naturally, the well-off can adapt their life styles and incur in the extra expense of having routine check-ups, including high-tech procedures, going to spas and gym workouts, and buying expensive pharmacological stabilizers. Furthermore, if risk is internalized, there is no major pressure to publicly intervene in social and environmental health-threatening conditions. Accordingly, international organizations have given up on major ecological interventions, now proclaiming “adaptation and mitigation” policies which are not far from a conservative business as usual attitude.

Deprived of resources, public health loses its traditional agenda of collective prevention against diseases, having to witness the lack of governmental policies on security and protection of the less affluent, who have become insolvent and unable to obtain social support.