Doing Health in Europe
The series of Contemporary European History, published by de Gruyter, Berlin, asks about the agency that has formed Europe during the last century (https://www.degruyter.com/serial/ceh-b/html?lang=en). Its focus is on the people who have shaped the continent through their work, their activism or simply through the ways they have organized their lives and on the processes these activities have spawned.
Within the series, the volume Doing Health in Europe intends to explore who created health in Europe during the last century. The phrase has a strange ring to it. We are not used to thinking of health as something created, like a piece of craftmanship, but if we accept that a lot of what determines health is, indeed, human-made, the question makes eminent sense.
There is no doubt that health care workers, i.e. doctors, nurses, pharmacists and all other people working in the health sector, have had some impact on people’s health. By providing diagnoses and administering medicine and treatment to people who feel ill, their actions have had a direct bearing on the bodies and minds of people seeking their services. But, clearly, they are far from the only ones.
Health is a complex phenomenon, notoriously difficult to define on either an individual or collective level. It consists both of tangible and clearly measurable items, such as fevers, injuries, births and deaths, and of social constructions, notably conventions about which manifestations of body and mind are considered “healthy” or “normal”. Factors determining different levels of health, however defined, are numerous and varied. They include biomedical aspects such as the presence or absence of pathogens, but also the social determinants of health: social, economic and environmental factors such as gender relations, income distributions and food regulations. The WHO estimates that the social determinants of health account for between 30-55% of health outcomes (https://www.who.int/health-topics/social-determinants-of-health#tab=tab_1). Other experts believe their impact may decide between 80% and 90% (https://www.himss.org/resources/social-determinants-health). Inasmuch as the vast majority of these socio-economic and environmental conditions have been the result of human actions, the people who were behind those actions have created health. In the sense that the understanding of health depends on their social construction, the people who were formative in such constructions have also created health. They include parents, teachers, researchers, administrators, business people, artists, politicians and possibly many more, working on different scales and with different forms of influence. Together with the healthcare workers, they have collectively formed the good, bad and mixed health outcomes experienced by Europeans throughout the twentieth century until today.
This volume seeks to unravel the agency of those individuals and groups who have created health in Europe, regardless of whether they were interested in or even aware of their impact. The focus is, therefore, on decisions and actions and their outcomes, more than on intentions. Thereby, we hope to reveal the frequently overlooked unintended but important consequences of human agency, as well as the intertwined quality of health of people living in complex societies and during a period of rapid, often tumultuous development. Such effects can be positive or negative or complicated. For instance, policy makers that waged brutal and destructive wars often also planned and implemented far-reaching welfare infrastructures, as efforts to maintain the health of soldiers required healthy populations at large. Similarly, effects may change over time. Economic growth has harmed population health in the short term but benefitted it in the long term (and may have negative effects again in the very long term in the future), which means that all those groups carrying economic growth had these ambivalent effects on population health. A poignant but not singular example may be the people in the coal industry, whose work helped to improve housing and living standards for some generations of people but contributed to climate change, which will affect the health of following generations.
We are inviting contributions that explore these questions by addressing specific groups of people and the impact of their various decisions and activities on health in Europe, or on determinants that have shaped health and the various groups of people who have driven those determinants. We realize that Europe is difficult to define, and that historiography is uneven with regard to cases across the continent. But we try to be as pan-European as possible and invite chapters that consider more than one place in Europe and connect their local findings to the continent as a whole. It is expected that all texts will in some way address the current knowledge of the mechanisms through which actors impact population health and its determinants, and discuss how these findings add to our understanding to the making of Europe when applied to circumstances in different parts of the continent since 1900.
In particular, we invite contributions on the following topics, though others are welcome as well:
Part I. Actors. Chapters in this section focus on individuals and groups that intentionally or unintentionally shaped population health through their actions. This may include, among others, politicians and reformers, insurance companies, industries, energy plants, urban planners, nutritionists, citizens as consumers, healthcare workers, researchers, mothers and other family members, anti-science activists, psychologists, and journalists.
Part II. Determinants. Chapters in this section focus on determinants of health (for better or for worse), which various actors have generated, for instance:
- Education: social reformers, nation builders, teachers
- Sanitation, urban and rural: politicians, engineers, physicians, social reformers
- Warfare and conflict: soldiers, politicians, nationalists
- Income, economic growth, inequalities, social status: workers, entrepreneurs, people in power
- Pollution, environmental poisoning, toxic waste: industrialists, public health experts, workers
- Housing, urbanization, rural living: citizens, peasants, urban planners, local and central politicians
- Food (safety, security, quality): regulators, consumers, transport facilitators
- Transportation: nation builders, politicians, workers, consumers
- (Recreational) drugs (cigarettes, alcohol, refined drugs): consumers, regulators, activists
First drafts of texts of approximately 8,000 to 10,000 words will be expected by 31 March, 2024.