Tom Crook
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From Asiatic cholera to COVID-19 – the many publics of modern public health
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This concluding chapter explores how the bigger historical picture opened up by the volume might be pursued further in the context of modern Britain. It does so by asking how we should explain the multiple and always problematic forms assumed by ‘the public’ within public health since its inception as a discrete field of government during the first half of the nineteenth century. The answer the chapter offers accords only a limited role to differing cultures of governance and the succession of liberal, social-democratic and neoliberal forms of statecraft. Of more importance, it suggests, has been the enduring interplay of a set of more basic, fundamental factors. The chapter highlights three in particular: democracy, by which is meant, loosely, considerations of citizenship and political subjectivity and inclusion; strategy, by which is meant considerations of organisational logistics and costs; and finally, epidemiology, by which is meant shifting distributions of morbidity and mortality. The chapter deals with each factor separately, but the argument is that they need to be grasped together if we are to understand why, and how, the public has proved such a problematic, yet central actor in the management of modern public health.

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Publics and their health

Historical problems and perspectives

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