Exhibit 189

Rethinking McKeown: the relationship between public health and social change

Exhibit 189 · Commentary

Rethinking McKeown: the relationship between public health and social change

From the 1870s they had worked tirelessly throughout the country, leading forward the foot soldiers under their command: humble employees of local government such as sanitary inspectors, housing officers, lady health visitors, trained midwives, and school medical officers.

Szreter's restatement of his critique of McKeown. He credits Medical Officers of Health and the local-government staff they directed from the 1870s, including sanitary inspectors, housing officers, health visitors, trained midwives and school medical officers, and argues that McKeown understated organized social intervention.

Source: Simon Szreter, American Journal of Public Health 92(5): 722–725
Date: May 2002
Quoted from: Am J Public Health 92(5):722-725, paragraph on Medical Officers of Health
Grade: Peer-reviewed
Document: https://pmc.ncbi.nlm.nih.gov/articles/PMC1447152/
Accessed: 2026-11-09
Cited by: Findings citing this exhibit

Cited by

Finding MED-10.2: Peer-reviewed Historians moved the credit for the nineteenth-century fall in mortality from diet toward organized public health run by local government. Szreter credited Medical Officers of Health and the sanitary inspectors, housing officers, health visitors, trained midwives and school medical officers they directed, and Colgrove wrote that McKeown's conclusions have been largely discredited by subsequent research.