Visualising British Public Health

Speakers: Amanda Sciampacone, Alex Mold, Hannah Kershaw

Chair: Jonathan Reinarz and Vanessa Heggie

Paper 1 Abstract: The “Shadow of Death”: Cholera and British Medical Topography in the Nineteenth Century

Amanda Sciampacone (Birkbeck, University of London)

With the emergence of cholera in India in 1817, the repeated and deadly epidemics that struck England between 1831 and 1866, and the mysterious nature of its epidemiology, British medics were compelled to determine the cause of the disease. Since the dominant miasma theory provided only partial answers, medics looked for other factors that may have propagated cholera. Increasingly in government and medical reports, writers concentrated on the climate of India and unusual meteorological phenomena in England as the cause of cholera’s morbidity and spread. The tropical heat and jungle miasmas were blamed for first producing cholera, while odd weather was identified as spreading the malady in Britain. While much of this discourse was textual, images were marshalled to support and visualize the arguments made about the disease and the conditions in which it spread. In these visual representations, medics mapped the disease to a certain type of ‘cholera weather’ that could spread across the nation. In attempting to visualize cholera, these representations suggested that the invisible disease had substance and a very real material presence. Cholera could be quantified and measured against other seemingly intangible phenomena. As my paper will demonstrate, the conflation of cholera with the climate of India, strange weather, and a heavy atmosphere powerfully evoked visual tropes of cholera as an elusive and malignant disease that had the potential to contaminate the very landscape of the British nation.

Paper 2 Abstract: Envisaging the public: public health, the public and the visual in modern Britain

Alex Mold (Centre for History in Public Health, LSHTM)

Dorothy Porter, in her wide-ranging survey of public health history, asserts that ‘For many students the idea of studying the history of public health provokes a very big yawn since it conjures up an image of investigating toilets, drains and political statutes through the ages.’ For the student of modern Britain, the recent history of public health is perhaps more likely to provoke a blank look than a yawn. The relevance of public health to the formation of the modern state in the nineteenth century is well established, but what can it tell us about more contemporary cultures of democracy?

If there is a grand narrative in the recent development of public health, it is that of the epidemiological transition. As mortality and morbidity from infectious disease declined towards the end of the nineteenth century, the incidence of chronic conditions increased. Public health, so long configured around combating infectious disease, ‘lost its role’. So too, in some ways, have its historians. Public health rarely features in the popular historical accounts of modern Britain, and the histories that do exist tend to focus on specific issues such as AIDS and smoking, or on the workings of public health services. Yet there is much to be gained by thinking more broadly about the nature of public health and its changing relationship with the public during the second half of the twentieth century and beyond.

This paper will contribute to a discussion about the meaning of the public in modern Britain through an analysis of a selection of public health posters. What do images of the public, and of public health, tell us about the relationship between these? Through visual sources we can begin to assess how the public were envisaged by public health, and what this means for wider discussions about the nature of the public in modern Britain.

Paper 3 Abstract: Envisioning teenagers and imagining risk: the construction of HIV-positive identities in British teenage girls’ magazines, 1985-1997

Hannah Elizabeth (CSTM, University of Manchester)

This paper explores the development of AIDS representations produced for the consumption of teenage girls in the popular teen-magazines Just Seventeen and MIZZ. Although AIDS coverage in teen-magazines changed significantly between 1985 and 1997, with new narratives, characters and focuses added to their representational repertoire, ideologically the underlying motives behind the magazine’s portrayals of the disease and ‘at risk’ and HIV-positive identities did not change radically. It will be argued that the changes in representational practices wrought by AIDS around teenage womanhood, sexuality and disease were more a multiplication than transformation of existing discourses and identities. Representations of AIDS were motivated by a complex interaction between profit and government edicts; with early coverage displaying a will to prevent the magazines’ predominantly white heterosexual underage female readership from panic and prejudice. Later, when the focus of AIDS-education was dominated by safer-sex, pervasive victim-blaming narratives which suggested those who risked ‘unsafe-sex’ were to blame for their HIV-positivity were juxtaposed by extensive sympathetic coverage of reasons why teenagers continued to practice ‘unsafe-sex’. This sympathetic coverage constructed several teenage identities from the vulnerable but oppositional frustrated teen existing in the confessional space of the magazine, to the empowered knowing teen who, through the consumption of safer-sex knowledge, could defend her unenlightened sisters.

An analysis of teenage media enriches and challenges those accounts provided by histories which track more conventional sources of public health information by reasserting the importance of asking which public(s) we are speaking of in histories of public health and recognising the uniqueness and agency of teenagers as subjects of historic investigation. Furthermore, focusing on magazines – multimedia texts characterised both by their interactivity and ability to respond rapidly to both their audience and political and cultural context – gives the historian a unique purchase on that most elusive of artefacts, the audience.

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