A History of Population Health

Rise and Fall of Disease in Europe


Winner of the 2021 Choice Outstanding Academic Title Award

In A History of Population Health Johan P. Mackenbach offers a broad-sweeping study of the spectacular changes in people’s health in Europe since the early 18th century. Most of the 40 specific diseases covered in this book show a fascinating pattern of ‘rise-and-fall’, with large differences in timing between countries. Using a unique collection of historical data and bringing together insights from demography, economics, sociology, political science, medicine, epidemiology and general history, it shows that these changes and variations did not occur spontaneously, but were mostly man-made. Throughout European history, changes in health and longevity were therefore closely related to economic, social, and political conditions, with public health and medical care both making important contributions to population health improvement.

Readers who would like to have a closer look at the quantitative data used in the trend graphs included in the book can find these it here.
Open Access
Download PDF

Prices from (excl. shipping):

Johan P. Mackenbach is Professor of Public Health at Erasmus MC, Rotterdam, The Netherlands. He is a member of the Royal Netherlands Academy of Sciences and the Academia Europaea, and has published widely on contemporary and historical health issues.
"[...] strengths of this excellent book include its meticulous and extensive documentation, transparent discussion of what data is and is not available, analysis of prevailing theoretical explanations, use of supplementary tables, and Mackenbach's clear and compelling writing."
- M. D. Lagerwey, Western Michigan University, in: Choice, February 2021 Vol. 58 No. 6

"Mackenbach’s longue durée, Braudel-inspired, and erudite book wades into scholarly territory that will be familiar to readers of Journal of British Studies. […] Mackenbach’s book will provide an important starting point for future research on the role of politics and public health in curbing COVID-19."
- Jacob Steere-Williams, College of Charleston, South Carolina, in: Journal of British Studies, Vol. 60 (3), 2021, pp. 746-748.
List of illustrations

Chapter 1. Introduction
 Utopia come true?
   Rising life expectancy
   The rise and fall of disease
 The epidemiologic transition theory
   The McKeown debate and the Preston-curve
   The role of human agency
  &;How to read this book
   Concepts, sources, data and methods


Chapter 2. Long-term trends in population health
 Changes in over-all population health
   Declining mortality
   Young and old, men and women
   Regional and social inequalities
   Rising height
   More years in good health, more years in bad health?
 Changes in disease patterns
   Shifting causes of death
   Shifts in the burden of disease
   Diseases rise, diseases fall
 Epidemiologic transition 2.0
   A theory in need of repair
   How: characterizing change
   When: staging change
   Where: locating change

Chapter 3. Understanding trends in population health
  Theories of population health
   An ‘ecological-evolutionary theory’ of the origins of disease
   Explaining long-term change
 Economic, political and sociocultural conditions
   Economic history: improvements in living standards
   Political history: the rise of the modern state
   Sociocultural history: the lights go on
 Public health and medical care
   A short history of public health
   The impact of public health
   A short history of medical care
   The Role of Medicine


Chapter 4. Health problems of pre-industrial societies
 Violence and hunger
 Great epidemics

Chapter 5. Health problems of industrializing societies
 Communicable diseases
   Cholera, dysentery, typhoid
   Scarlet fever, measles, whooping cough, diphtheria
   Pneumonia, influenza
 Maternal, infant and perinatal mortality
   Maternal mortality
   Infant mortality
  Other health problems of industrializing societies
   Pellagra, rickets, goitre
   Peptic ulcer, appendicitis
   Lung diseases caused by occupational and environmental exposures

Chapter 6. Health problems of affluent societies
  Chronic diseases
   Ischaemic heart disease
   Cerebrovascular disease
   Diabetes mellitus
   Stomach, colorectal, breast, prostate cancer
   Lung cancer
   Liver cirrhosis
   Road traffic injuries
  A new plague


Chapter 7. Why?
  Why did European population health improve?
   The rise and fall of disease
   The role of human agency
   The role of public health and medical care
   The Rise of the West: was there a ‘prime mover’?
  Why did some countries rush ahead or lag behind?
   Northern lights: the Swedish advantage
   Dutch comfort: we were the champions
   Southern miracles: from rear-guard to forefront
   Balkan troubles: the weight of the past
   Russian roulette: the value of life

Chapter 8. Outlook
  Feathers of Icarus
   Geopolitical instability
   Increasing inequality
   Global environmental change
  The way ahead
   The public health paradigm
   An expanding circle of concern
   Re-thinking Utopia
  By way of conclusion
   Through the telescope of history
   The European experience
   The role of politics
   The future

Health care professionals with an interest in medical history, students and scientists in public health, economics, sociology, and related disciplines, and anyone interested in the history of health and disease.
  • Collapse
  • Expand