Lester Breslow, M.D., M.P.H. APHA President, 1969

Social Justice at Home and Abroad

Public health, in the modern sense, began in the struggle for social justice. That was in the early days of the Industrial Revolution, when people flocked in from the farm lands to work in the factories under overcrowded conditions and in overcrowded homes with grossly inadequate sanitation, with child labor, with all of the things that we know that gave rise to the health problems of that day: tuberculosis and other infectious diseases. We have made much progress. We have overcome many of those conditions, not completely even yet. But we have made big progress in them and we have seen as a concomitant the improvement of health.

If we look at the modern situation, as Vic just pointed out, the social disparities in our country are increasing. The rich are getting richer and the poor are getting poorer. The health conditions in our inner cities particularly are giving rise to the modern epidemics. Those epidemics, such as coronary heart disease, started among the more affluent people in society

because they had enough resources to buy the fatty foods and to begin smoking cigarettes and to have a life of relative physical ease.

Now they have learned how to overcome those adverse health practices as we understand them. The people in the inner cities, however, have acquired just enough affluence to become vulnerable to our commercialized society, in which cigarettes, alcohol, and guns are pushed upon them.

In order to overcome that fundamental condition, which is increasing the chronic disease epidemics in the inner cities today, we must begin to attack that fundamental problem and overcome the social disparities. We need to give those folks in the inner cities the same conditions that those in the suburbs have now begun to obtain and thereby to overcome the epidemics.

So we really must join in the struggle for social justice in our modern day. We have not yet seen the vigorous and nonpolitical approach to that fundamental social problem. We, in the public health movement, have a great responsibility to point out the specific connection between the modern epidemics and life in the inner cities, and to develop the social justice movement of our day.

Dr. Lester Breslow: A Celebration of his Living

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