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The Deadly Truth: A History of Disease in America 1st Edition

4 customer reviews
ISBN-13: 978-0674008816
ISBN-10: 0674008812
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Editorial Reviews

From Library Journal

Is it possible to eradicate disease? Grob (history of medicine, Rutgers) addresses this question while offering a history of disease in America to illustrate the ongoing relationships among society, environment, and human health. Beginning with evidence from prehistoric skeletal remains and continuing to the present day, Grob demonstrates that disease is a natural part of our existence. Many historians see the discovery of antibiotics as a turning point in modern medicine, yet Grob provides interesting evidence showing that many diseases were on a decline even before the widespread use of antibiotics. In addition, as life expectancies increase, long-term and chronic diseases become more evident. While Grob contends that the eradication of disease is probably an unrealistic goal, he argues that we can still work to delay the onset of diseases and make them more manageable. The text is loaded with statistics on mortality rates and life expectancies that have been pulled from a vast collection of resources. Since some basic knowledge of genetics and immunology is assumed, this well-researched volume is recommended for academic library and health science collections. Tina Neville, Univ. of South Florida at St. Petersburg Lib.
Copyright 2002 Cahners Business Information, Inc.

From The New England Journal of Medicine

Perhaps the most important, if frequently overlooked, development in American history is the dramatic increase in life expectancy since the early 19th century. During the past 150 years or so, life expectancy at birth has more than doubled, and the average American has evolved from a young person to a 35-year-old adult. Until the appearance of Thomas McKeown's iconoclastic works in the mid-1970s, observers commonly attributed this achievement to the therapeutic triumphs of scientific medicine. But as medical historians since then have debated the causes of this demographic revolution, four other possible explanations have attracted considerable attention: improved living conditions, especially diet (McKeown's favorite), which increased resistance to infectious diseases, the leading killers of the past; public health measures, such as quarantine, filtered water, and effective waste removal; the decreasing virulence of some diseases; and serendipitous environmental changes. Twenty years ago, the distinguished medical historian Gerald N. Grob joined the debate with a brief for the fourth explanation in "Disease and Environment in American History," in Handbook of Health, Health Care, and the Health Professions, edited by David Mechanic (New York: Free Press, 1983). In The Deadly Truth, the first book-length survey of changing mortality in America, Grob expands (and somewhat modifies) his earlier explanation, examining the patterns of disease from the pre-Columbian period to the end of the 20th century. Animated by skepticism about the current tendency to identify the risk factors responsible for such ailments as cancer, diabetes, and cardiovascular disease -- and by Rene Dubos's pessimism about a disease-free world -- Grob insists (at least twice in nearly identical language) that "the faith that disease is unnatural and can be conquered rests on a fundamental misunderstanding of the biological world." Physicians rarely appear in Grob's narrative. Instead of focusing on heroic healers, Grob stresses the role of "unforeseen environmental changes," from the catastrophic effects of European diseases on Native Americans and the devastating toll of disease during the first two thirds of the 19th century to the dramatic decline of infectious diseases in the late 19th and early 20th centuries and the rise of chronic illnesses, such as cancer and coronary heart disease, after World War II. The waxing and waning of malaria and yellow fever provide the most striking examples of the results of environmental changes "shaped less by conscious design than by serendipity." In explaining the decline of such diseases as scarlet fever and rheumatic fever (and, to a lesser extent, smallpox and yellow fever), Grob stresses the diminishing virulence of the bacteria and viruses involved -- another factor obviously unrelated to human intent. He does, however, credit public health measures with helping to eradicate cholera and reducing the incidence of typhoid fever; and he concedes that therapeutic intervention (specifically, the deployment of an antitoxin after 1894) contributed to the declining death rate from diphtheria. Only after 1945, he claims, did "biomedical research [have] a major role in transforming medical practice." He may be right about this, though it depends on what is meant by "major" and "transforming." However, any fee bill, casebook, or patient testimony would show the error of the assertion offered on the first page, and repeated late in the book, that "before 1940 . . . the major function of medicine had been the diagnosis of disease." Grob concludes that, despite the indisputable improvement in the health of Americans, "the precise reasons for the changes in mortality and morbidity rates (and therefore life expectancy) remained murky." True, but readers of The Deadly Truth will find such reasons far less opaque than they may have before reading this book. Ronald L. Numbers, Ph.D.
Copyright © 2003 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS.

Product Details

  • Hardcover: 349 pages
  • Publisher: Harvard University Press; 1 edition (September 27, 2002)
  • Language: English
  • ISBN-10: 0674008812
  • ISBN-13: 978-0674008816
  • Product Dimensions: 6.1 x 9.2 inches
  • Shipping Weight: 1.5 pounds
  • Average Customer Review: 3.8 out of 5 stars  See all reviews (4 customer reviews)
  • Amazon Best Sellers Rank: #1,343,562 in Books (See Top 100 in Books)

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By Roger Sweeny on December 8, 2014
Format: Paperback
When this book was published, Gerald Grob was a retired professor of the history of medicine. He must have had a great system for making and accessing notes of everything he read (and/or some very capable research assistants). There is a wealth of information here–and 62 pages of footnotes at the end!

Unfortunately, the book is more parts than sum. There are lots and lots of numbers, but they are largely not comparable. For example, sometimes he will give death rates in per hundred or per thousand or per hundred thousand, sometimes as “1 death out of 67.5 people.” Sometimes life expectancy at birth, sometimes at 5 years or 20 years. Sometimes he’ll give death rates in the first year of life, or at ages 1-5 or 5-20. Sometimes there will be exotic measures like “the median age a 5 year old will live to.” No doubt this is because different researchers have reported different kinds of numbers. However, little attempt is made to bring the numbers together. Even when numbers are comparable, they are often separated by pages so it is hard to see patterns. The data cry out for “visual display of quantitative information”: pie charts, bar graphs, line graphs and more sophisticated graphics. Alas, there is only one figure in the entire book.

More and more I am coming to believe that a book like this, a summation of a substantial academic literature, should begin with a 15-25 page “executive summary”: “This is the forest; the rest of the book is the trees.”

Don’t get me wrong. Grob does talk about patterns and causes, and he is admirably frank in admitting, “We don’t know why X happened” or “We don’t know why things were different in Y and Z.” But I often felt lost in detail.

The two professional reviews give a fairly good idea of the substance of the book.
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0 of 1 people found the following review helpful By Sarah on December 20, 2014
Format: Paperback Verified Purchase
I purchased this for a class. It was interesting and provides a good introduction to the topic.
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0 of 1 people found the following review helpful By Sara Palacio on October 25, 2015
Format: Kindle Edition Verified Purchase
Nice. It help a lot.
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1 of 15 people found the following review helpful By JIONG ZHANG on December 3, 2012
Format: Paperback Verified Purchase
Not as good as the hard paper one I read in UW Health library. Print was not so good, kind of expensive.
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