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Wednesday 18 March 2020 14.00 - 16.00
U-3 HEA03 Health Policies in the 20th Century
Reuvensplaats 4, 201A
Network: Health and Environment Chairs: -
Organizer: Enrique Perdiguero-Gil Discussants: -
Josep Lluis Barona : Nutritional Policies in Interwar Japan: an International Model
Japan started a process of industrial development during the Meiji and Taisho Periods (1868-1926). At that time, beriberi, tuberculosis and nutritional deficiencies were major social diseases causing huge political concern. Nutrition and balanced diet were key factors to fight against these diseases and to improve the nutritional condition of ... (Show more)
Japan started a process of industrial development during the Meiji and Taisho Periods (1868-1926). At that time, beriberi, tuberculosis and nutritional deficiencies were major social diseases causing huge political concern. Nutrition and balanced diet were key factors to fight against these diseases and to improve the nutritional condition of the population. Tadasu Saiki established a research institute on nutrition in Tokio in 1916. The institute was nationalized in 1920 as Imperial State Institute for Nutrition, becoming subsequently National Institute of Health and Nutrition (NIHN).
In early 20th century, rice, miso soup and pickles constituted the basics of diet in Japan. The NIHN focussed research on the promotion of a well-balanced diet by reducing the rice proportion of the diet, increasing protein and fat intake. The Institute boosted as well food security systems of control and inspection. Nutritional research was also applied to the definition of dietary standards to palliate famine and to allow rationing policies. The Imperial State Institute for Nutrition played a crucial role in the introduction of “nutritional science” as an academic discipline, making scientific and applied contributions to improve the diet of the population, including the training of dietitians and nutritionists, spreading nutritional education.
The work done reached a wide impact in Western countries. Tadasu Saiki, director of the Imperial Institute gave lectures in Europe and America during the 1920s. He was invited by the League of Nations to report his work in 1925 and wrote an extensive report entitled “Progress of the Science of Nutrition in Japan” for the League of Nations (1926).
This paper is based on archival sources: “The present condition of the study of the nutritional problem in Japan” Geneva, League of Nations Archives, 12B/59161/55308 reported by Saiki before the 6th Meeting of the Far East Tropical Medical Association, October 13, 1925, Tokyo; "Progress of the science of nutrition in Japan". Geneva, Health Organisation of the League of Nations. Publications III. Health, 1926.III.25, C.H. 523; publications such as Saiki T. Progress of the Science of Nutrition in Japan. Geneva, League of Nations, 1926, and Charles Grey Egerton, "The Food of Japan", Geneva, League of Nations Archives, C.H.681, 1928, 81 p. (Show less)

Kari Tove Elvbakken : Rockefeller and Norwegian Health Policy after WWII
As in many other European countries, the Rockefeller Foundation contributed with funding of the Norwegian Public Health Institute in the late 1920s. The foundation also funded university departments, research institutes and scholarships for researchers from several disciplines. This paper will explore the distribution of the different funding instruments and scholarships ... (Show more)
As in many other European countries, the Rockefeller Foundation contributed with funding of the Norwegian Public Health Institute in the late 1920s. The foundation also funded university departments, research institutes and scholarships for researchers from several disciplines. This paper will explore the distribution of the different funding instruments and scholarships connected to the health services, health administration and medical research. The paper will analyse the relations between science and policy, focus on epistemic networks and the role of international influence and inspiration for the development in Norway. The aim of the paper is to understand the influence from the Rockefeller Foundation on Norwegian health policy after 1945. (Show less)

Heini Hakosalo : Brittle Bonds: the Effect of Tuberculosis on the Social and Familial Fabric in 20th-century Finland
From the beginning of the 20th century until the 1970s, tuberculosis was considered a major public health threat in Finland, and tuberculosis control constituted a prominent element of public health care. The disease constituted an immense burden to society. This burden is usually discussed in terms of mortality and (for ... (Show more)
From the beginning of the 20th century until the 1970s, tuberculosis was considered a major public health threat in Finland, and tuberculosis control constituted a prominent element of public health care. The disease constituted an immense burden to society. This burden is usually discussed in terms of mortality and (for the more recent times) morbidity. Some people have also ventured to estimate the economic impact of the disease. However, such figures do not exhaust the social and cultural impact of tuberculosis, which goes deep into the basic fabric of society. This paper focuses on the effect that tuberculosis had on families, and especially on the parental bond. Countless child-parent bonds were broken because of the disease, even when it did not lead to death. This disruptive impact was both direct and indirect. Diseased children and parents were removed from the family home to sanatoria, and healthy children of diseased parents were placed in preventoria or healthy households. The indirect impact was felt in those numerous cases when the disease pushed the family below the subsistance level, and turned it into a client of poor relief and public interventions, which often led to the placement of children out of home. The paper delievers an estimate of the number of child removals caused by tuberculosis and argues that there were structural features in Finnish 20th century society (at least until the late 1960s) that made families especially vulnerable to the disruptive effect of the disease. There features pertain to the economic structure and the typical livelihoods, to household wealth, and to the nature of social and healthcare practices. (Show less)

Enrique Perdiguero-Gil : Towards New Health Policies: the Role of Health Education in Spanish Health Reform (1970-1982)
The aim of this paper is to analyse the role of health education in the reform projects debated in Spain in the last years of Franco’s dictatorship and the Democratic Transition.
Before the Civil War, especially during the Second Republic, steps were taken to encourage health propaganda, as health education ... (Show more)
The aim of this paper is to analyse the role of health education in the reform projects debated in Spain in the last years of Franco’s dictatorship and the Democratic Transition.
Before the Civil War, especially during the Second Republic, steps were taken to encourage health propaganda, as health education was known at the time. The main topics addressed by health education were sexually transmitted diseases and the fight against infant mortality. After the Civil War, the new health authorities viewed health education with suspicion, as they were reluctant to allow the participation of the population in any social sphere. The principal health education activities aimed to decrease infant mortality. The participation of rural popularisers, who belonged to the Women’s Section of the fascist party that had supported the military coup, contributed to the cause. School health education proposals had no success.
At the end of the 1950s Spain abandoned autarchy and entered a period of economic growth. Access to healthcare (under a social security system) reached wider layers of the population and healthcare premises were improved. The health system was centred on curing disease. In this context, the role of health education did not increase, except in the case of the food and nutrition education programme (EDALNU), which published abundant material for use in schools.
When at the beginning of the Democratic Transition, left-wing doctors began to publish plans to reform a health sector that they considered unsustainable, it was considered that health education activities during the dictatorship had been practically null. The projects of health reform defended sensible changes in health policies and one of the main pillars of a new National Health Service was health education.
In this paper, I analyse the characteristics of health education proposals published in Spain during the Democratic Transition as a key element in the debates of health policies required to build a new health system. My sources are official documents, health reform projects and texts published by scholars for the training of health professionals.
The health education concepts handled during the Democratic Transition were, in general, old fashioned, used top-down strategies, and focused on damaging health behaviours isolated from the social environment. New ways to consider health education activities only appeared at the end of the period under study and increased their influence over the 1980s, especially through the work of community nurses in primary health centres. (Show less)



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