This volume is particularly timely in view of the current national discussion regarding universal health care delivery in the United States, its potential cost and efficacy. The book is the product of a workshop organized by the Harvard Center for Population and Development Studies and conducted by the American Academy of Arts and Sciences in Cambridge in 1989.
The volume is organized into three parts. The first comprises three chapters on social, behavioral, and anthropological research and its relevance to health and social change. The second explores the links between social research and action in a series of case studies. The final section is concerned with direct links between social research and social interventions. It addresses the effects of development on health and the potential contributions social science might make toward health care delivery.
The book’s primary emphasis is on developing the concept of the “health transition.” This term, coined by John Caldwell in 1900, means that health “is more than the absence of disease. Health is construed as the ability to function.” The transition does not imply that illness or sickness is eliminated, but that “a community has available a broader and more effective range of mechanisms through which to prevent and treat disease” (p. 3). The process examines the broader, interactive set of changes in the attitudes and behaviors of individuals in family roles, as well as changes in patterns of resource allocation and “in the nature of community supports for better health” (p. 5).
The case studies are especially useful. Two concern the use of tobacco, and a third, the HIV infection in three developed countries (and how the social sciences can help prevent and control it). Two, centered on Peru, deal with diarrhea and immunization; still another deals with the malaria transition and the role of social science research in that process.
The volume’s multicultural perspective should be particularly useful to health care practitioners for both the design and implementation of health care delivery programs. To this end, the references in each chapter also constitute a valuable contribution.
