[Prevention and health promotion--what about health policy? Historical and present day perspectives].
Three "main public health revolutions" have been described in the history of public health -the fight against communicable diseases by means of hygiene and bacteriology, the struggle against risk factors by early diagnosis and behaviour modification and the vitalisation of health resources by health promotion. This does not say much about governmental or societal strategies and their successes. In this article the development of health policies is outlined from the end of the 18 (th) century until today. What kind of state-run or social responsibilities have been defined? Have health policies been supported, constrained or pursued by the state? Has state control restricted the right of personal freedom? Public health measures were often claimed by social reformers and only hesitantly adopted by state action. It was under the special conditions of National Socialism in Germany that the "Volksgesundheit" became a national objective, achieved by selection and enforced even against the will of the persons concerned. In the aftermath, personal freedom thus acquired a high priority in health policy debates. Meanwhile this view seems to be questioned.
Stöckel
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S
Institut für Geschichte, Ethik und Philosophie der Medizin, Medizinische Hochschule Hannover. stoeckel.sigrid@mh-hannover.de
Hirschberg
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I
D005858:Germany; D006291:Health Policy / Q000266:history*; D006293:Health Promotion / Q000266:history*; D054625:Healthcare Disparities / Q000266:history*; D049671:History, 18th Century; D049672:History, 19th Century; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D009313:National Health Programs / Q000266:history*; D011322:Primary Prevention / Q000266:history*; D012959:Socioeconomic Factors