Children's Health in Historical Perspective.

Children's Health in Historical Perspective. Cheryl Krasnick Warsh and Veronica Strong-Boag, eds. (Waterloo, ON: Wilfrid Laurier University Press, 2005. xi plus 554 pp. $39.95).

This book brings together a sampling of recent scholarship on the history of child health. It is not a comprehensive history: rather, the collected essays provide case studies of various attempts to treat and prevent childhood diseases since the early nineteenth century. While the emphasis is on North America--eight of the seventeen essays cover topics in various regions of English and French Canada and five examine child health issues in the United States--there are also essays on Latin America, Australia, New Zealand, and French colonial Vietnam. In this sense, the editors fulfill their goal of showing that "children and health are not homogenous categories" but vary according to region, class, gender, and ethnicity (p. 4).

The collection is divided into four parts: the first, "Politics," examines how nationalism affected childrearing rhetoric and practices. Naomi Rogers examines how growing interest in child health reflected anxieties about the condition of recruits to the American Expeditionary Forces during the First World War. Anne-Emanuelle Birn likewise shows how the programs of the Rockefeller Foundation's Pan American Sanitary Bureau "clearly reflected U.S. hegemonic interests in Latin America in the early twentieth century" (p. 73). Yet, concern for child health and welfare was also "rooted in the region's indigenous cultures," and thus state-supported child health services found a "far more supportive home" in Latin America than they did in the United States (p. 91). Finally, Denyse Baillargeon demonstrates how burgeoning nationalism among French Canadians actually prevented them from adopting sanitary measures to benefit children, believing that adopting "Anglophone" public health initiatives would reinforce Anglo stereotypes about the inferiority of francophone culture.

The second section, "Nutrition," continues the theme of children as human capital in the service of nation building. Lisa Featherstone's essay on infant feeding in Australia confirms earlier work by Rima Apple and Janet Golden that debates about infant feeding were central to the professional ambitions of pediatricians and the rise of pediatrics as a legitimate medical specialty. (1) Judith Sealander explores how the professional study of food became identified as a quintessentially "American science," one that tended to feed the economic interests of the American food industry more than it did actual children. Aleck Ostry presents a similar study of the impact of the powerful Canadian dairy industry on expert advice regarding milk consumption.

In section three, the "Racial and Ethnic Dimensions" of child health policy in the United States, Canada, New Zealand, and French colonial Vietnam are explored. All five essays show definitively that public health reforms contained a mixture of genuine humanitarianism and the cultural biases of the white middle-class establishment. Despite the tendency to scapegoat and denigrate the health practices of immigrants and First Nation peoples, the public health campaigns of the first half of the twentieth century were extremely effective in eradicating many childhood diseases and dramatically reducing infant and child mortality.

Section four, "Experts," shows how the professional ambitions and biases of health experts led them to fail as many children as they actually helped. Hughes Evans discusses how the preconceptions of American physicians led them to deny that the high incidence of gonorrheal vaginitis was due to child sexual abuse. Cynthia Comacchio continues my work on adolescent health care by extending the story into English Canada, showing that the rise of national health insurance in Canada led to a much different adolescent health infrastructure than that found south of the border. (2) Janet Golden's essay shows that despite the defeat of federally-funded child health programs, many such programs "endured on the local level, attempting to provide children with an array of services aimed at preserving their health and improving their standard of living" (p. 391).

The final section, "Institutions," shows how rhetoric about child and nation justified the construction of children's hospitals and traveling clinics in both French and English Canada. The article by Marie-Josee Fleury and Guy Grenier provides a different perspective on francophone child health policies, arguing that despite their defensiveness, French authorities emulated Anglophone practices by constructing children's hospitals. Annemarie Adams and David Theodore challenge standard histories of hospitals, showing that at least in English Canada, architects resisted the tradition to a modern, scientific medical center, instead preferring traditional architectural forms that were visually soothing and which reinforced the social order. Finally, Sharon L. Richardson shows that even the most transient of institutions--the traveling clinic--could have a remarkable impact on the health of children in remote rural areas.

In the Introduction, the editors acknowledge that the collection falls short of being a full social history of child health, as "young voices and opinions remain for the most part missing" (p. 5). There is no doubt that finding first-hand accounts of children's experience with illness is difficult. Yet, as Russell Viner and Janet Golden observe in a recent essay, "there are diaries, letters, memoirs and other materials that demand examination," and one hopes that future work on child health will answer this call. (3) The beliefs of parents and other family members who sought help for the sick children are also rarely mentioned. Instead, the essays mostly describe how the bodies and minds of children were subjected to the control of powerful health professionals and government authorities. The editors acknowledge that despite their faults, the new sensibilities about child health and welfare that emerged in the early twentieth century has made the protection of the young "a benchmark of civilized society." They hope by providing a "contradictory history" of child health, the book will "assist today's policy-makers, professionals, and citizens as they think more critically about how to improve the health and well-being of all children" (p. 15). This worthy goal could have been more effectively accomplished had the editors provided a concluding essay that gave concrete suggestions as to how modern-day health professionals can improve the health of children in the developing world without replicating the prejudices of earlier generations of reformers. Nevertheless, this collection contains examples of the best scholarship in this field, and will provide an excellent foundation for those interested in exploring children's health issues past and present.

Heather Munro Prescott

Central Connecticut State University 

ENDNOTES

1. Rima D. Apple, Mothers and Medicine: A Social History of Infant Feeding, 1890-1950 (Madison, 1987); Janet Golden, A Social History of Wet Nursing in America: From Breast to Bottle (New York, 1996).

2. Heather Munro Prescott, "A Doctor of Their Own": The History of Adolescent Medicine (Cambridge, MA, 1998).

3. Russell Viner and Janet Golden, "Children's Experiences of Illness," in Roger Cooter and John Pickstone, ed., Medicine in the Twentieth Century (Newark, NJ, 2000), 575-587.