An erudite, thoroughly researched account of how infectious diseases and chronic illnesses have evolved in America, from pre-Columbian times to the present.
Grob (Emeritus Professor, History of Medicine/Rutgers Univ.) offers an examination of morbidity and mortality trends that is aimed at a narrower audience than was his highly readable The Mad Among Us (1994). The nature of specific diseases, the complex relationships between humans and pathogens, and the roles played by environment, population density, material comfort, and human behavior are elucidated here in a dauntingly statistics-laden text. Beginning with the introduction of infectious diseases by Europeans that decimated the Native American population, Grob moves on to the nature of the illnesses that afflicted the colonists and then those that came with the growth of cities, the migration of people, and economic development. He delineates the differences in the health of particular groups: blacks, whites, northerners, southerners, infants, coal miners, factory workers, etc. Statistics on life expectancy, morbidity, and mortality abound, although quotes from contemporary sources describing conditions do lighten the text at times. Finally, he examines the decline of infectious diseases and the rise of chronic illnesses as causes of disability and death in the 20th century. Throughout, Grob is careful to speak in probabilities, emphasizing how fragmentary our knowledge is and how much is uncertain. In words reminiscent of Alan Greenspan’s “irrational exuberance,” he concludes with the sobering warning that those predicting that disease can someday be completely conquered are suffering “at best a harmless and at worst a dangerous utopian illusion.”
A wealth of information for students of American history and the history of medicine.