History of Health and Disease in Modern Latin America

by

Diego Armus

• LAST REVIEWED: 30 September 2013
• LAST MODIFIED: 30 September 2013
• DOI: 10.1093/obo/9780199766581-0094

Introduction

Since the early 1980s, historical studies on disease and health in modern Latin America have produced a significant body of scholarship. Efforts to renew the traditional history of medicine and the spread of historical studies of population with a social and cultural emphasis are some of the trends that explain this historiographical process. Three ways of writing define the field: the history of public health, biomedical history, and the sociocultural history of disease. There is a good deal of overlap among these three approaches, because all three tend to discuss diseases, health, and medicine as socially generated processes of grouping biomedical and sociocultural phenomena. But they also have some distinctive features. The history of public health focuses mainly on the power—the institutions and professionals—of the so called hegemonic medicine; that is, the medicine of certified doctors and nurses, hospitals, health systems, health insurances, welfare support networks, and so on. It is a history of public health and in public health, because those who practice it—mainly public health specialists and historians—want to influence the production and direction of public health agendas. Biomedical history focuses on scientific developments, but the aim is to contextualize them. It tries to overcome the limitations of the traditional history of medicine, oftentimes a self-celebratory narrative of benevolent doctors and official medicine. Finally, the social and cultural history of disease looks at discourses, policies, and experiences related to health and maladies. This history focuses on problems related to social control, resistance and adaptation, change and continuity. It discusses disease metaphors, the production of political discourses, and its transformation –(when this in fact occurs) in effective policies; the material conditions of daily life and their influences on morbidity and mortality patterns; and the experiences of the sick, not only in the institutions of the hegemonic medicine but also in the realms of alternative, nonofficial medicines. This bibliography includes studies dealing with the period between the last third of the 19th century—when modern bacteriology became hegemonic—and the first decades of the Cold War period. Historical studies on mental health are not included. References to medical anthropology studies are limited to those cases where the historical dimension is not marginal. The historiography of this field is consistently growing in South and Central America, but it is in Brazil that this process is particularly strong and diverse.

Historiographical Essays

Since general overviews or narratives are not available thus far, historiographical essays are the best entrance to the available scholarship on the history of diseases and health in Latin America. Essays on the state of the field are not abundant. Duarte Nunes 2000 does so in Portuguese, but only focusing on the Brazilian case. In Spanish, Armus 2003 and Armus 2005 aim at the whole region, with an interpretative framework in terms of trends, legacies, and historiographical styles. In English, Armus and López Denis 2010 is the only essay that covers the periods before and after the triumph of bacteriology. Birn and Necochea López 2011 adds some updated information.

• Armus, Diego. “Disease in the Historiography of Modern Latin America.” In Disease in the History of Modern Latin America: From Malaria to AIDS. Edited by Diego Armus, 1–24. Durham, NC: Duke University Press, 2003.

  An effort to organize recent trends in the historical study of diseases by grouping the available literature along the lines of biomedical history, the history of public health, and the sociocultural history of diseases.

• Armus, Diego. “Legados y tendencias en la historiografía sobre la enfermedad en América Latina moderna.” In Avatares de la medicalización en América Latina, 1870–1970. Edited by Diego Armus, 9–40. Buenos Aires, Argentina: Lugar Editorial, 2005.

  An assessment of the growth of the field trying to connect historiographical discussions with regional and national legacies vis-à-vis matters of health and disease.

• Armus, Diego, and Adrián López Denis. “Disease, Medicine and Health.” In The Oxford Handbook of Latin American History. Edited by José Moya, 424–453. New York: Oxford University Press, 2010.

  DOI: 10.1093/oxfordhb/9780195166217.001.0001

  A critical discussion of relevant scholarly production ranging from colonial epidemiology and pharmacopoeia to 20th-century public health institutions, urban hygiene, and disease metaphors.

• Birn, Anne-Enmanuelle, and Raúl Necochea López. “Footprints on the Future: Looking Forward to the History of Health and Medicine in Latin America in the Twenty-First Century.” Hispanic American Historical Review 91.3 (2011): 503–527.

  DOI: 10.1215/00182168-1300164

  Complements the other articles in this section by adding information about scholarly production focused on the Cold War period as well as on gender and race.

• Duarte Nunes, Everardo. “Sobre a história da saúde pública: idéias e autores.” Ciencia & Saúde Coletiva 5.2 (2000): 251–264.

  An examination of the field of public health history in modern Brazil, written by a public health practitioner and advocate.