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International Journal of Epidemiology 2001;30:1267-1268
© International Epidemiological Association 2001

Symposium

Commentary: Medical care and the wider influences upon population health: a false dichotomy

Stephen Frankel

Department of Social Medicine, University of Bristol, Canynge Hall, Whiteladies Road, Bristol BS9 2PR, UK.

It is a dull fact that where polarized positions exist either there is no single truth, or the truth lies somewhere between the fortified positions of the key protagonists. McKeown's presentation of historical mortality patterns1 and Illich's nihilistic polemic2 came as refreshing antidotes to both the heroic history of past therapeutic triumphs and breathless optimism about the capacity of post-war science to conquer common chronic diseases in the way it appeared, then, to have conquered the major communicable diseases. Works of that sort, with the added spice of Cochrane's iconoclastic view of the scientific foundations of clinical activity,3 became the tracts that assuaged the public health doctor's . . . [Full Text of this Article]

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