Health in society
Literary Summary by Lynn Jansen
201900017 - 2025
,Content
Introduction to this summary............................................................................................... 4
Week 1....................................................................................................................................... 5
The New Public Health - Baum - Chapter 1: Understanding Health: Definitions and
Perspectives.......................................................................................................................5
The New Public Health - Baum - Chapter 2: A History of Public Health............................ 9
The New Public Health - Baum - Chapter 3: The New Public Health Evolves................. 13
Week 2................................................................................................................................... 24
The New Public Health - Baum - Chapter 4: Ethics, politics and ideologies: the invisible
hands of public health...................................................................................................... 24
The New Public Health - Baum - Chapter 5: Neo-Liberalism, Globalisation and Health..29
The New Public Health - Baum - Chapter 11: Changing health and illness profiles in the
twenty-first century: global and australian perspectives...................................................34
The New Public Health - Baum - Chapter 13: The Social Determinants of Health Inequity.
38
Week 3................................................................................................................................... 46
The New Public Health - Baum - Chapter 14: Global physical threats to the environment
and public health.............................................................................................................. 46
The New Public Health - Baum - Chapter 15: Urbanisation, population, communities and
environments: global trends............................................................................................. 53
The New Public Health - Baum - Chapter 16: Healthy economic policies........................59
The New Public Health - Baum - Chapter 17: Sustainable infrastructures for health,
well-being and equity........................................................................................................64
The New Public Health - Baum - Chapter 6: Research for a new public health...............69
The New Public Health - Baum - Chapter 7: Epidemiology and public health................. 71
2
,Introduction to this summary
This summary has been carefully prepared based on the book The New Public Health by
Baum. It covers chapters relevant for the “Health in Society” exam at Utrecht University for
the 2025–2026 academic year, with individual summaries organized on a week-by-week basis
structured by following the book's original structure.
I highly recommend referring to the tables and figures in the book whenever they are
mentioned in the summary, as they help provide a clearer understanding of the material. I also
recommend reviewing the critical reflection questions at the end of each chapter; the
summaries contain enough content to answer these questions.
To be fully transparent, some AI assistance was used, although only to clarify some confusing
paragraphs and to streamline certain sections for better readability.
Please do not share this file amongst peers.
The version you are currently reading is from weeks 1, 2, and 3; with a total reading time of
approximately 2 hours.
3
,Week 1
Introduction to (new) public health
The New Public Health - Baum - Chapter 1: Understanding Health:
Definitions and Perspectives
Introduction
The introduction emphasizes that health is a social, economical and political inquiry; as well
as a fundamental human right. Inequality, poverty, exploitation, violence and injustice are
seen as the cause of bad health. The toxic combination of bad policies, economics and
politics are the cause of world wide populations who don’t have good health. This chapter
presents five main perspectives on health.
1 - Health: the clockwork model of medicine
The clockwork model of medicine views the body like a machine, with health defined as
efficient functioning and illness seen as system breakdowns. Emerging from Linnaeu’s
classification of diseases in the 18th century and later advances in identifying disease causes,
this biomedical perspective has dominated Western medicine for two centuries. However, it
largely neglects the social and personal contexts of living with disease.
2 - Health as the absence of illness
The biomedical model distinguishes between disease (objective, diagnosable abnormalities)
and illness (subjective, cultural, and personal experience). But both disease and illness can
detract from health. While dominant in Western medicine (the biomedical model), it has been
criticized for being mechanistic, overly focused on the body, and neglecting social,
psychological, and spiritual aspects of health. Alternative traditions, such as midwifery,
herbalism, Ayurveda, Chinese medicine, and social medicine, have long offered broader
perspectives, though often marginalized.
Over time, behavioural psychology added an emphasis on lifestyle choices and prevention,
but the biomedical model still relies on contested notions of “normal functioning” and
reinforces a mind/body split. Its definitions of mental illness, shaped by cultural values, have
been heavily debated (e.g., hysteria, homosexuality, HIV stigma). Critics argue that medical
categories often reflect social norms rather than objective science.
The model has also been accused of disease mongering, with pharmaceutical interests
expanding disease categories (e.g., labeling obesity itself as a disease). Ultimately, the
absence of disease may be part of health, but health is more complex and multidimensional
than just the absence of disease.
In response to the limitations of defining health as only the absence of disease, the World
Health Organization broadened the concept to include a complete state of physical, mental,
and social well-being. Though criticized as idealistic, this definition encouraged health
initiatives beyond disease prevention. Well-being, however, has been difficult to define.
4
,Positive perspectives, such as VicHealth’s definition of mental health as social, emotional,
and spiritual vitality, and Indigenous views that connect health to land, culture, and
community, highlight broader and more holistic understandings of health. These emphasize
that true health goes beyond the physical body and involves personal, social, and cultural
dimensions.
Measuring health
Measuring health and well-being is difficult, as existing tools (e.g., SF36, Nottingham Health
Profile) focus on disease or deficits rather than positive states and are often static. Reviews
show these measures lack reliability, validity, and reflect professional definitions (Instead of
how everyday people understand or experience it). Overall, health is complex and resists
simple quantification, leading scholars like Antonovsky to argue for a salutogenic approach
(shift in focus from preventing illness to promoting well-being and strengths) that views
health on a continuum and incorporates people’s own definitions.
3 - Health: ordinary people’s perspectives
Health literature shows that ordinary people often define health differently from
professionals. People find illness easier to define than health, since illness demands action
while health is often taken for granted. Three main domains emerge: health as the absence of
illness, as the ability to function in daily life and as a sense of well-being. Studies (e.g., Pill,
Herzlich, Blaxter) reveal that people also see health as coping capacity, reserves to manage
illness, and a dynamic balance influenced by lifestyle and environment. Definitions by the
public often include a moral dimension, being healthy is tied to responsibility and identity,
while illness may be seen as “giving in.” Health inequalities are understood not only in
material terms but also in emotional ones, with disadvantaged groups reporting stress, shame,
and injustice when comparing themselves with others. People with illness or disability may
still consider themselves healthy, assessing health subjectively in relation to age,
expectations, and their own circumstances.
Public and private lay accounts
Cornwell’s study of working-class men and women in London showed that people give both
public and private accounts of health. Public accounts
tended to reflect the biomedical model, included moral judgments, and often divided illness
into causes seen as either the individual’s fault or not. Private accounts, which emerged only
after trust was established, were more personal and complex, drawing on lived experience
and the circumstances of others. These private perspectives revealed that people viewed
health as closely linked to overall life circumstances, highlighting the interplay between
individual and structural factors.
Health in cultural and economic contexts
Crawford’s interviews with adults in Chicago showed that understandings of health reflect
cultural and economic contexts and are socially valued. He identified two main discourses.
The first sees health as self-control, emphasizing discipline, self-denial, and willpower;
values associated with middle-class professionals but also present among some blue-collar
5
, workers (people who typically do manual or physical labor jobs). Here, health is achieved
through healthy behaviour, with strong moral judgments about body size and lifestyle
reflecting dominant cultural values of individualism and the Protestant work ethic. The
second discourse views health as a release mechanism, equated with feeling good and
providing relief from stress, pressure, and worry. This was common among working-class
men, who often resisted medical authority and public health messages as restrictive.
Crawford highlights the tension between these two perspectives, they contradict each other.
On one side, society pressures people to be disciplined and controlled (health as self-control);
on the other side, people also value relaxation, enjoyment, and release from control (health as
release mechanism). This tension can be linked to broader cultural contradictions between
discipline for production and indulgence for consumption.
Spiritual aspects
Ordinary people’s perspectives of health may also include a spiritual element.
Stainton-Rogers found that some people attributed health and illness to the influence of
religious or supernatural powers, with healing seen as the result of divine or external
intervention. Such perspectives are especially common among Indigenous communities,
where health and illness are understood in spiritual as well as physical terms, and traditional
healers are valued for their perceived ability to connect with these forces. Overall, research
on public perspectives highlights that health is complex, socially and culturally embedded,
and best understood within the context of everyday life rather than through fixed, static
categories.
4 - Health: critical perspective
Critical perspectives examine how definitions of health serve wider social and political
purposes. A central argument, influenced by Marxist analysis, is that capitalist systems
prioritize profit over well-being, producing illness through exploitative work conditions and
defining health in functional terms, valuing people mainly as productive workers. This
narrow definition ignores suffering, pain, and anxiety, limiting expectations of what health
could mean. The People’s Health Movement illustrates this view, stressing how global
economic structures shape ordinary people’s health. From a postmodern angle, Petersen and
Lupton argue that health has become both a right and a duty of citizenship, with illness seen
as failing social and economic obligations.
Political economy critiques argue that defining health as purely personal responsibility is
misleading. It protects powerful interests by shifting blame from systemic problems (such as
poor housing/environment) onto individuals. McKinlay warns this emphasis hides the real
causes of many health problems and benefits corporations and governments, because they
avoid blame or responsibility. Overall, the critical perspective highlights inequities in health,
the structural conditions shaping them, and the links between health outcomes in rich and
poor countries under globalization.
6
Literary Summary by Lynn Jansen
201900017 - 2025
,Content
Introduction to this summary............................................................................................... 4
Week 1....................................................................................................................................... 5
The New Public Health - Baum - Chapter 1: Understanding Health: Definitions and
Perspectives.......................................................................................................................5
The New Public Health - Baum - Chapter 2: A History of Public Health............................ 9
The New Public Health - Baum - Chapter 3: The New Public Health Evolves................. 13
Week 2................................................................................................................................... 24
The New Public Health - Baum - Chapter 4: Ethics, politics and ideologies: the invisible
hands of public health...................................................................................................... 24
The New Public Health - Baum - Chapter 5: Neo-Liberalism, Globalisation and Health..29
The New Public Health - Baum - Chapter 11: Changing health and illness profiles in the
twenty-first century: global and australian perspectives...................................................34
The New Public Health - Baum - Chapter 13: The Social Determinants of Health Inequity.
38
Week 3................................................................................................................................... 46
The New Public Health - Baum - Chapter 14: Global physical threats to the environment
and public health.............................................................................................................. 46
The New Public Health - Baum - Chapter 15: Urbanisation, population, communities and
environments: global trends............................................................................................. 53
The New Public Health - Baum - Chapter 16: Healthy economic policies........................59
The New Public Health - Baum - Chapter 17: Sustainable infrastructures for health,
well-being and equity........................................................................................................64
The New Public Health - Baum - Chapter 6: Research for a new public health...............69
The New Public Health - Baum - Chapter 7: Epidemiology and public health................. 71
2
,Introduction to this summary
This summary has been carefully prepared based on the book The New Public Health by
Baum. It covers chapters relevant for the “Health in Society” exam at Utrecht University for
the 2025–2026 academic year, with individual summaries organized on a week-by-week basis
structured by following the book's original structure.
I highly recommend referring to the tables and figures in the book whenever they are
mentioned in the summary, as they help provide a clearer understanding of the material. I also
recommend reviewing the critical reflection questions at the end of each chapter; the
summaries contain enough content to answer these questions.
To be fully transparent, some AI assistance was used, although only to clarify some confusing
paragraphs and to streamline certain sections for better readability.
Please do not share this file amongst peers.
The version you are currently reading is from weeks 1, 2, and 3; with a total reading time of
approximately 2 hours.
3
,Week 1
Introduction to (new) public health
The New Public Health - Baum - Chapter 1: Understanding Health:
Definitions and Perspectives
Introduction
The introduction emphasizes that health is a social, economical and political inquiry; as well
as a fundamental human right. Inequality, poverty, exploitation, violence and injustice are
seen as the cause of bad health. The toxic combination of bad policies, economics and
politics are the cause of world wide populations who don’t have good health. This chapter
presents five main perspectives on health.
1 - Health: the clockwork model of medicine
The clockwork model of medicine views the body like a machine, with health defined as
efficient functioning and illness seen as system breakdowns. Emerging from Linnaeu’s
classification of diseases in the 18th century and later advances in identifying disease causes,
this biomedical perspective has dominated Western medicine for two centuries. However, it
largely neglects the social and personal contexts of living with disease.
2 - Health as the absence of illness
The biomedical model distinguishes between disease (objective, diagnosable abnormalities)
and illness (subjective, cultural, and personal experience). But both disease and illness can
detract from health. While dominant in Western medicine (the biomedical model), it has been
criticized for being mechanistic, overly focused on the body, and neglecting social,
psychological, and spiritual aspects of health. Alternative traditions, such as midwifery,
herbalism, Ayurveda, Chinese medicine, and social medicine, have long offered broader
perspectives, though often marginalized.
Over time, behavioural psychology added an emphasis on lifestyle choices and prevention,
but the biomedical model still relies on contested notions of “normal functioning” and
reinforces a mind/body split. Its definitions of mental illness, shaped by cultural values, have
been heavily debated (e.g., hysteria, homosexuality, HIV stigma). Critics argue that medical
categories often reflect social norms rather than objective science.
The model has also been accused of disease mongering, with pharmaceutical interests
expanding disease categories (e.g., labeling obesity itself as a disease). Ultimately, the
absence of disease may be part of health, but health is more complex and multidimensional
than just the absence of disease.
In response to the limitations of defining health as only the absence of disease, the World
Health Organization broadened the concept to include a complete state of physical, mental,
and social well-being. Though criticized as idealistic, this definition encouraged health
initiatives beyond disease prevention. Well-being, however, has been difficult to define.
4
,Positive perspectives, such as VicHealth’s definition of mental health as social, emotional,
and spiritual vitality, and Indigenous views that connect health to land, culture, and
community, highlight broader and more holistic understandings of health. These emphasize
that true health goes beyond the physical body and involves personal, social, and cultural
dimensions.
Measuring health
Measuring health and well-being is difficult, as existing tools (e.g., SF36, Nottingham Health
Profile) focus on disease or deficits rather than positive states and are often static. Reviews
show these measures lack reliability, validity, and reflect professional definitions (Instead of
how everyday people understand or experience it). Overall, health is complex and resists
simple quantification, leading scholars like Antonovsky to argue for a salutogenic approach
(shift in focus from preventing illness to promoting well-being and strengths) that views
health on a continuum and incorporates people’s own definitions.
3 - Health: ordinary people’s perspectives
Health literature shows that ordinary people often define health differently from
professionals. People find illness easier to define than health, since illness demands action
while health is often taken for granted. Three main domains emerge: health as the absence of
illness, as the ability to function in daily life and as a sense of well-being. Studies (e.g., Pill,
Herzlich, Blaxter) reveal that people also see health as coping capacity, reserves to manage
illness, and a dynamic balance influenced by lifestyle and environment. Definitions by the
public often include a moral dimension, being healthy is tied to responsibility and identity,
while illness may be seen as “giving in.” Health inequalities are understood not only in
material terms but also in emotional ones, with disadvantaged groups reporting stress, shame,
and injustice when comparing themselves with others. People with illness or disability may
still consider themselves healthy, assessing health subjectively in relation to age,
expectations, and their own circumstances.
Public and private lay accounts
Cornwell’s study of working-class men and women in London showed that people give both
public and private accounts of health. Public accounts
tended to reflect the biomedical model, included moral judgments, and often divided illness
into causes seen as either the individual’s fault or not. Private accounts, which emerged only
after trust was established, were more personal and complex, drawing on lived experience
and the circumstances of others. These private perspectives revealed that people viewed
health as closely linked to overall life circumstances, highlighting the interplay between
individual and structural factors.
Health in cultural and economic contexts
Crawford’s interviews with adults in Chicago showed that understandings of health reflect
cultural and economic contexts and are socially valued. He identified two main discourses.
The first sees health as self-control, emphasizing discipline, self-denial, and willpower;
values associated with middle-class professionals but also present among some blue-collar
5
, workers (people who typically do manual or physical labor jobs). Here, health is achieved
through healthy behaviour, with strong moral judgments about body size and lifestyle
reflecting dominant cultural values of individualism and the Protestant work ethic. The
second discourse views health as a release mechanism, equated with feeling good and
providing relief from stress, pressure, and worry. This was common among working-class
men, who often resisted medical authority and public health messages as restrictive.
Crawford highlights the tension between these two perspectives, they contradict each other.
On one side, society pressures people to be disciplined and controlled (health as self-control);
on the other side, people also value relaxation, enjoyment, and release from control (health as
release mechanism). This tension can be linked to broader cultural contradictions between
discipline for production and indulgence for consumption.
Spiritual aspects
Ordinary people’s perspectives of health may also include a spiritual element.
Stainton-Rogers found that some people attributed health and illness to the influence of
religious or supernatural powers, with healing seen as the result of divine or external
intervention. Such perspectives are especially common among Indigenous communities,
where health and illness are understood in spiritual as well as physical terms, and traditional
healers are valued for their perceived ability to connect with these forces. Overall, research
on public perspectives highlights that health is complex, socially and culturally embedded,
and best understood within the context of everyday life rather than through fixed, static
categories.
4 - Health: critical perspective
Critical perspectives examine how definitions of health serve wider social and political
purposes. A central argument, influenced by Marxist analysis, is that capitalist systems
prioritize profit over well-being, producing illness through exploitative work conditions and
defining health in functional terms, valuing people mainly as productive workers. This
narrow definition ignores suffering, pain, and anxiety, limiting expectations of what health
could mean. The People’s Health Movement illustrates this view, stressing how global
economic structures shape ordinary people’s health. From a postmodern angle, Petersen and
Lupton argue that health has become both a right and a duty of citizenship, with illness seen
as failing social and economic obligations.
Political economy critiques argue that defining health as purely personal responsibility is
misleading. It protects powerful interests by shifting blame from systemic problems (such as
poor housing/environment) onto individuals. McKinlay warns this emphasis hides the real
causes of many health problems and benefits corporations and governments, because they
avoid blame or responsibility. Overall, the critical perspective highlights inequities in health,
the structural conditions shaping them, and the links between health outcomes in rich and
poor countries under globalization.
6
