Rudolf Virchow, poverty and global health: from “politics as medicine on a grand scale” to “health in all policies”

Carl Flügge, one of the last holistic hygienists and discoverer of droplet transmission of infectious diseases

Carl Flügge is best known for the promotion of studies demonstrating the transmission of all manner of infections, but particularly tuberculosis, by coughed droplets. But it is seldom recognised that Flügge was also influential in a number of other fields comprising the practice of hygiene. One-hundred years following his death in 1923, we review literature related to the studies of Flügge and his colleagues and students and illustrate the particular emphasis he laid upon the environment within which disease and its transmission might be fostered or prevented, embracing and studying aspects essential to the health of any community ranging from fundamental microbiology in the laboratory to subjects as disparate as housing, clean water supply, nutrition, sanitation, socio-economic circumstances and climate. Very early in his career he promoted breast feeding for the prevention of seasonal gastro-enteritis and later the sheltering of cough as a means of preventing the transmission of infected respiratory droplets, not only as regards tuberculosis, but also concerning all manner of other respiratory infections. By the time of Flügge's death the complexification of available scientific methodologies comprising hygiene made it difficult for any individual to comprehend and study the wide range of hygiene-related subjects such as Flügge did. Carl Flügge was one of the last holistic hygienists and an originator of the study of environmental health as a pillar of hygiene.

1845 or 2023? Friedrich Engels's insights into the health effects of Victorian-era and contemporary Canadian capitalism

The Condition of the Working Class in England (hereafter, CWCE) by Friedrich Engels is a masterpiece of urban research not only for its explicit descriptions of the living and working conditions of members of the Victorian-era working class and their effects on health but also its insights into the sources of these conditions through a political economy analysis. For Engels, the capitalist economic system, with the support of the state apparatus, prematurely sickened and killed men, women and children in its unrestrained pursuit of profits. Our reading of CWCE in 2023 concludes that Engels identified virtually every social determinant of health now found in contemporary discourse with his insights into how their quality and distribution shape health clearly relevant to present-day Canada. Revisiting CWCE directs our attention to how the same economic and political forces that sickened and killed members of the English working class in 1845 now do so in present-day Canada. Engels's insights also suggest means of responding to these forces. We place these findings within Derrida's concept of spectre and Rainey and Hanson's concept of trace to show how ideas from the past can inform the present.

Health Equity through Clinical Research - Meeting the Challenge of Inclusion

Health Equity through Clinical Research Representativeness is perhaps one of the most important requirements in medical research, especially for health disparities research. Study findings should apply to all members of the population without selection bias. The authors detail the multiple approaches to ensuring representativeness that were developed in the HANDLS study.