Public health and colonialism: a new or old problem?

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Abstract
Epidemiology is not alone as a discipline in facing awesome challenges.1 It would also be wrong to ascribe to epidemiology any particular failures; many disciplines have shared difficult times as the world around them is restructured. What is at stake for the entire spectrum of public health disciplines—from “hard” medicine to “soft” policy—is nothing more than a need to re-think their own role in the new global social order. Gradually, the enormity of the economic changes that have been pushed through by the neo-liberal project are becoming clear to the public health movement.2 Knowing this, can we justify investment in ever more sophisticated “technical fixes” for what we know are socially created health problems?3 Is the future of policy to make the new global division of labour ever more efficient when this leads to social inequalities that are themselves a determinant of ill health?4 Is surgery's contribution to the global coronary heart disease epidemic only to conduct ever more bypass operations when it is the Western diet (now being sold worldwide) that needs to be confronted?5 These are big questions and lead to the realisation that a re-think of the conception and practice of public health in the 21st century is long overdue. Put starkly, is the public health movement going to bow down or stand up to the new unequal distribution of …

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