Introduction: Histories of Health

Paul Puschmann; Jan  Kok; Sanne Muurling; Tim Riswick

doi:10.51964/hlcs23635

Author(s)

Paul Puschmann Radboud University Nijmegen
Jan Kok Radboud University Nijmegen
Sanne Muurling Radboud University Nijmegen
Tim Riswick Radboud University Nijmegen

DOI:

https://doi.org/10.51964/hlcs23635

Keywords:

Health, History of health, Mortality decline, Health transition, Causes of death

Abstract

Over the past two centuries, global health has undergone a revolutionary transformation, with life expectancy more than doubling. While the decline in the burden of infant and childhood mortality has contributed significantly to this improvement, all age groups have experienced remarkable improvements in health and longevity. Yet this health revolution has been uneven and remains incomplete. This introductory article discusses key theoretical frameworks — demographic, epidemiological, and health transition models; fundamental cause theory; and the life course approach — while also critically assessing (some of) their limitations. We highlight how health improvements have coincided with persistent and emerging inequalities, both between and within societies, shaped by such factors as socio-economic status, gender, race, and intersecting forms of disadvantages. The article explores enduring debates, such as the relative importance of nutrition, public health, and medical interventions in driving mortality decline, and identifies key knowledge gaps, including the social origins of morbidity, early-life determinants of adult health, and the historical timing of the rise in health disparities. Recent advances in historical demography, particularly life course and family-based analyses using individual-level cause-of-death data with a standardized international coding and classification system, have opened up new avenues for research. By situating contemporary inequalities in their historical context and linking individual health and disease trajectories to broader social processes, this article provides a foundation for the contributions in this issue and underscores the need for interdisciplinary, longitudinal approaches to the history of health.

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