Reading the December issue of the Journal of Public Health I was surprised to come across an editorial by Clara Bambra entitled, “Lessons from the past: celebrating the 75th anniversary of Poverty and Public Health by George McGonigle and John Kirby.”
McGonigle was born near Sunderland in my own home county of Durham and in 1924 became the Medical Officer of Health for Stockton on Tees, a post he held until his death in 1939.
Poverty and Public Health describes the health of the urban poor in the North East of England in the 1930s with a particular focus on the population of Stockton on Tees. Three studies he conducted in Stockton showed that the causes of inequalities in health included unemployment, poverty and the resulting sub- and malnutrition.
His first study showed that the health of people moved to new accommodation following slum clearance was poorer than that of those who remained in uncleared slum dwellings. His explanation of this apparently paradoxical finding was that those families moved from the slums had to pay a higher proportion of their family income on rent thus reducing that spent on food.
His third study showed that the standardised mortality rates among the unemployed were almost a third higher than those employed. It also noted a strong correlation between income and death rates.
McGonigle’s work was clearly groundbreaking and predated the Black Report by more than 40 years. Yet Poverty and Public Health is largely unknown in the public health community. I was brought up in the neighbouring town of Darlington, spent 40 years as a public health physician and have just written a chapter on the history of public health yet I also was unaware of his work.
Is there a message here I wonder? Does it demonstrate a prevalent tendency for the plaudits and the financial rewards go to those who make their presence felt on the establishment stage whilst toilers in the vineyard like McGonigle remain unsung in spite of doing heroic work there?
My own experience suggests that this is indeed the case. Which raises the question who are the other unsung heroes of public health who have not had the benefit of a Clare Bambra to shine a light on their deeds?
Paul Walker, December 2011.