Public Health Confronts Modernity in the Shadow of the Pandemic

Abstract

Empirical science in the eighteenth and nineteenth centuries transformed public health. Improvement in nutrition and living conditions were the driving forces, linked to basic sanitation. The principles of public health also proved highly effective in prevention of chronic disease, such as cardiovascular disease and cancer. However, the dominant force in biomedicine has become genomics and “precision medicine,” both of which ignore the role of environmental exposures, and focus on individual, not collective risk. Genetic determinism and technological solutions have narrowed the scope of research aimed at improving population health, and reduced the benefits that biomedical science and public health could provide. The COVID-19 pandemic is the same story in bold print.