HHH column: Safeguarding a healthy future by Martijn van der Meer

The HHH column is a blog in which History, Health & Healing members share their thoughts: on research, current affairs, and anything to do with medical history. Each author will invite a new author to participate in the conversation. Last time, self employed historian and publicist Catharina Th. Bakker passed the pen on to Martijn van der Meer, PhD candidate at Erasmus University.

Martijn van der Meer

In recent years, a growing group of health professionals and policymakers has begun to claim that we have to revolutionise Dutch healthcare. Instead of a health care system that focuses predominantly on curing diseases reactively, we would need to develop a preventive and proactive approach to health problems. This call to arms recently translated into health policies such as the National Prevention Agreement and Solid Start, specifically targeting young children for preventive intervention. A key medical rationale for doing so is that the chances for a healthy future increase when children are raised in a stable environment and nurtured adequately.

Others are far less excited about the increasing attention for preventive intervention in private life. These critics interpret recent calls for preventive medicine as another sign of the increasingly assertive attempts to place all biological aspects of human life under governmental and medical control. They understand the attention for health risks as dissolving the boundaries between healthy and diseased children, “medicalising” normal development, and subjecting a growing group of children to surveillance mechanisms.

Both perspectives draw on history to support their claims. In the policy documents promoting preventive health care, reforms are often positioned as the desirable extension of a growing focus on “lifestyle” and “future health risks” in twentieth-century public health policy. Likewise, critics of this development often interpret the increasing dominance of prevention in political discourse as yet another example of the undesirable growing “governmental interference in the private sphere” in the twentieth century.

Both interpretations, however, lack historical evidence and suffer from an unsubstantiated top-down understanding of the relationship between political discourse and everyday preventive health practice in the twentieth century. We still know little about the effects of child health interventions in this period on so-called “children-at-risk” and their families. Which child health interventions were developed in the twentieth century? How were these legitimised politically? Can one detect an observable historical “increase” of surveillance, governmental control, and “medicalised” interpretations of child health in the twentieth century? And to what extent did these interventions contribute to more healthy futures in the eyes of historical actors themselves?

I am over the moon that NWO awarded Ralf Futselaar, Timo Bolt and me a PhDs-in-the-Humanities-grant to answer these questions. In my project, I move away from understanding the relationship between preventive policy and practice as top-down and analyse the long term history of child health intervention as the co-construction of preventive policy and practice. I will first investigate how, throughout the twentieth century, children have been identified as “being-at-risk” within local consultation bureaus and the consequences for the children and families involved. Second, I examine which institutions, organisations, and individuals formed local public health infrastructures and how they enabled preventive child health intervention. Finally, I investigate to which extent the changing Dutch political discourse on child health and local public health infrastructures interacted throughout the twentieth century.

With a combination of archival investigation and digital methods, I will analyse the history of Dutch preventive child health intervention on these interacting levels. I intend to experiment with an “open notebook” approach to my research and publish my archival notes, scans, code, and preliminary findings on Humanities Commons twice a year. I will also send a newsletter regularly to interact with interested health professionals. But above all, I hope to provide an exciting contribution to existing research on the history of public health and preventive medicine, the social history of child healthcare, and medical humanities, and discuss these results with members of the History Health &Healing network!

Martijn passes the pen on to Hieke Huistra, assistant professor at Utrecht University.