Chronic diseases-cardiovascular disease, cancer, chronic respiratory disease and diabetes-are not only the principal cause of world-wide mortality but also are now responsible for a striking increase in the percentage of sickness in developing countries still grappling with the acute problems of infectious diseases. The "double disease burden" - the onset of significant mortality from chronic, non-communicable diseases while mortality from communicable diseases remains high - is a problem of developing countries. Developed countries had the historical "luxury" of dealing with chronic diseases after the weight of communicable diseases had largely lifted. However, in both developed and developing countries old and new communicable diseases such as tuberculosis or HIV/AIDS enhance morbidity and mortality, and some infectious diseases may lead to chronic disease; for example, the papilloma virus and cervical cancer. Exposure to environmental pollutants particularly prenatal or in infancy is clearly recognized as a major driver of later chronic ill-health. Double health burdens in Asia and the Pacific and the problems that this poses for health care regimes, resource allocation, strategies for prevention and control and the need for integrated approaches to both non-communicable and infectious diseases will challenge the future viability of the region. The primary aim of this book is to offer a historical picture of the development of a leading global health problem and policy responses to it in the context of a demographically, economically and politically very significant region of the world with a view to better understanding of the double disease burden and the development of more effective health policy to deal with it.

Originally published in 1988, the essays in this book focus primarily on colonial medicine in the British Empire but comparative material on the experience of France and Germany is also included. The authors show how medicine served as an instrument of empire, as well as constituting an imperializing cultural force in itself, reflecting in different contexts, the objectives of European expansion - whether to conquer, to occupy or to settle. With chapters from a distinguished array of social and medical historians, colonial medicine is examined in its topical, regional and professional diversity. Ranging from tropical to temperate regions, from 18th Century colonial America to 20th Century South Africa, this book is an important contribution to our understanding of the influence of European medicine on imperial history.

The Asia-Pacific region has not only the greatest concentration of population but is, arguably, the future economic centre of the world. Epidemiological transition in the region is occurring much faster than it did in the West and many countries face the emerging problem of chronic diseases at the same time as they continue to grapple with communicable diseases.

This book explores how disease patterns and health problems in Asia and the Pacific, and collective responses to them, have been shaped over time by cultural, economic, social, demographic, environmental and political factors. With fourteen chapters, each devoted to a country in the region, the authors take a comparative and historical approach to the evolution of public health and preventive medicine, and offer a broader understanding of the links in a globalizing world between health on the one hand and culture, economy, polity and society on the other.

Public Health in Asia and the Pacific presents the importance of the non-medical context in the history of human disease, as well as the significance of disease in the larger histories of the region. It will appeal to scholars and policy makers in the fields of public health, the history of medicine, and those with a wider interest in the Asia-Pacific region.

The Asia-Pacific region has not only the greatest concentration of population but is, arguably, the future economic centre of the world. Epidemiological transition in the region is occurring much faster than it did in the West and many countries face the emerging problem of chronic diseases at the same time as they continue to grapple with communicable diseases. This book explores how disease patterns and health problems in Asia and the Pacific, and collective responses to them, have been shaped over time by cultural, economic, social, demographic, environmental and political factors. With fourteen chapters, each devoted to a country in the region, the authors take a comparative and historical approach to the evolution of public health and preventive medicine, and offer a broader understanding of the links in a globalizing world between health on the one hand and culture, economy, polity and society on the other. Public Health in Asia and the Pacific presents the importance of the non-medical context in the history of human disease, as well as the significance of disease in the larger histories of the region. It will appeal to scholars and policy makers in the fields of public health, the history of medicine, and those with a wider interest in the Asia-Pacific region.

Chronic diseases-cardiovascular disease, cancer, chronic respiratory disease and diabetes-are not only the principal cause of world-wide mortality but also are now responsible for a striking increase in the percentage of sickness in developing countries still grappling with the acute problems of infectious diseases. This "double disease burden" poses demanding questions concerning the organisation of health care, allocation of scarce resources and strategies for disease prevention, control and treatment; and it threatens not only improvement in health status but economic development in the many poorer countries of the Asia Pacific region. This book presents an historical account of the development of the double disease burden in Asia and the Pacific, a region which has experienced great economic, social, demographic and political change. With in-depth analysis of more than fifteen countries, this volume examines the impact of the double disease burden on health care regimes, resource allocation, strategies for prevention and control on the wealthiest nations in the region, as well as the smallest Pacific islands. In doing so, the contributors to this book elaborate on the notion of the double disease burden as discussed by epidemiologists, and present real policy responses, whilst demonstrating how vital health is to economic development. Health Transitions and the Double Disease Burden in Asia and the Pacific will be of great value to both scholars and policy makers in the fields of public health, the history of medicine, as well as to those with a wider interest in the Asia-Pacific region.

There is a growing conflict in medicine between the research imperative, with its implicit goal of overcoming death itself, and the re-emergent clinical imperative to treat death as a part of life, and to make the process of dying as tolerable as possible. Central to this conflict is the rise of scientific medicine and the decline of religious and associated moral discourses. Many of the Anglo Saxon countries are also marked by a moral and religious pluralism which breeds controversy over bioethical issues such as euthanasia.
It seems that modern medicine has put the cure of bodies before the care of persons. Some scholars attribute this to a metaphysical heritage of dualism and reductionism. This heritage has become problematic in the modern age when waning belief in a divine order leaves the individual self as the bearer of meaning. At the same time, knowledge about nature and society has been increasing at such an accelerated pace, it has become even more difficult to develop a unified secular worldview. When the dying self contemplates its own disintegration in this context, the search for meaning may rest heavy indeed.
Chapters one and two address these larger issues. Chapter three focuses on medicine's approach to cancer as a prime example of the strengths and weaknesses of the research imperative. Chapter four looks at the diffusion of the theory and practice of palliative care throughout the Anglo Saxon world. The fifth chapter discusses the development of effective pain control, essential to palliative care and one of modern medicine's unsung triumphs. The sixth chapter addresses the changing meaning of euthanasia in Western history in the past century, as ittransitioned from a philosophical position to a widely-debated policy proposal.
This book is for palliative care practitioners, and all health care professionals with an interest in end-of-life care. It is also for students in palliative care and the history of medicine, and for anyone interested in the history of this intriguing field.