Kazovsky, Nick McKeown; Proceedings of the SPIE 96, Vol.

Perhaps more seriously, McKeown took too restrictive a view of those other factors. Because TB is not a water-borne bacillus, he argued that the decline in TB mortality could not be a result of cleaner water and better sewage disposal. Public health measures deserved no more credit than medicine. This interpretation was effectively challenged by Szreter (1988), who noted that TB was an "opportunistic" infection, taking advantage of the presence of other infections that water-borne. Gastro-intestinal diseases, in particular, tend to reduce the nutritional uptake from food consumption. But sanitary measures reducing the prevalence of gastro-intestinal disease could then increase the nutritional value of diets, and more generally improve "host resistance." No matter how wealthy you are, drinking sewage is a seriously bad idea.

The McKeown thesis - The Lancet

 Thomas McKeown, Meet Fidel Castro: Physicians, Population Health and the Cuban Paradox

Generally Essays: Mckeown Thesis Definition free …

Judge McKeown has been active in community and civic affairs. She has served on the national boards of Volunteers of America and Girl Scouts of the U.S.A. and is the past chair of the White House Fellows Foundation.

Medical Humanities Lexicon: The McKeown Thesis

Judge McKeown has received a number of prestigious awards, including the ABA Margaret Brent Women of Achievement Award, the Georgetown University John Carroll Award, the Georgetown University Law Center Outstanding Alumnae, the University of Wyoming A&S Outstanding Alumna, the Outstanding Mentor Award from Big Sisters, the Federal Bar Association Community Service Award, and the Girl Scouts’ “Cool Women” Award.

Awadallah, and Nick McKeown,

Medical Humanities Lexicon: The McKeown Thesis | …

Freedman, Justin Pettit, Jianying Luo, Nick McKeown, Scott Shenker,"Ethane: Taking Control of the Enterprise (Sigcomm "Test of Time" Award Winner, 2017),"
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The marginalization of the medical profession that was explicit in McKeown's findings has thus continued through the subsequent generation of research on the determinants of population health. No one would now deny the powerful contribution of modern medicine to improvements in longevity, function and quality of life of individuals. But it is, I think, fair to say that the general attitude of students of population health is that medical care is "powerful within limits" and cannot explain the major gradients in health within populations any more than it can explain the historical changes studied by McKeown.

This page lists people with the surname McKeown

About 40 years ago, Thomas McKeown demonstrated that the historic decline in the great killer diseases owed little or nothing to progress in medicine. A generation of research on population health followed, highlighting the large social gradients in health within populations. These vary greatly across societies, but appear largely unrelated to medical care. Medicine was acknowledged as "powerful, but within limits"; the major determinants of health lie elsewhere.

We may have missed something. Cuba has achieved "first world" population health status despite a minimal economic base. Far from marginalizing medicine, Cuba has by far the world's largest physician workforce. But doctors' roles are significantly expanded. The system seems to work.

Reaction to the McKeown Thesis - World history

Furthermore, McKeown somewhat overplayed his hand. His leading example, tuberculosis, does in fact show a marked downturn in mortality rates in the late 1940s, when effective medical therapy was developed. In the long historical sweep, the overall decline is so large that it is easy to miss this kink, but in relative terms - and to the patients and doctors of the late 1940s - the effect was very significant. They might understandably reject the claim that "medicine doesn't matter" while missing the crucial point that on the larger historical scale, other and more powerful factors had been at work.

The McKeown Thesis and Public Health: Time for a Dignified Burial

McKeown's medical scepticism continues to find support, however, in aggregate data on population health. When compared across high-income countries, measures such as life expectancy, age-adjusted mortality or potential years of life lost do not show a correlation with expenditures on healthcare or the available supply of doctors or other personnel, or hospital capacity. Nor, however, do they show any correlation with average per capita income levels. In low- and middle-income countries there is quite a strong correlation with both income and health spending, making it impossible to infer anything about which, if either, is the more important factor.