Contagion and Confinement: Controlling Tuberculosis along the Skid Road - Hardcover

Lerner MD PhD, Professor Barron H.

Hardcover

ISBN 10: 0801858984 ISBN 13: 9780801858987

Publisher: The Johns Hopkins University Press, 1998

Synopsis

Most historians of tuberculosis have focused on the sanatorium era of the early twentieth century, losing interest in the disease with the discovery of curative antibiotics in the 1940s. In Contagion and Confinement, Barron H. Lerner offers the first in-depth look at the history of tuberculosis control in the antibiotic era, providing a vital account of this neglected chapter in the history of the disease. He argues that the new antibiotic drugs, rather than being a simple panacea, actually highlighted the complex social problems that continued to predispose people to tuberculosis and interfere with its treatment.

The most controversial strategy used by American health officers to control tuberculosis was forcible detention. Since 1903, Lerner notes, health departments have locked up tuberculosis patients whose behavior presented a public health threat. Using Seattle's Firland Sanatorium as a case study, he focuses on the surprisingly recent use of detention between 1950 and 1970. Although Firland planned to use confinement only as a last resort, Lerner explains, the facility detained nearly 2,000 patients, most of them alcoholics from Seattle's famous "Skid Road." In retrospect, it is clear that Firland staff members overused detention. But Lerner also finds that they worked hard to improve the lives of the alcoholic patients society had forgotten.

Given the resurgence of tuberculosis and the renewed use of detention in the 1990s, Contagion and Confinement raises issues that are both timely and controversial. Although modern public health officials are duly concerned with civil liberties, they still have great authority to detain tuberculosis patients who do not take their antibiotics. Recent studies show that such persons are most likely to be homeless, HIV-positive, or drug users. Society is still struggling, Lerner concludes, to balance public health concerns with respect for patients.

About this title

Review:

"Lerner's excellent, thoroughly researched, clearly-formulated book deals with the experiences of tuberculosis (TB) control in Seattle, Washington, during the post-World War II period, especially at the Firland Sanatorium, but the implications speak to TB prevention, and, indeed, to transmissible disease prophylaxis in general." -- Peter Baldwin, Journal of the American Medical Association

"Contagion and Confinement has universal relevance. This book will appeal to a broad spectrum of health care professionals, including pulmonologists, infectious-disease specialists, public health officials, and those interested in the relation between poverty and tuberculosis. It is exceedingly well referenced and uses primary sources extensively." -- Daniel Wlodarczyk, New England Journal of Medicine

"Contagion and Confinement provides a window into changing public health priorities, emerging medical technology, persistent problems found on the Skid Road, and the complicated and ever-present tension between individual rights and the public's health." -- Carolyn G. Shapiro-Shapin,Social History of Medicine

"Insightful analysis." -- Booklist

Synopsis:

Historians of tuberculosis have generally focused on the sanatorium era of the late 19th and early 20th centuries, losing interest in the disease with the discovery of curative antibiotics in the 1940s. But the author of this work argues that the availability of drugs actually highlighted the complex social problems that predisposed people to tuberculosis and interfered with its treatment. Lerner offers an in-depth look at the history of tuberculosis control in the USA after 1945 and at the issue of forcible detention of non-compliant tuberculosis patients. Since 1903, Lerner notes, health departments have locked up tuberculosis patients whose uncooperative behaviour presented a public health threat. Using Seattle's Firland Sanatorium as a case study, he focuses on the surprisingly recent use of detention between 1950 and 1970. Although Firland's policy during this period was to use confinement only as a last resort, Lerner explains, the facility detained nearly 2000 patients, most of them alcoholics from Seattle's famous "Skid Row". Given the resurgence of tuberculosis and the renewed use of detention in the 1990s, the text raises issues which are still controversial.

Although modern day public health officials are duly concerned with civil liberties, they still have great authority to detain tuberculosis patients who do not take their antibiotics. Recent studies show that such persons are most likely to be homeless, HIV-positive, or drug users. Society is still struggling, Lerner concludes, to balance protection of the public's health with the rights of patients.

About this edition

• Publisher: The Johns Hopkins University Press
• Publication date: 1998
• ISBN 10: 0801858984
• ISBN 13: 9780801858987
• Binding: Hardcover
• Number of pages: 264