Health promotion through Neighborhood Health Centers: A tribute to George Rosen on the 20th anniversary of his death

Abstract

George Rosen was not only one of the most noted medical historians in the United States, but also a pioneer in the scientific and practical establishment of public health. He promoted the socio-historical foundation of public health and emphasized the ambivalent role of the government between the creation of healthy living conditions and the control of individuals. Rosen was one of the first to point out the consequences of approaching social medicine exclusively, from the perspective of modern bacteriology. The article shows that Rosen located elements of a democratic and holistic health system in his analysis of the Neighborhood Health Centers of the early 20th century. At the same time, he assessed the reasons for the demise of these efforts with the expansion of the medical-industrial complex after Word War II. According to Rosen this development was mainly due to the lack of a solid financial plan that was feasible for the entire country. Until today the integration of medical care, social security and psychosocial counseling has not been re-established in this kind of community-oriented form. The Neighborhood Health Centers were mainly characterized by a democratic integration of the population to be served, by their intercultural approach and by the cooperation of people from a variety of professional backgrounds. They were thus an example of a cooperative, community-based health promotion in residential areas with a high degree of social problems. The aspects of integrative programs, proximity to residential areas and the participation of the population present key elements that could also prove significant for the future development of health promotion in today's health system. Reading George Rosen's work creates an awareness for the central questions concerning the definition of the 'New Public Health'.