Economic growth, disruption, deprivation, disease, and death: On the importance of the politics of public health for development

This essay argues that, contrary to current opinion in the social and policy sciences, the relationship between rapid economic growth and health is a fundamentally problematic one. Fast economic growth entails environmental, ideological, social, administrative, and, above all, political disruption. If there is no successful political and administrative response to these challenges, then the "four Ds" of disruption, deprivation, disease, and death may all ensue. The historical case of nineteenth-century Britain is examined in detail to demonstrate its consistency with this analysis and to show that the politics of public health in Britain's industrial cities was the vital factor transforming economic growth and the four Ds into health-enhancing economic and social development. The essay concludes that the new concepts related to "social capital" may provide a helpful perspective with which to understand the complexities of economic growth, the politics of public health, and "development.".