Antagonism and accommodation: Interpreting the relationship between publichealth and medicine in the United States during the 20th century

Throughout the course of the 20th century, many observers have noted import ant tensions and antipathies between public health and medicine. At the sam e time, reformers have often called for better engagement and collaboration between the 2 fields. This article examines the history of the relationshi p between medicine and public health to examine how they developed as separ ate and often conflicting professions. The historical character of this rel ationship can be understood only in the context of institutional developmen ts in professional education, the rise of the biomedical model of disease, and the epidemiologic transition from infectious disease to the predominanc e of systemic chronic diseases. Many problems in the contemporary burden of disease pose opportunities for effective collaborations between population-based and clinical intervention s. A stronger alliance between public health and medicine through accommoda tion to a reductionist biomedicine, however, threatens to subvert public he alth's historical commitment to understanding and addressing the social roo ts of disease.