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Book Review
Understanding Health: A Determinants Approach
Helen Keleher and Berni Murphy (eds)
ISBN: 978-0-195516-61-6 2004 361 pages Oxford University Press, USA
Jeffrey Fuller
Northern Rivers University Department of Rural Health, University of Sydney and Southern Cross University, Lismore NSW
As a teacher of public health I am always on the look out for generalist undergraduate student texts and reference books. Until recent years, much of this material has been from the UK and the USA. Fortunately this situation has now changed, for instance with the publication of Fran Baum's, The New Public Health and also with texts that focus internationally but that included Australian and New Zealand content, such as Global Public Health edited by Robert Beaglehole. The recent edited publication by Helen Keleher and Berni Murphy, Understanding Health: A Determinants Approach is a welcome addition to these Australian and New Zealand offerings.
Keleher and Murphy's stated intention was to produce a text for undergraduate health science students that introduced the underlying social, environmental and biological determinants of health necessary to the understanding of health and health problems.
The book contains twenty-eight chapters from thirty-one authors over three sections: (1) Determinants of Health; (2) Health Promotion Action: Responding to the Determinants; and (3) Determinants Approach to Public Health Issues. The focus is on health promotion as a key public health strategy (section two) and then for illustrative development, section three covers specific issues from alcohol to the workplace. Seminal literature is referenced that exposes the reader to important landmark works in public health (eg, Beaglehole, Berkman & Kawachi, Doll & Hill, Giddens, Last, Marmot, McMichael, Rose). The book has both a national and international focus, and while most of the authors are either from Deakin University or Victorian public health posts, their diverse backgrounds ensure wide discipline coverage (epidemiology, health promotion, history, psychology, medicine, social science, etc) and also a good descriptive mix of theory and practice.
The chapters are well presented with key concepts highlighted, case studies used throughout to illustrate the concepts, dot point chapter summaries and discussion topics posed at the end. This presentation will help students focus on what is important and then for reinforcement. While a good range of public health terms and concepts are provided, such as the discussion on proximal and distal determinants (p.10) or on Bradford Hill's criteria for causation (p.52), the nature of an edited text means that the sequencing of material is somewhat up to the individual chapter authors, rather than the most logical grouping and sequencing for student learning. However, different authors leads to a variety of perspectives, such as the refreshingly different treatment of public health history that comes from the different analysis of Damian Jolley (ch 8) and Judith Raftery (ch 9).
This edited text from Keleher & Murphy is well worth considering for undergraduate student use across the range of health disciplines, most certainly as a reference and particularly for its introductory articulation of the health determinants approach to understanding public health.
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