Spring 2024 - HSCI 408 D100

Plagues, Pollutants and Poverty: The Origins and Evolution of Public Health (3)

Class Number: 4428

Delivery Method: In Person


  • Course Times + Location:

    Jan 8 – Apr 12, 2024: Thu, 8:30–11:20 a.m.

  • Instructor:

    Bruce Lanphear
    1 360-684-2110
  • Prerequisites:

    90 units, including HSCI 230 (or 330) with a minimum grade of C-.



Origins and evolution of public health. Transitions in public and population health, focusing on changing concepts and interventions in public health, such as the sanitarian movement, the rise of bacteriology and vaccines, nutritional deficiencies, chronic diseases, occupational health, maternal and child health, and environmental health.


COURSE DESCRIPTION: Plagues, Pollutants and Poverty is an undergraduate and graduate-level overview of the origins and evolution of population health. Students will become familiar with a broad spectrum of diseases, like smallpox, polio, lead poisoning and lung cancer. You will learn key concepts, such as herd immunity and "shifting the curve". You will read landmark studies, like case control studies of cigarettes and lung cancer and landmark ethics cases, such as the Tuskegee Syphilis study. You will examine how poverty and racism result in stark disparities in health. Finally, you will explore mysteries, like why we live longer and the decline in coronary heart disease. Students will also become familiar with the origins of human disease and questions about why we are failing to prevent preventable diseases. Students will be encouraged to critically evaluate and compare the contribution of population strategies, like water treatment and vaccines, with clinical strategies, like coronary artery bypass surgery and mammography. You will learn through video lectures, discussions, book reflections, and reading assignments. The course is divided into weekly modules, each focused on a different topic. Each topic will be explored chronologically so you will become familiar with how public health and population health hve evolved. We will also explore key concepts in population health and the transitions from microbial disease to chronic, man-made disease.


LEARNING OBJECTIVES: Upon completion of this course students should be able to:
1. Identify landmark studies and key figures in public health and population health
2. Appreciate how population strategies, not medical care or medical science, led to greatest reductions in disease and increase in life expectancy
3. Describe and compare a contemporary public health problem or solution with an historical problem to gain insight into how public health evolves. 

EXPECTED OUTCOMES: Students will be able to describe: key figures and events in public health; be familiar with landmark studies in the development of germ theory, vaccines, epidemiology, occupational health, maternal & child health, and environmental health. Students will also be able to describe major transitions in public health. Finally, students will gain experience in research and writing about the history of public health.


  • Final Project 30%
  • Midterm Exam 30%
  • Book Reflection 30%
  • Attendance and Participation 10%


Class participation and attendance (10%): Students will be evaluated on their willingness to participate in class, as well as the degree to which their participation enhances discussion in the class.

Book reflection (30%): Students will read one popular book that they select from a list of classic or popular public health books, such as Rachel Carson's "Silent Spring" and John Updike's "The Jungle". They will write a one-page reflection of their book, focusing especially on how the book changed their view of public health.

Midterm Exam (30%): Students will complete a midterm exam that includes multiple choice questions and open-ended questions on the history of public health.

Draft Proposal: Prior to the submission of the final written assignment, students will write an one-page project description that will be reviewed and critiqued by the course director to help them refine their final class project. The draft proposal will not be graded.

Final Class Project (30%): Students will write a final paper that compares a historical public health problem or solution with a contemporary public health issue, explores a public health mystery, or describes how an indigenous practice provided population health benefits or how colonialism disrupted a traditional practice and created an epidemic. Essays are to be a maximum of three pages + references and will be assessed for content (75% of the mark) and style (e.g., grammar, flow, ease of reading = 25% of the mark). References are expected and the word limit must be strictly adhered to. Full details of assignments will be given during class.



REQUIRED TEXT: No textbook is required for this course. Assigned readings will be journal articles and other readings available in the SFU library or provided by the instructor.


The first assignment for students is to read one popular or historical book about public health. It should NOT be a book you have already read. You can also propose to read a different book on the history of public health, but you will first need approval from the course director if it is not on this list. After reading the book, students will write a one-paragraph description of the book and a one-paragraph reflection or insight(s) you gained from the book. I am especially interested in how the book changed your perception of the role of public health. Each paragraph should be 500-words of single-space text.  

1.        The Discovery of Insulin - Michael Bliss
2.        Silent Spring - Rachel Carson
3.        Panum on Measles - Peter Panum
4.        Snow on Cholera - John Snow
5.        The Ghost Map - Steven Johnson
6.        Guns, Germs and Steel - Jared Diamond
7.        Betrayal of Public Health - Laurie Garrett
8.        Mirage of Health – Rene Dubos
9.        Rats, Lice and History – Hans Zinsser
10.      Plagues and Peoples – William McNeill
11.      The Remedy by Thomas Goetz
12.      Ashes to Ashes - Richard Klugman
13.      Protecting America’s Health – Philip Hilts
14.      The Great Influenza – John M. Barry
15.      Doubt is Their Product - David Michaels
16.      Deceit and Denial – David Rosner and Gerald Markowitz
17.      The Jungle – Upton Sinclair
18.      Rose’s Strategy of Prevention – Geoffrey Rose
19.      And the Band Played On – Randy Hilts
20.      Poison Profits – Philip and Alice Shabecoff
21.      Living Downstream – Sandra Steingraber
22.      Our Stolen Future – Theo Colborn and others
23.      Polio: An American Story by David Oshinsky
24.      Toms River by Dan Fagin
25.       Extra Life by Steven Johnson


Your personalized Course Material list, including digital and physical textbooks, are available through the SFU Bookstore website by simply entering your Computing ID at: shop.sfu.ca/course-materials/my-personalized-course-materials.

Registrar Notes:


SFU’s Academic Integrity website http://www.sfu.ca/students/academicintegrity.html is filled with information on what is meant by academic dishonesty, where you can find resources to help with your studies and the consequences of cheating. Check out the site for more information and videos that help explain the issues in plain English.

Each student is responsible for his or her conduct as it affects the university community. Academic dishonesty, in whatever form, is ultimately destructive of the values of the university. Furthermore, it is unfair and discouraging to the majority of students who pursue their studies honestly. Scholarly integrity is required of all members of the university. http://www.sfu.ca/policies/gazette/student/s10-01.html