The Rise and Fall of "Universal Health Coverage" as a Goal of International Health Politics, 1925-1952.

The UN Sustainable Development Goals of 2015 have restored universal health coverage (UHC) to prominence in the international health agenda. Can understanding the past illuminate the prospects for UHC in the present? This article traces an earlier history of UHC as an objective of international health politics. Its focus is the efforts of the International Labor Organization (ILO), whose Philadelphia Declaration (1944) announced the goal of universal social security, including medical coverage and care. After World War II, the ILO attempted to enshrine this in an international convention, which nation states would ratify. However, by 1952 these efforts had failed, and the final convention was so diluted that universalism was unobtainable. Our analysis first explains the consolidation of ideas about social security and health care, tracing transnational policy linkages among experts whose world view transcended narrow loyalties. We then show how UHC goals became marginalized, through the opposition of employers and organized medicine, and of certain nation states, both rich and poor. We conclude with reflections on how these findings might help us in thinking about the challenges of advancing UHC today.

Inventing the Right to Know: Herbert Abrams's Efforts to Democratize Access to Workplace Health Hazard Information in the 1950s.

In the 1980s, the right-to-know movement won American workers unprecedented access to information about the health hazards they faced on the job. The precursors and origins of these initiatives to extend workplace democracy remain quite obscure. This study brings to light the efforts of one of the early proponents of wider dissemination of information related to hazard recognition and control. Through his work as a state public health official and as an advisor to organized labor in the 1950s, Herbert Abrams was a pioneer in advocating not only broader sharing of knowledge but also more expansive rights of workers and their organizations to act on that knowledge.

"Educate the Individual... to a Sane Appreciation of the Risk" A History of Industry's Responsibility to Warn of Job Dangers Before the Occupational Safety and Health Administration.

The Occupational Safety and Health Act of 1970 and the Workers Right to Know laws later in that decade were signature moments in the history of occupational safety and health. We have examined how and why industry leaders came to accept that it was the obligation of business to provide information about the dangers to health of the materials that workers encountered. Informing workers about the hazards of the job had plagued labor-management relations and fed labor disputes, strikes, and even pitched battles during the turn of the century decades. Industry's rhetorical embrace of the responsibility to inform was part of its argument that government regulation of the workplace was not necessary because private corporations were doing it.

The Establishment of Wonsan Laborers' Hospital during the Japanese Occupation and Its Significance.

On July 3, 1928, the Wonsan Labor Union established the Wonsan Laborers' Hospital in Seoku-dong, Wonsan for the purpose of reducing medical consultation fees for its members. The union's efforts to improve the welfare of its members include the establishment of an educational institute, a consumers union, a barbershop, and a relief department. The Laborers' Hospital, which began with ten wards, was led by a team of two doctors, one midwife, two pharmacists, and four nurses. The two doctors were Cheol-sun Cha and Jeong-kwon Lee, and the midwife/nurse was Sun-jeong Kim. Union members received a 40% discount on medicine, and this was utilized by a daily average of 60 to 70 workers, or 21,000 workers annually. The Laborers' Hospital was clearly distinct from medical facilities founded as charity institutions in that funds were raised by the recipients themselves, and that the recipients formed a community based on their common status as laborers. However, the Wonsan Laborers' Hospital was shut down in roughly April 1929 due to the breaking of the general strike, and the heightened suppression of union activities prevented any additional opening of laborers' hospitals until Korea's liberation from Japan. Nevertheless, the history of the Wonsan Laborers' Hospital represents a key development in Korea's health coverage. It is not adequate to declare, as was the case in past research, Korea's health coverage to be simply an imitation of the Western system and lacking its own history. Despite some differences in scale and operation, the development of health coverage in the Korean peninsula is in line with the history of health coverage development in the West. The Wonsan Laborers' Hospital, founded and operated by the laborers themselves, thus holds great significance in the history of Korea's health coverage, The findings of this study are expected to stimulate new and more diverse discussions on the history of health coverage in Korea.

Labor unions: a public health institution.

Using a social-ecological framework, we drew on a targeted literature review and historical and contemporary cases from the US labor movement to illustrate how unions address physical and psychosocial conditions of work and the underlying inequalities and social determinants of health. We reviewed labor involvement in tobacco cessation, hypertension control, and asthma, limiting articles to those in English published in peer-reviewed public health or medical journals from 1970 to 2013. More rigorous research is needed on potential pathways from union membership to health outcomes and the facilitators of and barriers to union-public health collaboration. Despite occasional challenges, public health professionals should increase their efforts to engage with unions as critical partners.

Truncating a disease. The reduction of silica hazards to silicosis at the 1930 international labor office conference on silicosis in Johannesburg.

The current nosology and etiology of silicosis were officially adopted by the 1930 International Labor Office (ILO) Conference on silicosis in Johannesburg. Convened by the International Labor Office and by the Transvaal Chamber of Mines, it paved the way to the adoption of a 1934 ILO convention which recognized silicosis as an occupational disease. Even though it constituted a social and sanitary turning point, the Johannesburg conference, strongly influenced by South African physicians working for the gold mining industry, reduced silica hazards to silicosis, an equation which is questioned nowadays. While the definition of silicosis adopted in 1930 was a major step in the recognition of occupational pneumoconioses, it also led to the under-identification of some pathogenic effects of silica. Going back to history opens new avenues for contemporary medical research.

Miners, silica and disability: The bi-national interplay between South Africa and the United Kingdom, c1900-1930s.

This paper investigates silicosis as a disabling disease in underground mining in the United Kingdom (UK) before Second World War, exploring the important connections between South Africa and the UK and examining some of the issues raised at the 1930 International Labour Office Conference on silicosis in Johannesburg in a British context. The evidence suggests there were significant paradoxes and much contestation in medical knowledge creation, advocacy, and policy-making relating to this occupational disease. It is argued here that whilst there was an international exchange of scientific knowledge on silicosis in the early decades of the twentieth century, it was insufficient to challenge the traditional defense adopted by the British government of proven beyond all scientific doubt before effective intervention in coal mining. This circumspect approach reflected dominant business interests and despite relatively robust trade union campaigning and eventual reform, the outcome was an accumulative legacy of respiratory disease and disability that blighted coalfield communities.

To live and die in America: labor in the time of cholera and cancer.

A popular explanation of the epidemiological transition is that the germs that caused infectious disease mortality were defeated by the "magic bullets" of mainstream medicine over the course of the 20th century, permitting the population to get old enough to get the chronic diseases of heart disease and cancer. This explanation is false. The most important causes of infectious disease were the political and economic structures that favored capital at the expense of labor so blatantly that it left a large portion of the working population virtually at death's door. This was remedied only when resistance by labor created a more livable workday, child labor laws, and a higher wage, resulting in improvements in nutrition and housing. Chronic disease increased as firms transformed the production process by introducing more mechanized and chemically intensive production processes. This has transformed our food, water, air, and work processes in unprecedented ways and created a historically unique chronic disease pattern.

Social movements and risk perception: unions, churches, pesticides and bananas in Costa Rica.

BACKGROUND: Between 1992 and 2010 in the Costa Rican Caribbean, a social movement coalition called Foro Emaús sought to change people's view on problems of high pesticide use in banana production. OBJECTIVE: To understand the formation and membership of Foro Emaús, its success period, and its decline. METHODS: Semi-structured interviews of 28 key actors; a questionnaire survey among school personnel (n = 475) in Siquirres, Matina, and Talamanca counties; and secondary data from newspapers, leaflets, and movement documents were used. RESULTS: Foro Emaús developed activism around pesticide issues and put pressure on governmental agencies and banana companies and shaped people's perception of pesticide risks. The success of the Foro Emaús movement led to the reinforcement of a counteracting social movement (Solidarismo) by conservative sectors of the Catholic Church and the banana companies. We found that the participation of unions in Foro Emaús is an early example of social movement unionism. CONCLUSIONS: Scientific pesticide risk analysis is not the only force that shapes emerging societal perceptions of pesticide risk. Social movements influence the priority given to particular risks and can be crucial in putting health and environmental risk issues on the political and research agenda.

Cradles of industry and occupational medicine in the modern world: Milan 1906 -- Annus Mirabilis.

BACKGROUND: The example examined is Milan, Italy's main industrial city, where the great International Exhibition was held in 1906. This was the culmination of a period of accelerated industrial growth that modern-day historiography considers to be when Italy's first real industrial revolution began. The twenty-five years between the National Industrial Exhibition of 1881, which was also held in Milan, and the 1906 Exhibition truly reflected a period which was crucial for this transformation to take of. Alongside industry, which was then going through a phase of reorganization and development, Milanese civil society was increasingly turning its interest and attention to what was called the "social question". In an atmosphere of debate and exchange of ideas and experience with Turin, another major industrial city of the north and the birthplace of the Italian engineering and automobile industries, social organizations, political parties and trade unions began to be established thus heralding the Italian approach towards twentieth-century welfare. RESULTS: This is the context in which the first International Congress on Occupational Diseases was held in Milan from 9 to 14 June 1906 within the framework of the International Exhibition. The success achieved with this initiative. organized by Luigi Devoto and Malachia De Cristoforis, which was to continue with the founding of the International Permanent Commission on Occupational Health, showed that the time was ripe for a new subject to appear on the scene--the occupational health physician--who from then on was to play an important role in the promotion of workers' health. CONCLUSIONS: The article outlines the main features of the Italian industrial transformation at the turn of the new century with special attention focused on Milan, the capital of industry in Italy. It also describes the impact on public opinion caused by the events surrounding the epic construction of the transalpine railway tunnels which began in 1856 with the Mont Cenis tunnel, then the tragic enterprise of the St. Gotthard tunnel in 1883, ending in 1906 with the inauguration of the Simplon tunnel. The Milan congress is examined as well as the developments which, from then on, began increasingly to give physicians specialised in occupational diseases a higher profile in events of an international nature in the defence of workers' health but also in the interests of economic development.

The workhouse populations of Lancashire in 1881.

This article investigates the characteristics of the workhouse populations in Lancashire in 1881. The analysis is based on the snapshot view provided by the 1881 census and, despite the limitations of such an approach, this large-scale survey reveals significant variations in the experience of poverty and local relief policies in a largely industrial region that had been at the forefront of the anti-poor law movement. The workhouse populations are shown to be diverse, and contrast markedly with pauper populations previously studied. Lancashire's Poor Law Unions are divided into three types: conurbation, urban industrial and rural. These three groups appear to represent three different patterns of workhouse residency. The workhouse populations in rural Lancashire are broadly similar to those discussed elsewhere, being dominated by elderly males. However, urban industrial workhouse populations contained large numbers of adults of working age and the absence of children from workhouses in the conurbation is particularly striking.

Do unions contribute to creative destruction?

We apply a shift-share approach and historical unionisation data from 1918 to study the impact of regional unionisation changes in Norway on regional wage and productivity growth, job-creation and -destruction and social security uptake during the period 2003-2012. As unionisation increases, wages grow. Lay-offs through plant closures and shrinking workplaces increase, causing higher retirement rates, while job creation, plant entry and other social security uptakes are unaffected. Productivity grows, partly by enhanced productivity among surviving and new firms and partly by less productive firms forced to close due to increased labour costs. Thus, unions promote creative destruction.

The young Lipset on the iron law of oligarchy: a taste of things to come.

Lipset's 'Democracy in Private Government' was a remarkable publication for three reasons. It was his first attempt to challenge Michels' 'iron law of oligarchy' and would lead to a programme of research that that would culminate with the publication of the widely admired classic study Union Democracy. Second, the inspiration for this work came from Lipset's student days when he was a socialist activist trying to understand why leftist governments often failed to carry out substantial programmes of social reform. Third, although it was one of his earliest publications it bears all the hallmarks of the work that would subsequently make Lipset a giant of political sociology: the enthusiasm for classic sociological problems; the appreciation of history; and the ingenious use of the small n comparative approach. Finally, I would argue that Lipset's study of democracy within private government represents a missed opportunity for sociology though there are signs that this is being rectified in recent years.

An outstanding female figure in the history of occupational health: Ersilia Majno Bronzini.

BACKGROUND: Starting with the obituary "Ersilia Majno Bronzini: an outstanding female figure in Occupational Health", probably written by Luigi Devoto and published in the journal La Medicina del Lavoro (1933), a reappraisal is made of Majno Bronzini's contribution to occupational health. METHODS: Most references were collected from the archives of the journal Il Lavoro (1901), the archives of the association "Union of Women", the periodical founded by Majno Bronzini (1899) and other material. RESULTS: Majno Bronzini's selected published papers (1895, 1900, 1902) on the working conditions of women and child labour proposing a national occupational health law were found. The importance of a women's network for occupational health is also shown in Majno Bronzini's correspondence with Anna Celli Frantzel and Maria Montessori. In 1902 Angelo Celli officially congratulated Majno Bronzini's (and Anne Kuliscioff's) efforts to promulgate the first law on women and child labour during his speech before the Italian Parliament, published by II Lavoro. Majno Bronzini and Nina Rignano Sullam were the only two women participating in the First International Congress on Occupational Health in Milan (1906). The correspondence between Majno Bronzini and Devoto (1901-1933) and Devoto's formal acknowledgement of Majno Bronzini (1910) when inaugurating the new "Clinica del Lavoro" institute is well documented. CONCLUSIONS: Majno Bronzini dedicated a significant part of her life to occupational health, together with Anna Celli Frantzel and Maria Montessori along with many others. This research shows how important her contribution was to occupational health development.

Local knowledge, state power, and the science of industrial labor relations: William Leiserson, David Saposs, and American labor economics in the interwar years.

Recent scholarship has frequently emphasized modern states' use of social science to impose universalized conceptions of rationality and order upon diverse, highly localized settings. The New Deal era experiences of William M. Leiserson and David J. Saposs, however, provide an analytical alternative. As students of the pioneering labor economist John R. Commons, Leiserson and Saposs sought to create mechanisms for state oversight of industrial labor relations that recognized local practices and arrangements. Although their approach failed to take hold within the National Labor Relations Board, localized institutional and political contingencies, and not a hegemonic modernism, account best for their frustrated aspirations in the late 1930s.

The view from the cotton: reconsidering the Southern Tenant Farmers' Union.

Having been evicted from their homes because of incentives created by the New Deal's AGricultural ADjustment Act, sharecroppers in Arkansas formed the biracial Southern Tenant Farmers' Union (STFU) in 1934. Led by socialists and radicals, the organization ultimately claimed upward of thirty thousand members and constituted an assault on the social, economic, and racial status quo of the South. Historians have celebrated the STFU, especially its commitment to biracial cooperation and equality. This article digs beneath this carefully constructed image of the union to scrutinize the internal dynamics of the movement. It revises a number of interpretations surrounding the STFU. Although the greatest obstacles to the union's success were external, it also faced internal divisions that diminished its efficacy. The STFU's decentralized structure did not foster strong connections between leadership and membership, resulting in misunderstandings. But most importantly, the union struggled to live up to its creed of biracialism and equal treatment of African Americans. Ultimately, the STFU was less an aberration that tirelessly confronted the social and racial ills of the South and more an organization that reflected some of those ills even as it grappled with them.

Universal health coverage as a global public health goal: the work of the International Labour Organisation, c.1925-2018.

We examine the efforts of the International Labour Organisation (ILO) to extend medical care under social security, through international conventions, advocacy and technical assistance. We consider the challenges faced by the ILO in advancing global health coverage through its labourist, social security model. The narrative begins in the interwar period, with the early conventions on sickness insurance, then discusses the rights-based universalistic vision expressed in the Philadelphia Declaration (1944). We characterize the ILO's postwar research and technical assistance as "progressive gradualism" then show how from the late-1970s the ILO became increasingly marginalized, though it retained an advisory role within the now dominant "co-operative pluralistic" model.