Medical Innovation in the Twentieth Century

There was a tendency for public health and medical research to overlap in Latin America over the first half of the twentieth century. There was also a gradual movement of medical education toward the emerging hegemony of the U.S. model of the teaching hospital conjoined with the laboratory, led by full-time clinicians and medical and life scientists. Even so, the leading medical figures of the continent were notable in their ability to maintain relative autonomy from U.S. and local state sponsors and carve a niche for themselves and their disciples under adverse conditions. They were also successful in making their mark in areas outside of tropical medicine and public health, with pioneering forays into tuberculosis, physiology, cardiology, oncology, psychiatry, and nutrition. Latin American physicians were also at the forefront of a eugenics movement that distinguished itself from dominant trends elsewhere by embracing the idea that, while race mattered (and widespread elite racism reigned), acquired characteristics could be inherited. This dovetailed with growing acceptance that the mixed-race masses could become citizens of modern nations given the extension of certain state policies in education, health, and welfare. After World War II, as Latin American countries began to show notable increases in population growth rates, the region became a focus for national and international population control efforts. Paradoxically, the partial success of public health programs (the control of malaria, for example) was now criticized by population growth alarmists for exacerbating the boom. The region’s health actors, often outside the loop of the more dynamic efforts to introduce birth control and family planning, were slow to respond. Nevertheless, a number of Latin American physicians achieved prominence as political leaders in the postwar period, playing crucial roles a number of regimes advocating dramatic social transformation.

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