by Kathleen A. Klippenstein
University of Manitoba
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Catherine Carstairs, Bethany Philpott and Sara Wilmshurst, Be Wise! Be Healthy! Morality and Citizenship in Canadian Public Health Campaigns. Toronto: Vancouver: UBC Press, 2019, 308 pages. ISBN 978-0-7748-3719-4, $34.95 (paperback)
Over the past century, Canadians have repeatedly found themselves the target of public health campaigns encouraging them to adopt healthier behaviours and lifestyles. While the stated purpose is to help individuals live longer and better lives, an underlying goal has always been to create a healthier society and to reduce healthcare costs. The most effective tools of persuasion have included both ‘carrots’ and ‘sticks,’ as this book clearly shows. It illuminates how, through much of the 20th century, changes in behaviour have been motivated not only by the idea that certain ways of living will result in better health, but by the sense that conform-ing to these behaviours is not simply a personal option, but part of one’s social and moral duty as a good citizen.
“Be Wise! Be Healthy” explores the history of public health campaigns in Canada, focussing particularly on those of the Health League of Canada, a privately funded organization which touted the message of what it means to be a healthy citizen of Canada through the concept of “social hygiene.” From its beginnings in 1919 (as the Canadian National Council for Combating Venereal Disease: CNCCVD) until the gradual decline of its influence in the 1970s, this public health organization defined health as encompassing not only a certain physical standard. It also emblazoned moral, mental, and social standards into the minds of Canadians. The Health League was founded and directed by Dr. Gordon Bates, a vocal and tireless advocate. The League promoted a way of living and behaving to promote individual, family and community health in clearly defined ways. For instance, a healthy Canadian was a good citizen, and to take care of one’s own health was understood as part of what it meant to be responsible, productive, and even patriotic. Indeed, being in good health was touted as a valuable contribution that Canadians could and should make to their community and nation.
This language feels strangely old fashioned and even uncomfortable today, being more narrowly prescriptive than we are accustomed, and even insensitive to people who may be less inclined or able to conform. It clashes with contemporary notions of diversity, tolerance, and inclusiveness as inherent characteristics of Canadian society, with its resultant vast range of cultural expressions, values, morals, and lifestyles. But at that time, the campaigns made great strides in disseminating quite new scientific knowledge about nutrition, diet, and disease, and were seen as highly effective in improving the level of public health in Canada.
The book begins with an introduction to the origins of the public health movement in Canada and the evolution of The Health League of Canada campaigns. The book then methodically works through the hallmark missions of the League, whose goals included educating Canadians about the benefits of milk pasteurization, the necessity of child immunizations, the seriousness of venereal disease, and the necessity to avoid extramarital sex as a means of disease prevention. The second half of the book focuses on a number of factors contributing to the ill health of Canadians, which Public Health Campaigns were combating through a variety of methods; mostly education and public advertising. The League emphasized education as the key to preventing disease and ill health, and it got broader attention by arguing that ill health of Canadian workers leads to decreased productivity through absenteeism in the workplace, an issue, it asserted, that affects the overall strength of the nation.
“Be Wise! Be Healthy!” includes illustrations of posters, slogans, and other products along with extensive description and analysis of the variety of media and campaigns used to educate and persuade the public to change behavior. The Health League of Canada created their own magazine, distributed flyers, and funded films that played in theatres across the country to raise money and communicate its messages around public health. The media and messages that ‘struck a chord’ also provide a glimpse into the realties and motivations of men and women in the mid-20th century.
The authors’ descriptions of the Health League of Canada include an analysis of both the positive and negative impacts that the League had on Canadians. For example, the book doesn’t shy away from highlighting where the more sinister schools of thought—like the eugenics movement of the early 20th century—influenced the campaigns of the League. It also notes the League president Dr. Gordon Bates’ emphatic opposition to Medicare, or in his words “sickness insurance.” The strengths and weaknesses of public health campaigns are laid out for readers to draw their own conclusions.
As a student of pharmacy, I can relate to the League’s sense of urgency to prevent disease and promote the maintenance of good health, rather than simply to treat illness. Though the language of the League is anachronistic today, the key messages of their campaigns remain largely relevant, as Canadians can indeed improve the trajectory and quality of their lives by making better choices about their personal health. Through eating well, exercising regularly, seeing the doctor/dentist, and taking time for rest and relaxation, Canadians in the past and today are investing in their health and future. Unlike those early days, messages urging people to work towards health goals have today become ubiquitous enough to be understood as common knowledge (though often confusing or contradictory in their details), even while new momentums in our lifestyles—like the orientation towards more screens and sitting—can make even apparently obvious good advice very hard to follow.
This book reveals the fascinating history of the Health League of Canada—the pioneering private public health initiative and early forerunner of what is today considered preventative medicine—as a pioneering entity towards improving the health of individuals and Canadian society overall. Though the Health League of Canada disbanded in the 1970s, privately funded public health campaigns such as the Breast Cancer Society of Canada and the Canadian Health Coalition are still prevalent today, calling for donations, funding research, and lobbying for the improvement of our public health care system.
“Be Wise! Be Healthy!” is supported with meticulous primary and secondary research and is well illustrated and referenced, including endnotes and an index. It makes an important contribution in the areas of Canadian social and medical history and will be of interest to a large audience.
We thank Clara Bachmann for assistance in preparing the online version of this article.
We thank S. Goldsborough for assistance in preparing the online version of this article.
Page revised: 25 April 2021
