'Building the Worlds That Kill Us'—a history of America through the lens of disease and death

Throughout U.S. history, the question of whose lives are long and healthy and whose lives are short and sick has always been shaped by the social and economic order. From the dispossession of indigenous people and the horrors of slavery, to infectious diseases spreading in overcrowded tenements and the vast environmental contamination caused by industrialization, and through climate change and pandemics in the 21st century, those in power have left others behind.

The book "Building the Worlds That Kill Us," by David Rosner, the Ronald H. Lauterstein Professor of Sociomedical Sciences and Professor of History at the Mailman School of Public Health, and Gerald Markowitz, a distinguished professor of history at John Jay College, provides a new way of understanding U.S. history through the lens of death and disease.

The authors demonstrate that the changing rates and kinds of illnesses reflect social, political, and economic structures and inequalities of race, class, and gender. These deep inequities determine the disparate health experiences of rich and poor, Black and white, men and women, immigrant and native-born, boss and worker, indigenous and settler.

This book both underscores how those in control have always seen some lives as more valuable than others, and emphasizes how those most affected by the unequal rates of disease and death have challenged and changed these systems.

Columbia News caught up with David Rosner to discuss the book, along with what he's reading now and his other projects.

Why did you and Gerald Markowitz write this book?

We've been working on the history of occupational and environmental disease for 40 years—10 books on specific issues from lead poisoning and children to asbestos and chemical poisoning. Gradually, we were struck by how many of our current health problems are linked to exposure to modern industrial production processes—cancers, heart disease, endocrine disruptions, and, of course, the existential threats posed by climate change due to emissions from the petrochemical industry. It became obvious that the future of public health is going to be focused on these man-made threats.

It also became clear that much of the history of public health was a response to man-made issues: Every historical event produced its own set of paradigmatic models of death and disease. For example, the development of crowded slums in the 19th century created an environment in which infectious disease epidemics were the main killers; the creation of a society built around cotton led to a system of slavery in which the whip, chain, over-work, and starvation killed and maimed Black people; the growth of an industrial capitalist state in the late 19th century produced untold hardships and suffering among workers and their families; the post-World-War world of plastics and other synthetic materials humans have never come in contact with before are producing subtle chronic and neurologic conditions.

It occurred to us that the model of exploitation that we saw, which was creating these occupational and environmental issues, was much broader than we realized. Disease itself was a product of the social systems we had built—originating with the first British colonists who came to North America and started destroying the communities of indigenous peoples, weakening them to the point that they were virtually wiped out when smallpox and other diseases emerged.

What is the worst example in the book of the inequities that have determined disparate health experiences in the US, and how those most affected by these disparities have challenged things?

Probably the most obvious and upsetting example is the discrepancies in life span and health between white and Black citizens. Throughout American history, Black people have died at younger ages, had higher infant and maternal mortality rates, as well as greater incidences of virtually every disease you can name.

The forms of racism that essentially destroyed generations of Black Americans cannot be overstated. If all the years of lost life as measured by the difference in age of death between white and Black Americans were added up, we would see that Black Americans have paid with literally millions of years of lost life. There is no amount of money that reparations could pay for the countless years of collective lost life the dominant culture extracted to build this country.

The Civil Rights movement targeted these inequities in health and disease and death rates. The demands for equal justice led to the recognition of diseases of poverty in this country, which would otherwise have remained invisible.

In the 1960s, the activism around childhood lead poisoning was a prime example of how groups like the Black Panthers and the Young Lords forced those in power to recognize that poverty itself is a form of disease creation, and that lead poisoning from paint on the walls of slum housing was not just a problem, but a symptom of poverty, racism, and the disregard of entire portions of our population.

What books have you read lately that you recommend, and why?

Ta-Nehisi Coates's "Between the World and Me" made a deep impression, a personal history of gravity and thought. Barbara Kingsolver's "Demon Copperhead" also impressed me, for it gave me a kind of sympathy for folks I normally would not feel sympathetic about.

What's next on your reading list?

I'm trying to read through Ta-Nehisi Coates's work. I'm about to start "We Were Eight Years in Power," and then I'll read "The Message." I'll see where I go from there.

What are you teaching this semester?

This spring, I'm teaching Corporate Responsibility for Toxins—commonly called Poisoned Worlds by undergrads.

What else are you working on now?

I'm completing a very long law review article on the response to regulatory reforms in the early 1970s. In the article, I look at recent neoliberal moves to undercut the regulatory state. I've been deeply involved in some major lawsuits for several states over the pollution of those states with PCBs. For instance, my and Gerald Markowitz's work has been central to trying to hold Monsanto accountable for having polluted Missouri's school systems, waterways, and the broader environment.

Provided by Columbia University