In Pursuit of Health Equity: A History of Latin American Social Medicine by Eric D. Carter (review)

Reviewed by: In Pursuit of Health Equity: A History of Latin American Social Medicine by Eric D. Carter Ian Read Eric D. Carter In Pursuit of Health Equity: A History of Latin American Social Medicine. Chapel Hill, NC: The University of North Carolina Press, 2023. xv + 289 pp. Table, notes, references, index. 99 hardcover (ISBN 978-1-46967-444-5) ; 24. 95 paperback (ISBN 978-1-469-67445-2) ; 9 e-book (ISBN 978-1-469-67446-9). This book explores the history and complexities of social medicine in Latin America, highlighting its deep roots, institutional foundations, and political impact. Social medicine, though challenging to define and categorize, primarily focuses on structural factors affecting health, and strives for health care equity through political action. In this regard, Eric Carter examines how social medicine intersects with the medical profession and politics, tracing its evolution from its first days, marked by paternalistic practitioners in the early twentieth century, to more inclusive and politically engaged social medics by the end of the century. The book also challenges European-oriented origin stories of social medicine. In such a challenge, Carter joins other scholars who give the Global South more credit in shaping health and development discourse. Another notable contribution is the book's regional scope—a rarity in a field dominated by national histories. In beginning the story decades earlier than when social medicine was supposedly consolidated after the 1960s, Carter finds its development has not been through the wholesale application of European or North American ideas. In the European-oriented view, social medicine can be traced back to figures like Rudolph Virchow and Friedrich Engels, who highlighted the social causes of illness in the nineteenth century. Carter makes a convincing case for a more comprehensive and ideologically diverse approach to the history of social medicine, its institutional networks, its influence on health and social policy in Latin America, and its orientation around social justice and equity. The book uses a Foucauldian approach to examine the intellectual roots, expert networks, and policy development of social medicine in Latin America. In this way, social medicine cannot be separated from the construction of disciplinary knowledge, its development as a scholarly field, and its struggles against mainstream medicine and adverse geopolitical conditions. This emphasis on disciplinary knowledge is complemented by informal network analysis, adopting a life trajectory approach to understanding how individuals and institutions developed social medicine in the region as collective acts of knowledge production. Interestingly, Carter does not use Michel Foucault to point to the risks of social medicine's often expansive use of state power to pathologize social variables previously not within the realm of medicine—to the harm of its disciplined subjects. Does "freedom" mean free of diseases caused by colonialism, poverty, and power imbalances, or is it autonomy from the state? Carter leans toward the former, reflecting a more traditional leftist position. End Page 201 The book's seven chapters support the importance of social medicine as a movement and idea in Latin America, demonstrating its impact on health policy and society over the twentieth century. In Chapter 1, the origins of social medicine in Latin America are discussed, challenging the idea that it simply diffused from Europe and highlighting its emergence as a response to the social question posed by modernization. Chapter 2 examines how international networks have influenced social medicine, emphasizing the contentious debates over policy models. Chapters 3 and 4 focus on Chile and Argentina's contributions to social medicine in the 1930s and 1940s. Chapter 5 explores the decline of social medicine during the Cold War, which was often due to technocratic policymaking. Chapters 6 and 7 cover the revival of social medicine in the 1970s with new theoretical currents, despite right-wing authoritarian governments. The second wave of social medicine resisted neoliberal policies and influenced health policy. The chapters also mention countries such as Cuba and Costa Rica that remained disconnected from these networks. Carter writes an ambitious but sometimes sprawling history of collective health movements and programs, emphasizing their political and cultural origins and operations, and finding many important regional trends that so often go missing in national history. Of course, no regional study like. . .