The Health of the Commonwealth by James E. Higgins

Book Review presents reviews of recent publications on Pennsylvania subjects by noted scholars, historians and journalists.

The Health of the Commonwealth
A Brief History of Medicine, Public Health, and Disease in Pennsylvania
by James E. Higgins
Temple University Press/The Pennsylvania Historical Association, 138 pp., paperback $19.95

The history of public health and medicine is more important now than ever. As Pennsylvania weathers global pandemics and health crises, it is essential to understand how our current health care system developed, how knowledge of disease and its treatment have evolved, and how state government has determined its public health responsibilities.

Fortunately, James E. Higgins’ The Health of the Commonwealth provides a wonderful synthesis of the history of public health and medicine in the Keystone State. Although this topic has not been neglected by historians in the past, it has always focused on individual communities (especially Philadelphia and Pittsburgh) or specific health topics and events. Higgins’ work is the first to look at this important part of Pennsylvania history as a whole, covering the entire state including its rural communities, from the days of William Penn to the ongoing opioid epidemic.

Higgins argues that the history of public health and medicine in Pennsylvania is “no less vital to understanding the state’s past than is its political or industrial history.” In chapters ordered chronologically, he demonstrates why events like Philadelphia’s 1793 yellow fever epidemic, the deadly outbreak of typhoid in Plymouth in 1885, and Jonas Salk’s 1954 discovery of a polio vaccine are just as noteworthy as the Battle of Gettysburg or the Homestead Strike.

Although The Health of the Commonwealth is a thin volume, it helps readers quickly appreciate how Pennsylvania helped shape changing public health and medical trends and how it was shaped by them. Higgins has written this book for a general audience, but it will be of interest especially to students of state history, government and medicine. He concludes with a brief afterword addressing the current coronavirus pandemic in Pennsylvania (the crisis was just beginning as the book went to press), one final reminder why looking to our past can help us understand and respond to changes in health and medicine that impact us all today.

Tyler Stump
Pennsylvania State Archives