From silent spring to the threat of a four degree world

Abstract

This chapter positions the late Tony McMichael’s contributions in the social, political and ecological context in which he worked from the early 1970s to the present. We document how his research and writing were shaped by this milieu and explore some of the barriers, challenges and opportunities that shaped his career. McMichael’s work was distinguished in two respects. These are, first, the range of epidemiology subspecialties that he mastered (including occupational health, cancer, nutrition and environmental health), and second, the depth and lasting impact of his research. We provide examples of the work he and his colleagues carried out on lead, smoking, health inequalities and the links between diet and cancer. In recent decades, Tony was probably known best for his focus on the effects of adverse global ecological and environmental changes, and climate change in particular. He contributed to an improved understanding of causality within epidemiology, rejecting an exclusive focus on downstream, ‘proximal’ determinants of health and disease. He also challenged his discipline to extend its temporal boundaries, both into the past and the future. There are many challenges ahead for epidemiology and for the broader discipline it endeavours to serve, public health. Tony McMichael’s thinking and writing, and the example he set as an epidemiologist advocate for environment and health, will be as relevant and influential in the future as they have been in the past four decades.