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Short abstract:

Drawing on historical sources and methods of analysis, this paper argues that authorizing strategies used to maintain the promise of modern epidemiology as an alternative to autocratic health governance have had long-term costs for the authority of public health measures.

Long abstract:

In spring 1931, Detroit health official John Gordon proposed that modern science could solve the problem of cooperation in public health. The existing public health system expected trust in the judgement of experts, certified by the state and other accrediting institutions. Gordon, to the contrary, anticipated a modern public health system in which trust resided in a new ecological science of health and disease, capable of producing highly granular facts about dynamic disease occurrence. Such a system promised to align public health codes with the liberal ideal of personal freedom, constituting a more democratic approach bound to improve cooperation.

Despite a century of technical development beyond Gordon’s wildest imagination, epidemiology has yet to solve the problem of cooperation. Indeed, by the third year of the Covid-19 pandemic, the US government had determined that epidemiologically-informed social policy was no longer doable, resorting instead to the anti-social policy that critics have described as “you do you.” And yet, the discourse of “trust in science” has been maintained even through such moments of breakdown.

This paper examines Gordon’s system at an early moment of breakdown, demonstrating that, in contrast to the democratizing discourse, power in Gordon’s system remains concentrated in “epidemiological specialists” who manage the system through ad hoc negotiations, and who citizens are expected to trust implicitly. I identify the authorizing strategies used to maintain the promise of modern epidemiology as an alternative to autocracy and argue that these strategies have had long term costs for the authority of public health measures.