In the progressive public health tradition, Meredeth Turshen criticizes conventional approaches to disease and offers an alternative framework based on the concept that health and illness are socially produced throughout the world. Using contemporary and historical accounts of great moments and great debates in public health, Turshen exposes the failure to improve health even when a specific program like smallpox vaccination succeeds. Her analyses incorporate theoretical contributions from Marxism and feminism.

The book is divided into four parts. Part 1 outlines current and alternative approaches to health, theories of disease causation, the policies and practices that follow from these theories, and issues of equity and access to health care. A chapter of women's health in three African countries illustrates these concepts. Part 2 describes limits to conventional public health, using case histories of plague control, dioxin decontamination, sanitary reform, and smallpox and malaria eradication. In Part 3, Turshen presents case histories of preventive medicine, nutrition and agribusiness, mental health, and AIDS in Africa to suggest new approaches based on an alternative model of social production. Part 4 looks to the future of public health. It examines basic issues in integrating public health research, training, and services, and concludes with an agenda for action.