Economical epidemiology, pathological populations, and the long history of the Demographic and Health Survey

This article examines the history of population health surveillance in modern Africa, considering the Demographic and Health Survey (DHS) programme as a bridge between twentieth and twenty-first century epidemiology. Tracing this tradition of surveillance from pre-war Britain, through its extension...

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Main Author: John Nott
Format: Article
Language:English
Published: Taylor & Francis Group 2025-12-01
Series:Global Public Health
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Online Access:https://www.tandfonline.com/doi/10.1080/17441692.2025.2517786
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author John Nott
author_facet John Nott
author_sort John Nott
collection DOAJ
description This article examines the history of population health surveillance in modern Africa, considering the Demographic and Health Survey (DHS) programme as a bridge between twentieth and twenty-first century epidemiology. Tracing this tradition of surveillance from pre-war Britain, through its extension into the British Empire, and its subsequent employment in post-colonial demography, this article makes two related arguments. The first, that surveys like the DHS complement and encourage economic logics in medicine. Focussing initially on questions of human capital, cross-sectional surveys have tended to promote and promise efficiency in terms of medical research and interventions, thereby reducing the need for extensive and expensive infrastructure. In Africa, this utility has meant that cross-sectional surveillance gained particular traction in the context of colonisation and again following the widespread implementation of Structural Adjustment Programmes from the early 1980s. The second argument takes that the collection of demographic and social data means that these surveys represent a unique form of surveillance medicine, one which encourages associations between illness, family, and society at large. Epidemiology drawn from these data promotes this pathologisation of population, binding the epistemology of contemporary Global Health to old ideas, and siting subaltern families and communities as a prime locus of disease.
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spelling doaj-art-eff52f2bdbd14391839055e8856f900d2025-08-20T03:22:07ZengTaylor & Francis GroupGlobal Public Health1744-16921744-17062025-12-0120110.1080/17441692.2025.2517786Economical epidemiology, pathological populations, and the long history of the Demographic and Health SurveyJohn Nott0Science, Technology and Innovation Studies, University of Edinburgh, Edinburgh, UKThis article examines the history of population health surveillance in modern Africa, considering the Demographic and Health Survey (DHS) programme as a bridge between twentieth and twenty-first century epidemiology. Tracing this tradition of surveillance from pre-war Britain, through its extension into the British Empire, and its subsequent employment in post-colonial demography, this article makes two related arguments. The first, that surveys like the DHS complement and encourage economic logics in medicine. Focussing initially on questions of human capital, cross-sectional surveys have tended to promote and promise efficiency in terms of medical research and interventions, thereby reducing the need for extensive and expensive infrastructure. In Africa, this utility has meant that cross-sectional surveillance gained particular traction in the context of colonisation and again following the widespread implementation of Structural Adjustment Programmes from the early 1980s. The second argument takes that the collection of demographic and social data means that these surveys represent a unique form of surveillance medicine, one which encourages associations between illness, family, and society at large. Epidemiology drawn from these data promotes this pathologisation of population, binding the epistemology of contemporary Global Health to old ideas, and siting subaltern families and communities as a prime locus of disease.https://www.tandfonline.com/doi/10.1080/17441692.2025.2517786Population healthsurveillance medicinedata historydemographyepidemiology
spellingShingle John Nott
Economical epidemiology, pathological populations, and the long history of the Demographic and Health Survey
Global Public Health
Population health
surveillance medicine
data history
demography
epidemiology
title Economical epidemiology, pathological populations, and the long history of the Demographic and Health Survey
title_full Economical epidemiology, pathological populations, and the long history of the Demographic and Health Survey
title_fullStr Economical epidemiology, pathological populations, and the long history of the Demographic and Health Survey
title_full_unstemmed Economical epidemiology, pathological populations, and the long history of the Demographic and Health Survey
title_short Economical epidemiology, pathological populations, and the long history of the Demographic and Health Survey
title_sort economical epidemiology pathological populations and the long history of the demographic and health survey
topic Population health
surveillance medicine
data history
demography
epidemiology
url https://www.tandfonline.com/doi/10.1080/17441692.2025.2517786
work_keys_str_mv AT johnnott economicalepidemiologypathologicalpopulationsandthelonghistoryofthedemographicandhealthsurvey