US MEDICAL AND ILLNESS HISTORY
While studying I found a few peculiarities that really stood out to me that has kinda changed the
direction of what I’m going for in this topic. When reading I saw a lot about the racial
dispartities that occur in the united states when viewing the medical system. When looking at the
pharmasutical industry I was stuck wondering if their might be targeted advertising campaigns in
these areas. I found some articles talking about the abundance of cigarette adds in lower income
communities. It talks about brands like Newports and Malboro cigarette companies spending a
healthy bit of their budget on advertising in these areas. This not
Health illness and medicine went from local to cosmopolitan.
Hoffman, Beatrix. The Wages of Sickness: The Politics of Health Insurance in
Progressive Era America.
INTRODUCTION
Although previous historical accounts have typically emphasized the role that the organized medical
profession played in bringing down the legislation, Hoffman draws attention to other forces as well:
employers and insurance companies eager to protect their economic interests from state
intervention; labor unions concerned that the costs of such a program would reduce wages.
Together these interests came to constitute a formidable alliance against reform, utilizing in addition
a powerful cultural ideology that such state intervention was “un-American,” a violation of national
notions of autonomy and responsibility. Soon compulsory insurance came to be branded as
“socialized medicine.” In the context of hostilities to Germany and its Bismarckian welfare apparatus
(and later Bolshevik Russia), this label proved a devastating political stigma for the proposed
legislation. Supporters found it difficult to achieve broad consensus around a proposal that, in its
specifics, often divided reformers, be they labor activists or advocates of maternal and child health.
Well over forty million people in the United States have no health insurance, while government and
private insurers offer health plans that are limited, restrictive, or prohibitively expensive. Hospital
emergency rooms have become the inefficient and costly providers of primary care for those who fall
through the wide cracks in insurance coverage, and polls show that a majority of Americans are
“frustrated and angry” with their health care system. The defeat of the Clinton administration’s reform
plan in 1994 ended hopes that the United States would adopt universal health coverage for all its
citizens before the end of the century.
When Progressives first proposed government-sponsored health insurance in 1915, their vision of
protecting working people from the economic burden of sickness seemed well within reach. Inspired
by the passage of Britain’s National Insurance Act of 1911, New York reformers led a contentious,
highly publicized campaign for compulsory health insurance in their state. Had they been successful,
their plan might have planted the seeds of a full-fledged system of universal health coverage in the
United States.
The campaign for health insurance was fought hardest in New York State. As with most Progressive Era
legislation, reformers worked to establish health insurance systems in individual states rather than on
the national level. After the adoption of health insurance. 4 In New York, the AALL published its model
bill, several states debated the need for health insurance, but only California and New York actually
introduced health insurance legislation. The California battle was short-lived; in 1918 voters there
defeated a referendum that would have amended the state constitution in favor of the AALL introduced
its health insurance bill in the state legislature four times between 1916 and 1919, and New York was
the only state in which the proposal came anywhere close to success.
The leaders of the American Federation of Labor ( for higher wages. But equally important to opponents
was the perception that compulsory AFL thought social insurance would undermine trade union benefits
and forestall labor’s demands health insurance would erode their group’s autonomy. For doctors to be
free to set their own ) fees, for employers to limit their responsibility for the health of workers, for
insurance companies to sell more policies, and for labor leaders to win the loyalty of workers, each
group demanded the ability to operate independently, free from government (and reformer)
interference. For these groups, protecting their economic interests was inseparable from defending
their autonomy.
The defeat of health insurance was a blow against gender equality in the U.S. welfare state. Health
insurance was one of the few Progressive Era proposals that treated men and women equally and
acknowledged the importance of women’s earnings to the family, and it was the only one that offered
maternity benefits. (women impact)
campaign and made it still more vulnerable to attack. AALL ’s proposal as part of their plan to use the
new women’s vote to promote sweeping social legislation. But when yet another group of women
workers came forward to oppose them, the conflict weakened the reformers’
UNDERSTANDING THE HEALTH INSURANCE CAMPAIGN REQUIRES ATTENTION
TO IDEOLOGICAL AND CULTURAL FORCES. THE ABILITY OF INTEREST GROUPS
AND POLITICIANS TO DEFEAT HEALTH INSURANCE RESTED NOT JUST ON THEIR
ECONOMIC AND ORGANIZATIONAL MUSCLE BUT ON THEIR SKILLFUL
DEPLOYMENT OF THE RHETORIC OF AMERICANISM — RHETORIC THAT WOULD
BECOME AN INSTRUMENT OF POLITICAL AND STATE POWER DURING THE FIRST
WORLD WAR AND THE RED SCARE. THE STORY OF THE PROGRESSIVE ERA
HEALTH INSURANCE CAMPAIGN DEMONSTRATES THAT AMERICA’S LIMITED
WELFARE STATE WAS BORN NOT SIMPLY OF PREEXISTING STRUCTURAL
CONSTRAINTS BUT OF POLITICAL AND IDEOLOGICAL STRUGGLES AND
TURBULENT HISTORICAL CHANGES. AMERICAN RESISTANCE TO UNIVERSAL
HEALTH CARE, THEN, HAS NOT BEEN PREDETERMINED, INEVITABLE, OR
INSURMOUNTABLE — AND A DIFFERENT FUTURE IS MORE THAN CONCEIVABLE.
(IMPORTANT TO UNDERSTANDING)
CHAPTER ONE
But in 1915, at the age of fifty-four, Bollhausen was doing fine handwork for an antiques dealer when he
was stricken with pleurisy, pneumonia, and heart trouble. When he stopped work to enter the hospital,
most of the family’s income stopped as well. His son was tubercular and unable to work, and the family
was forced to turn to the Charity Organization Society for help. A charity report described the
Bollhausen family’s rapid decline: “[H]ospital treatment, then a few day’s work, illness again, no money
to pay the doctor, the use of patent medicines suggested by neighbors, the hospital again with some
improvement followed by four weeks in the country ... work again too hard for him, another illness,
dispensary treatment ... eight months of sickness and treatment and still unable to undertake regular
work.”
The story of the Bollhausen family was just one of hundreds of cases cited in a 1917 study of illness
among New York City wage earners. The report, sponsored by the Russell Sage Foundation, surveyed
690 families on relief and found that sickness was a major factor leading to charity dependence for 452
of them. 2
These findings corroborated the experience of John Kingsbury, director of one of the largest New York
City charities.
In 1918 Kingsbury declared that the connection between ill health and economic dependence was “so
direct and obvious to anyone who is in [charity] work that I have repeatedly said that good relief work
tends more and more to be health work.” 3 (PG 19)
Forty-two states passed workmen’s compensation laws between 1911 and 1920, so at least some wage
earners could receive compensation for injuries received on the job. 6 Disease and sickness, however,
even if directly caused by working conditions, were not covered by workmen’s compensation. And many
of the illnesses common among workers were indeed related to their jobs. Miners, stonecutters, and
textile workers suffered from high rates of respiratory illness, especially tuberculosis.
A doctor in New York City, asked in 1916 about the most frequent ailments among the working
populations he treated, said that hemorrhoids and chronic constipation were common among factory
operatives, and that fur workers, cap makers, bakers, and hairdressers tended to suffer from
tuberculosis, bronchitis, and asthma.
Doctor quote ““found many men who had begun work when only nine or ten years old. They had no
experience in recreation as we understand it.” Often relaxation was found only in drink, and alcoholism
ravaged bodies as well as families and communities. 9 Poor nutrition, overcrowding, inadequate
sanitation, and lack of preventative health services and education added to the medical problems of the
poorest city dwellers.
Whether for skilled male workers earning twenty dollars a week or for women pieceworkers making
only five, stopping work meant stopping wages. And lost income made it difficult to pay not only for
life’s basic necessities but for doctor bills as well. Lack of medical care commonly led to the vicious cycle
of worsening health and continuing inability to return to work. It was this cycle that compulsory health
insurance intended to break.
PAIN, BY KEITH WAILOO
CHAPTER 5
The surge of painkilling drugs into the market since the 1980s (encouraged by both Reagan-era
conservative deregulation and continuing liberalization) had both relieved and damaged society, and by
the early years of the new century a new liberal-conservative. consensus began to emerge around the
need for market surveillance. Limbaugh was a poster image for these developments; so too was
OxyContin.
Private industry promised relief in ways conservatives loved, through direct-to-consumer advertising
(DTCA) of drugs; to libertarians, drugs promised better access through the rise of Internet pharmacies;
and to liberals, lowering the barriers to regulation promised effective remedies for the undertreated. 2
Limbaugh’s addiction shed light on the exuberant drug market that regulatory reform had produced; but
OxyContin’s rise also forced both liberals and conservatives to look closely at the world they had made—
a marketplace that claimed to solve Americans’ problems far more efficiently and completely than
government programs ever could, but one that also had the capacity for great harm.
THE FORCES OF LIBERALIZED ACCESS TO RELIEF (THROUGH MEDICAL
MARIJUANA AND PHYSICIAN-ASSISTED SUICIDE) AND THE FORCES OF
NEOCONSERVATIVE DEREGULATION (WEAKENING FDA OVERSIGHT OF
INDUSTRY) HAD OPENED THE DOOR TO INNOVATION IN THE PAIN MARKET.
COMBINED, THESE FORCES UNLEASHED A NEW WORLD OF RELIEF SYMBOLIZED BY DRUGS LIKE
BEXTRA, VIOXX, CELEBREX, AND OXYCONTIN. OXYCONTIN SEEMED IDEALLY SUITED FOR THE
ERA—IT WAS AN OLD DRUG, IDENTICAL TO THE PERCODAN OF THE 1950S, BUT NOW IN A
TIME-RELEASE FORMULATION FOR PEOPLE IN TOO MUCH OF A HURRY FOR REPEATED
MEDICATION. IT ALSO APPEALED TO CANCER PHYSICIANS WARY OF OPIOIDS IN END-OF-LIFE
CARE. THE DRUGS PROMISED RELIEF WITHOUT ADDICTION.
By 2010, few of the players involved in the painrelief markets—patients, doctors, drug manufacturers,
and regulators— had escaped the controversies that defined the OxyContin era or the policing and
increased political scrutiny that marked these times. Limbaugh was just one of many casualties.
BY 2001, THE DRUG’S SALES ACCOUNTED FOR 80 PERCENT OF THE
COMPANY’S REVENUE. AS ONE REVIEWER NOTED IN 2003, “IF THE DRUG HAD
REMAINED LIMITED TO PATIENTS WITH THE MOST SEVERE PAIN, THE STORY
WOULD PROBABLY BE DIFFERENT, BUT ADVOCATES FOR PAIN TREATMENT
MINIMIZED THE DANGER OF ADDICTION AND RECOMMENDED PRESCRIBING
OXYCONTIN FOR MILDER AND CHRONIC PAINS.” 25
POSSIBLE TOPICS
THE HEROIN HOUSEWIFE
SEPERATION OF BUSINESS AND STATE
I was mostly looking at the pain epidemic going into the 1990/early-mid 2000s. Some of the stuff I was
reading brought up some interesting questions that I wonder if it would help the United States as a
whole, socially/economically. When I see how influential the labor unions were to pushing away
government assisted healthcare in the 1920s. They pushed to make sure that their workers would
continue to support the unions over the government and buisness. They would do this by passing
influential and long lasting legislation but it all seems superficial, it seems that they did this to maintain
their power on government and the corporations that unions would work against. I say superficial
because people needed workmens comp and maternity leave but they were trying to push one of the
most influential and probably most earth shattering policy since the emancipation proclimation THAT
THIS FREE OR SOCIALIZED HEALTHCARE (MUCH LIKE EUROPES CURRENT SYSTEM) This was
Meier, Barry. "Narcotic Maker Guilty of Deceit Over Marketing: Producer of OxyContin to Pay
$600 Million." New York Times (1923-), May 11, 2007.
Three former and a current executive and president of Purdue will admit guilt to having
marketed OxyContin as “less likely to be abused” where 600 Million will be paid in order to not
be charged criminally with “misbranding”
2006 and 2007 were times when the justice department had been attacking the pharmaceutical
industry. Their main weapon is using the “misbranding” statute which are can be very broad.
Even the company Bristol-Myers would plead guilty to this statute for a blood-clotting medicine.
They would say that this drug could be used for a variety of different uses that they have never
been tested or approved for.
What could this mean? To think that even a company that does not inherently have any addictive
qualities to its medicine to motivate a company to advertise falsely is a little shocking. When we
see these companies start to branch out their advertising what are they doing? Well they are
doing this in order to make as much money as possible. If you can branch your product out in as
many different directions as possible then you stand to have a much larger target audience that
you can sell to.
These business practices could be useful in a certain extent, such as in a company that provides
tools with different functions that er.hey can advertise. But in a pharmaceutical business this can
cost people their health and lives. These underhand tactics are not designed to give as much
relief to the consumer, but to line the pockets of the producers.
The argument made by Purdue: that OxyContin has a delayed response time built into the drug
which they say would make the drug less prone to abuse and addiction than the faster acting
Vicodin or Percocet.
This claim would “become the linchpin of an aggressive marketing campaign that helped to
company sell over $1 billion dollars worth of OxyContin.
“PURDUE PHARMA, HEAVILY PROMOTED OXYCONTIN TO DOCTORS LIKE THE
GENERAL PRACTITIONERS, WHO OFTEN HAD LITTLE TRAINING IN TREATING
SERIOUS PAIN OR IN RECOGNIZING SIGNS OF DRUG ABUSE.” (BIG)
If this is the case then this is a predatory strategy that is gets its power due to the ignorance of
some doctors. Imagine if you are a doctor who might be new to the field or does not treat many
chronic pain cases. When you are approached by a Purdue Pharma salesmen
Keefe, Patrick Radden. Empire of pain: The secret history of the sackler dynasty. NYC, NY:
Anchor Books, A Division of Penguin Random House LLC, 2022.
Arthur Sackler is a man who was always moving forward and working on his “next big thing.”
He was the man who helped to start off all of the marketing campaigns that we see today for the
pharmaceutical industry.
He ran advertising and marketing firms for almost all of the big pharmaceutical companies and
was always hoping to have a “cure all” pill.
Arthur Sackler was also an idealist, he had dreams, and he worked hard to pursue what he
believed to be a righteous cause. He believed that these medications were out there to save the
lives of as many people as it could, and that is how he would market. He would be infatuated
with drugs like Thorazine which he saw as miraculous for its abilities to calm down mental
patients.
Thorazine was recognized by pharmaceutical representatives as a success because it was a major
tranquilizer, but they believed that even more revenue could be gained if they had developed a
minor tranquilizer. The reason for this being that, most people do not suffer from an ailment that
requires such a strong drug, so they could make a lesser version that could be promulgated to a
much larger market.
From this the drug Miltown from Wallace Laboratories was created. It was a way to relieve
anxiety and stress from everyday life. Instead of using barbiturates or alcohol which can have
side effects that make daily life challenging like being sleepy and addiction.
Look at the shift from turning inward (calisthenics/exercise) and helping through things like drug
therapy
Tomes, Nancy. Remaking the American Patient : How Madison Avenue and
Modern Medicine Turned Patients into Consumers. Studies in Social Medicine.
The University of North Carolina Press, 2016.

Consider, for example, the assessment rendered by Dr. Otis Webb Brawley, then head of the
American Cancer Society, in a 2012 interview for the New York Times. While holding hospitals,
doctors, and insurance companies accountable for the nation’s problems, he also blamed
patients for buying into “the notion that more care— more treatment, more screening, more
scans, more drugs— is better care.” At the same time the U.S. system failed to offer basic care
to the poor and uninsured, “many Americans, particularly wealthier ones, are . . . gluttonous in
their consumption of health care resources and often use them unwisely.”

Greene JA, and Herzberg D. “Hidden in Plain Sight Marketing Prescription Drugs to
Consumers in the Twentieth Century.” American Journal of Public Health 100, no.
5 (May 2010): 793–803.
United States v. Chas. Pfizer Co., 245 F. Supp. 801 (S.D.N.Y. 1965) (Sigmamycin)
Herzberg, David. Happy Pills in America : From Miltown to Prozac, Johns Hopkins University
Press, 2009.
The notion that pills could restore selfhood had become commonplace, pervading popular as well as
medical culture. Advertisers were not the only ones spreading the gospel of neurochemistry, the idea
that consciousness and selfhood were manifestations of biology, and therefore both knowable and
controllable. According to this gospel, brains were like other parts of the body, capable of
malfunctioning and leaving their owners painfully ‘‘not themselves.’’ Luckily, advances in medical
science promised to fix the mechanical breakdowns (‘‘correct the chemical imbalance believed to
cause the disorder,’’ as the Paxil ad put it) (INTRODUCTION)
Herzberg, David. Happy Pills in America : From Miltown to Prozac, Johns Hopkins University Press,
2009.
Feminist groups would have qualms against some of the drugs like valium and miltown, This
criticism that feminists think that tranquilizers are designed to sedate you and just make you banal to
all the issues that might affect women, and they saw it as a way to make women happy with being
subjucated.
When drugs like Prozac come on the scene, advertisement firms are going to notice this and they
will advertise Prozac as a “new tranquilizer” one that wont put you down and make you content to
stay where you are, but instead Prozac will lift you up and bring make you more aware and
energetic.
Medical advertising was less regulated than some other goods because these were restricted
towards physicians, because there was the common idea that you could not fool a doctor because
they would know much more than any of the regulators so they put it more on the physician to
decipher I the information provided towards them is valid and correct. (this is one of the ways the
OxyContin will make headway by convincing doctors that it is safe, and with your doctors care, had
almost no addictive side effects.)
The woman is white and well-dressed; her neck and the uncovered portion of her arm look welltoned; she walks among blurry figures whose coats and ties are nevertheless visible. She therefore
represented what Americans were likely to have already known or suspected about antidepressants:
of the tens of millions who used them, far more were white than nonwhite, well-off than poor, and (by
a two-to-one margin) women than men. (ADD FOR PAXIL) (Pg 2)
The Paxil ad might seem to be a recent phenomenon, but its roots stretch back to the origins of
modern medicines in post–World War II America. The first blockbuster psychiatric medicine, the
minor tranquilizer Miltown, was introduced in the 1950s, and use of the drugs reached a peak as
early as 1973, when almost one hundred million prescriptions were written for Miltown’s successor,
Valium, alone. Long before direct-to-consumer advertisements like Paxil’s, drug marketing
campaigns supposedly limited to doctors’ eyes were designed to ‘‘escape’’ the medical world and
spread into popular consciousness—informal campaigns that suffered few if any of the restrictions
imposed on advertisements in later decades. And throughout these years, tranquilizers and
antidepressants served as icons in the inner lives of the white middle classes, defined in part
through contrast with illegal ‘‘street’’ drugs, and praised or vilified for what they revealed about the
nature and fate of white middle-class culture. (pg 3)
The meteoric rise of tranquilizers and antidepressants signified broader developments in American
society after World War II: the commercialization of medicine and science, the embrace of
psychology and self-fulfillment as a political language, intensified campaigns to police social groups
through drug regulation, and social movements organized in part around new concepts of identity.
(pg 4)
First, they open new windows onto the expanding postwar consumer culture. Much has been written
about tranquilizers’ and antidepressants’ impact on the medical professions—how biological
psychiatrists brought an end to Freudian dominance, for example, or how pharmaceutical companies
influenced the diagnostic categories of mental illness. I look in a different direction, examining the
commercial development and popular marketing of blockbuster medicines after World War II. This
story shows how the expanding consumer culture not only enveloped individual buyers but, by
making consumers out of doctors and patients, reconfigured social institutions such as the medical
system. Like suburban houses, new cars, and washing machines, medicine became part of a new
consumerist ‘‘American dream’’ that reconfigured conceptions of what a good middle-class life—
what happiness itself—ought to be like.
As these examples suggest, this book is as much about people as it is about drugs. The importance
of Miltown, Valium, and Prozac emerged not just from their pharmacology but from the actions of
many different groups of Americans: physicians and patients, yes, but also corporate executives,
advertisers, journalists, political activists, and many others. Each of these groups struggled over the
place of ‘‘mind drugs’’ in medical practice, in consumer society, and in political cultures as they
sought to take advantage of personal, professional, or political opportunities. It was their actions, and
not the drugs themselves, that produced the dramatic transformations in American medicine,
commerce, and culture that have reshaped the very meaning of identity since World War II. (pg 5)
By the early 1970s, Valium alone had become the most prescribed medicine in America and in the
rest of the world (see appendix B). The availability of these drugs helped cement medicine’s
expanded postwar commitment to psychological health, providing ordinary physicians and their
patients new ways to combat anxiety, tension, depression, and the ill-defined troubles of the
stomach, skin, and heart that often accompanied them. (personal note) This would formalize and is a
great example of the switch in the Doctor-Patient relationship.(pg 5)
Key facilitators in this formalized relationship were drug marketers, who took on new importance as
they underwrote the psychotropic phenomenon with a profusion of clever advertisements and publicrelations ploys. Pharmaceutical companies had always been commercial enterprises, of course,
even the ‘‘ethical’’ or prescription drug firms that advertised only to physicians. But the postwar boom
created what seemed like a wholly new drug industry. Drug companies now routinely sold antibiotics
and the era’s other new wonder drugs as brand-name products, marketing them with unprecedented
intensity not just to physicians but also to the general public through a variety of creative means.
Tranquilizers were among the most profitable of the new brand-name drugs —the leading products
of an industry that was itself one of the most profitable sectors of the booming postwar economy.
Commercial dynamics, in other words, shaped American notions of medicine from the earliest days
of modern miracle drugs, beginning with Miltown, the first true blockbuster (pg 6)
In some ways, drug advertisers’ agendas dovetailed with those of doctors and patients. Advertisers
described the tranquilizers and antidepressants as truly revolutionary medical advances, helping to
anchor them in the therapeutic arsenal as ‘‘medicines’’ rather than as ‘‘narcotics’’ or ‘‘dope.’’ In doing
so they added their voices to psychiatrists’ calls to recognize the medical significance of
psychological suffering. At the same time, however, advertisers had their own take on the meaning
of psychological illness, one designed to cast the widest possible net for potential customers. Their
campaigns thus tended to conflate psychological illness with the familiar daily problems that
populated the cultural landscape of consumerism. These problems—marital discord, frustration with
traffic, housekeeping woes, an inability to ‘‘fit in’’—were undoubtedly real sources of misery, but they
had not always been interpreted as illnesses. (pg 6)
Drug advertisers targeted physicians but also designed their appeals to escape into popular
consciousness. Their messages enjoyed a wide, almost pervasive, circulation in medical and
popular circles, playing a central role in establishing the nature and meaning of the new medicines.
The ubiquity of the campaigns, and the well-reported profits of the drug companies that directed
them, spread an idea that subtly altered the medical message: tranquilizers and antidepressants
were consumer goods. And like other goods, they were available to bring comfort and convenience
to consumers’ psychic and emotional lives. This idea had particular resonance in the postwar era, a
time when Americans were increasingly taught to see consumer spending as a civic duty and a
badge of political freedom, (IMPORTANT)
As white-collar men struggled to adapt to their new positions as family patriarchs, consumers-inchief, and cogs in the corporate world, cultural critics revived old fears of ‘‘race suicide’’ in new ways.
They held up Miltown as the ultimate consumer good, an icon of the soft conformity that threatened
to destroy the nation’s ‘‘best men’’ by comforting them into submission.
Librium and later Valium, prescribed for women at twice the rates of men, became symbols of how
society limited affluent women’s self-fulfillment and kept them safely ensconced in the home. These
criticisms only became sharper during a panic over Valium addiction in the 1970s. In later decades
Prozac became a blockbuster because the drug’s supporters successfully portrayed it as a
nonaddictive, commercially available self-enhancement technology that helped women become
‘‘supermoms’’ with careers and loving families—the perfect solution to the Valium crisis. (pg 8)
Antidepressants such as Prozac and its precursors—initially referred to as psychic energizers —
were used to elevate mood, reduce suicidal impulses, and counteract a range of other depressive
symptoms such as insomnia, anxiety, and disturbance of appetite. The best known antidepressants
were Prozac and its competitors Paxil and Celexa, first available in the late 1980s, but a wide range
of earlier antidepressants had been in (much lesser) use since the late 1950s. (pg 9)
Barbiturate sedatives, for example, had been available since the early 1900s, but like alcohol and
the opiates, these drugs stupefied as they calmed; users acted drunk, with impaired thinking and
physical control. Amphetamine stimulants were first made available in the 1930s, but like cocaine
they could elevate energy above normal or healthy levels into something approaching mania. ∫ Both
barbiturates and amphetamines tended to give users an immediate, intense high that fostered
dependence or addiction. According to their supporters, minor tranquilizers and antidepressants
solved these problems: their effects were predictable, they produced no high or addiction, and they
improved rather than impaired social functioning. These distinctions seemed more readily apparent
for the antidepressants, which took two weeks to produce their effects and seemed to act directly on
some underlying mechanism of depression, than for the minor tranquilizers, which even to some
psychopharmacologists seemed little more than improved versions of existing sedatives. (pg 9)
They were genuinely exciting new treatments for an intractable illness, but physicians rarely used
them, and they garnered little public attention until the late 1980s, when depression had gained
prominence, the tranquilizers’ star had dimmed, and easier to use new antidepressants like Prozac
had emerged. Indeed, for much of the 1960s and 1970s, advertisers for antipsychotics and
antidepressants often portrayed their drugs as slightly more powerful versions of the minor
tranquilizers, helpful for ‘‘everyday’’ patients with common troubles. At the same time, manufacturers
of older drugs like barbiturates and amphetamines, and even over-the-counter sleep aids and
caffeine pills, marketed their products as tranquilizers or antidepressants. (Pg 10)
To emphasize such economic and cultural factors is not to imply that the su√erings of the anxious or
depressed, and the relief provided for many by tranquilizers and antidepressants, have simply been
social constructions with no basis in reality. In fact, the cultural dynamics of this story are so powerful
precisely because real su√ering and real relief were at stake. It was just such matters of
psychological well-being that made the nervous illnesses, and the medicines used to treat them, so
potent as both symbol and substance in broader debates over social welfare. (pg 10)
Zaretsky, Natasha. No Direction Home : The American Family and the Fear of National Decline, 19681980. University of North Carolina Press, 2007.
In the 1960s the United States is feeling compromised and it many Americans would view this as
the start of the decline of the United States.
The United States citizens were complaining about and protesting the war in Vietnam that was
going poorly, OPEC in 1973 caused a huge crisis in the country, and let the United States know
that it was not fully in control.
Their was the Watergate Scandal that made people question the institution of the president and
the United States was in trouble of being overthrown in the world economy, from powerhouses
like Japan and Germany. PEOPLE FELT LIKE THE UNITED STATES WAS GOING THE
WAY OF IMPERIAL ROME
In the 1960s and 70s Americans were hit by a whole heap of crisis and problems inflation and
unemployment were also growing at this time, which had to put much more stress on the citizens
that grew up in a booming economy.
THE 1960S ALSO CHALLENGED THE NUCLEAR FAMILY, THE SECOND WAVE
FEMENISTS, GAY LIBERATION AND RACIAL MOVEMENTS WERE STARTING TO
TAKE SHAP AND ATTACK THE NUCLEAR FAMILY.
“Policymakers and social scientists claimed that the institution of the family was under
unprecedented strain, and editorials began appearing in newspapers and magazines that asked
whether the traditional family was permanently out of favor. In this context, the family became a
lightning rod in American politics. After the 1973 Roe v. Wade decision, a profamily movement
arose that perceived the family to be under attack by organized feminism, abortion rights, and
gay liberation; its activists would soon become an influential force in the Republican Party.” (pg.
2 introduction)
Noting these various upheavals, historians have argued that the early 1970s was a time of
profound economic, social, and cultural dislocation, when anxieties about both national decline
and family decline came to the fore. But historical accounts of the 1970s have tended to treat
these two sets of anxieties as analytically distinct, with the theme of national decline falling
under the provenance of diplomatic, military, political, and economic history and the theme of
family decline falling under the provenance of cultural, social, and gender history. (pg 2)
At any given point in American history there is a common fund of ideas and images clustering
around the idea of the family and intrinsic to a sense of national identity. It includes such themes
as masculinity and femininity, domesticity, childhood, old age, marriage, kinship, and
community. This loose fund operates at the level of assumptions rather than assertions, and
values rather than descriptions. Normally, it is both flexible enough to respond to social and
cultural change and precise enough to help constitute a national community (pg 4)
In nineteenth-century America, for example, the dominant family ideology celebrated the white,
middle-class home as a refuge from the ravages of industrial capitalism. Of course, there were
families that did not conform to this ideal: Native Americans who lived in tribes, African
Americans who lived under slavery, and Slavic, Italian, and Chinese immigrants who lived in
all-male ethnic communities. But as the dominant social class, the middle class embodied what
can be described as a national family ideal. 3 (pg 4)
During periods of large-scale social transformation, however, this fund of familial values
invariably has undergone revision. Thus the American Revolution was accompanied by a shift
from the colonial “goodwife” to Republican motherhood. The Civil War was fought to preserve
the union and abolish slavery but also for American Victorianism: the dual sphere family, the
full-time mother in the home, a protected childhood, and a rational-moderate rather than
chivalric ideal of masculinity. Progressivism witnessed the birth of companionate marriage, the
entry of women into public life, and a renewed “crisis of masculinity.” This book contends that
the late 1960s and the 1970s represented another historical turning point when both America’s
national identity—its political alignments, welfare institutions, and international policies—and
its family ideal were transformed as part of a single process. (pg 5)
More than any other institution, the American family crystallized Luce’s aspirations. For Luce,
the family was not just any family, but rather an idealized model: a white, middle-class family
made up of a male breadwinner, a full-time wife and homemaker, and children. Nowhere was
this family more celebrated than in the pages of Henry Luce’s own Life magazine. Week after
week, with an estimated readership of twenty million people, the magazine circulated images of
American family life that fused collective ideals of middle-class consumption with Cold War
imperatives. Mothers, fathers, and children smiled cheerfully in detached suburban homes;
toddlers played in family gardens; contented wives prepared dinner in shiny, appliance-filled
kitchens; and excited families embarked on cross-country vacations. (1940-50s) (pg 5)
They implied that more and more people were entering the ranks of the middle class and
fulfilling the American Dream, that new house- hold commodities and technologies were
creating unprecedented leisure, and that the sacredness of the domestic realm made the Cold War
worth fighting.
But despite the gulf between fantasy and reality, the image of the white, middle-class, nuclear
family expressed an ideal that had meaning for Americans of all races and classes: the ideal of
the family wage. With its origins in industrial capitalism and especially in the New Deal, that
ideal maintained that a male head of household—whether middle or working class—should
garner enough earnings to support a wife, who would maintain the household and take care of
children. Aiming to ensure that the ravages of the Great Depression would never be suffered
again, that ideal contained a promise of security that had universal meaning for all families, even
those who had in fact been excluded from its fulfillment. 7 (pg 6)
The white, middle-class family ideal embodied the aspirations of the American Century, but it
was also an object of sustained criticism and anxiety. Thus, when Luce first elaborated his vision
of the American Century, he did not present it as a fait accompli. On the contrary, even as he
drew on earlier notions of American exceptionalism, he questioned whether the nation possessed
the moral and psychological reserves to fulfill his vision. Surveying war-torn Europe, Luce
remarked that the British were “calm in spirit” precisely because they were “fighting for their
lives.” Americans, by contrast, were the most fortunate people in the world, but, according to
Luce, they were also unhappy, nervous, gloomy, and apathetic. The American Century was not a
birthright, he suggested. Instead it was something that would have to be fought for and earned.8
(pg 6)
WHEN, IN 1949, ARTHUR M. SCHLESINGER JR. DEFINED THE ERA AS AN “AGE OF
ANXIETY,” he was not alone in appropriating the language of psychology for a bleak diagnosis
of the national mood. 9 As the Cold War intensified in the late 1940s and early 1950s, critics
worried that the nation was losing its bearings. These worries stemmed from the same consumer
society showcased each week on the pages of Life. (pg 6)
Within sociology, Talcott Parsons argued that the nuclear family was the site at which boys and
girls internalized their proper societal roles. Taken together, these disciplines identified the
family as the main conduit of the politics, culture, and society of the nation. In the context of the
American Century, the family thus shouldered enormous national responsibilities. It had to
prepare children for the du- ties of liberal citizenship and democratic participation, it had to
instill a healthy work ethic and a sense of military honor into boys, and it had to socialize girls
for the demands that would one day be required of them as wives, mothers, and homemakers.11
(pg 7)
Philip Wylie social critique: famously warned in Generation of Vipers that America’s democratic
ideals were under threat by mothers who wielded too much power within the home. Wylie’s
white, middle-class mom smothered her sons, emasculated her husband, and chose crass material
gain over civic commitment. As he saw it, so long as these mothers remained at the helm of
middle-class family life, the nation was at risk of being destroyed by what he called “Momism.”
While the acerbic tone of Wylie’s best-selling book stood out, Generation of Vipers was by no
means unique in placing a dominating mother figure at the center of national anxieties. (pg 8)
Many sociologists, anthropologists, and psychoanalysts trained in the interdisciplinary field of
“culture and personality” studies argued that slavery had left a disturbing mark on the black
family in the form of gender inversion. According to this theory, African American men had
emerged from slavery unable to fulfill their obligations as breadwinners and were, as a result,
almost in a state of arrested development—feminine and childlike. African American women,
meanwhile, were dominating matriarchs who wielded an inappropriate amount of economic and
emotional power within the home. These arguments were often premised on an implicit contrast
between a pathological model of black family life and a normative white ideal. But the postwar
discourse of Momism betrayed a profound anxiety that white and black families actu- ally had
more in common than at first appeared. 13 (Pg 8)
Countercultural critiques of American society and the quest for authenticity often went hand in
hand with visible redefinitions of masculinity and femininity. Youth was posed against age,
protest against obedience, authenticity against conformity, and freedom against authority. (pg 9)
In 1973, the television documentary “An American Family” premiered on pbs and portrayed the
dissolution of one white, middle-class family. Newspapers published editorials in which opinion
makers questioned the fate of the family, and legislators attempted to figure out which
governmental programs helped or hurt them. All of these hearings, conferences, commissions,
and studies revolved around a host of themes: the new economic pressures confronting families
in an era of inflation, the ways in which outside institutions (such as schools) and cultural forces
(such as the mass media) were transforming the meanings of both childhood and parenthood, and
the proper relationship between the family and the state.15 (pg 10)
In 1950, less than one-fourth of married women were in the labor force, and among women with
children under the age of six, the number was 12 percent. By 1972, however, 40 percent of all
married women worked outside the home, and the figure for mothers with children under the age
of six was up to 30 percent. 16 By 1976, for the first time, the number of married women with
school-age children in the labor force exceeded 50 percent. It was clear that even the presence of
very young children was no longer considered a bar to women’s employment, the Department of
Labor reported in 1973. 17 (pg 11)
By March 1973, the Department of Labor noted that approximately 855,000 preschoolers were
living in fatherless families. 20 By the early 1970s, one out of every six children was living in a
family where the father was either absent, unemployed, or out of the labor force. 21 The increase
in numbers of women who were having their first babies outside of wedlock—from 5 percent in
the late 1950s to 11 percent in 1971—suggested that the trend would continue. Taken together,
the data painted a picture of the United States as a country in which the nuclear family once
featured on the pages of Life was becoming less and less common at the same time that new
family forms—families shaped by divorce and separation, single parenthood, and dual wage
earning—were becoming more visible.
the birth of what sociologist Daniel Bell in 1976 called a “post-industrial” society.23 This
society was transforming the older, nuclear family model, which defined its security largely in
terms of the family wage, into one in which both men and women would need to enter the labor
market in order to sustain a household. Although this had in fact always been the case for most
working-class families in the United States, and although the transition occurred over many
decades, in the early 1970s the two-earner family emerged as a norm for the American middle
class. Pg (12)
Observers pointed out that although this erosion of parental authority was most acute for poor
and working-class families, even affluent families were vulnerable. “In a sense, our families, or
at least our children, are being victimized by prosperity, are they not?” asked Minnesota senator
Walter Mondale, who was chairing the hearing of the Senate Subcommittee on Children in
September 1973. When the question was posed to psychologist Urie Bronfenbrenner, he
answered affirmatively. The cocktail hour, Bronfenbrenner explained, had replaced the
children’s hour. As a result, the nation’s children were paying the price for what psychologist
William James had described in 1906 as the “bitch-goddess Success.” Bronfenbrenner went on to
describe an experiment in which babies born into middle-class families had a microphone affixed
to their clothing during the first year of life.
Researchers heard the father’s voice on average less than forty seconds a day.24 The shocking
finding suggested that a literal crisis of father absence within poor and working-class families
was being mirrored by a figurative crisis of father absence within middle- and upper-class
homes. Even men who resided under the same roof as their children were in effect missing. In a
1977 article in the Washington Post, Bronfenbrenner spoke of “The Calamitous Decline of the
American Family.” Middle-class families, he contended, were “now approaching the social
disintegration of lower class families a decade ago.”25 (pg 13)
Over the prior three decades, critics like Wylie had challenged the racial integrity of the white,
middle-class family by implicitly establishing an affinity between black and white families, since
both bore the stamps of maternal domination and crippled male authority. In the debate over the
family that coalesced between 1970 and 1975, postwar anxieties came to the surface as
academics and legislators cited census data as proof that cultural traits once confined to African
American families were infiltrating the white middle class. As historian Christopher Lasch
explained, the middle-class family had become nothing more than “a pale copy of the
ghetto[’s].” 27 (Pg 13)
A critical reappraisal of the nuclear family was central to the feminist project of the 1970s.
Throughout their writings, feminists often identified the family as the primary site of women’s
oppression, although their understanding of what that meant and their remedies for addressing it
were not always the same. Some feminists believed that sexism within the family would
automatically be overcome by addressing the legal and institutional barriers to women’s full
participation in public life. Others critiqued the nuclear family as a place where women had been
burdened with the responsibilities of housework and childrearing to the detriment of their own
development as autonomous human beings.32 (pg 15)
How the advancements in medicine and advertising combine
Who is the person or group that helped to start the medical advertising revolution.
Meeting notes:
There are massive things that are affecting households
Anxieties that affect the home.
In this context they are promoting their product as xyz and fraiming it in xyz
What are the solutions that these ads are pushing themselves for.