Public Health and Rockefeller Wealth: Alliance Strategies in the Early Formation of Finnish Public Health Nursing

Ann Yrjälä
Åbo Akademi University Press, Finland
9517652550 (pb)

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Cover of book This book is a published Sociology PhD thesis in the style common in Continental Europe. The book, divided into eight chapters, analyses the development of public health nursing in the early to mid-twentieth century Finland, especially the influence of the Rockefeller Foundation on this process. The theoretical approach is based on the sociology of the professions, more specifically the analysis of the boundaries of the jurisdiction claimed by a certain profession, so-called 'boundary-work'. One of the key theorists addressing the question as to why are certain occupations are or become professions, i.e. why are some regarded as different from others in terms of, for example, status, power and control, is Andrew Abbott (1988). Public Health & Rockefeller Wealth uses the concepts of actors as well as the notion of interdependence as expressed in Abbott's system of the professions approach. This is sometimes called a neo-systems theories approach.

Yrjälä uses Abbott's work and that of other sociologists to develop an interpretative framework of and theoretical perspective on the developments taking place in public health nursing in Finland in the early half of the twentieth century.

The research methods are those belonging to historical sociology, more specifically qualitative methods, which, as one would expect are in a PhD thesis, are very well described. The author conducted extensive research in archives in the USA including that of the Rockefeller Foundation, and in Finland.

Part three of Public Health & Rockefeller Wealth consists of three chapters, which follow each other more or less chronologically. The first one is around scientific philanthropy and its influence on early Public Health, followed by a focused analysis of the Rockefeller Foundation and Public Health in general and in Finland in particular. The third chapter in this section presents the Public Health Nursing in the Municipality of Helsinki, this is perhaps what we in Britain would call a health demonstration project. Part 4, the Conclusion, attempts to bring the empirical data and the theoretical perspectives together. I stress the word 'attempts' because the excellent empirical data and the thorough review of the sociology of the professions literature presented earlier in the book are not as well woven together here, as one would have liked.

This thesis combines some of the strengths of the Sociology of Health and Illness (or Medical Sociology), which is one of the more applied sub-disciplines of sociology and the Sociology of the Professions with its well-developed theoretical foundations. The Sociology of the Professions and Medical Sociology are closely related since much of the early work in the former focused on the medical profession, and subsequently on Nursing, Midwifery and the so-called Allied Health Professions. Therefore, Yrjälä adds to a long tradition of the study of occupations in the health sphere using the theoretical frameworks developed in the Sociology of the Professions. Her work links in particularly with scholarly work in the Nordic countries, the UK and North America.

Yrjälä's work focuses on a period of change in Finland, the time of the developing welfare state. Times of change are good periods to study for sociologists, because the social changes taking place the help the sociologist challenges the taken for granted views that come along with the status quo. Public Health and Rockefeller Wealth will be of interests to those studying the sociology of the professions; historians of nursing, particularly Public Health nursing; political scientist interested in the development of the welfare state in Finland; and those researching the work of the Rockefeller Foundation. The latter has an interesting parallel in the present-day charitable work of the Melissa and Bill Gates Foundation and its funding of health projects in developing countries. Someone need to conduct a comparative sociological study of the workings and influence of these two large American philanthropically organisations.


As this thesis has been produced by a small university press in Finland, it might be useful to the interested reader to have the address of the distributors:
Oy Tibo-Trading Ab
PO Box 33
Pargas, Finland

Edwin van Teijlingen
University of Aberdeen