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Understanding
Health FOURTH EDITION

edited by
Helen Keleher and
Colin MacDougall
vi

Tables
6.1 Are we nearly there yet? 87
10.1 Cannabis quiz 138
10.2 Obtaining descriptive evidence: what proportion of young people in Australia has
used cannabis? 139
10.3 Recent cannabis use: the impact of ‘Mull it Over’ on a Year 10 class 142
10.4 Impact of ‘Mull it Over’: comparison of intervention and comparison groups 142
10.5 Daily smokers aged 14 years or older from 1991 to 2013 149
14.1 The UN Convention on the Rights of the Child 217
17.1 Continuum of strategies for empowering health education 258
17.2 Principles of empowerment-based health education 259
17.3 Empowering behaviours and attitudes 260
17.4 Conceptualising organisational domains of community empowerment (selected
authors) 263
18.1 Framework for health-promoting actions and outcome levels 272
 vii

Theory to Practice boxes

2.1 The Commission on Social Determinants of Health 21
2.2 Structure versus agency 24
3.1 Primary health and the social model of health 37
3.2 Theories in primary health care—a snapshot 38
3.3 Primary health care in Indigenous contexts 45
3.4 Tasmania’s social determinants of health project 45
5.1 Tobacco control and the primary prevention of smoking 67
5.2 Ten points for best practice planning in population health 74
6.1 Theories in global health 81
6.2 Working in global health 89
7.1 Models of health promotion 96
7.2 Collective Impact 102
8.1 Public health information development unit 120
10.1 Evidence is … 138
10.2 Quality research 143
10.3 Active transport 146
11.1 Classical conditioning and cigarettes 161
11.2 Good intentions as punishment—victim blaming in health promotion 163
11.3 Cognitive behaviour therapy 164
11.4 Groupthink 166
11.5 The early years agenda and the public health approach 172
12.1 Glossary of terms 178
12.2 Analysing models of social determinants 180
12.3 Culture and rights 181
12.4 Details of ACCHOs 187
12.5 Ten steps to overcome racism—wirkara way 193
13.1 Classic theories underpinning an ecological public health 199
13.2 Old, new and ecological public health—contrasts and similarities 200
13.3 Climate change 201
viii Theory to Practice boxes

13.4 Doubt and evidence 207

13.5 Diverse meanings of health 208
13.6 Effective communication about social and ecological determinants of health 209
14.1 What are human rights? 213
15.1 A social inclusion initiative 228
15.2 Promoting inclusion for refugee-background young people in Australia 230
16.1 Social marketing interventions: determining benchmarks 244
16.2 Reducing drink-driving in rural Wisconsin 245
16.3 A code of ethics for social marketing 250
17.1 Health education as liberation 257
18.1 Strategic thinking about smoking cessation programs 276
19.1 Levels of government responsibility for policy 292
20.1 Author of ‘Little Children are Sacred’ report speaks out at (Melbourne) University
lecture 303
20.2 The exercise of power by using agenda management techniques 304
20.3 Patan Academy of Health Sciences, Nepal 307
20.4 The civic custodian 308
20.5 Indigenous health content in medical schools 309
20.6 What is needed to advocate healthy public policy in organisations? 310
 ix

Research to Practice boxes

1.1 Health and the social gradient 14
2.1 The determinants of early childhood 27
3.1 Population health planning for primary health care 43
4.1 WHO world health reports 58
6.1 The fight against malaria 88
8.1 Measures of education attainment by young adults 113
8.2 National longitudinal surveys 115
9.1 Study designs in epidemiology 132
10.1 Health inequalities in Australia 147
11.1 Gene–environment interactions in breast cancer 157
12.1 NHMRC principles for research 182
12.2 Racism and primary health care services 192
14.1 Dr Jonathan Mann 217
15.1 Intersectionality—informing population health research 226
16.1 Assessing the condom retailing environment in Vietnam 249
17.1 Education for girls—global perspectives 265

Boxes
1.1 Australia’s Medicare system 11
1.2 Theoretical concepts of health equity and health inequity 12
4.1 Early scientific developments 53
4.2 Public health developments of the twentieth century 55
4.3 Essential public health services 61
5.1 Data categories for developing a healthy community profile 72
7.1 Milestones in the history of health promotion 93
7.2 The partnership continuum 101
x

Abbreviations
ABS Australian Bureau of Statistics
ACCHO Aboriginal Community Controlled Health Organisation
ACCHS Aboriginal Community Controlled Health Service
ACOSS Australian Council of Social Services
ACSQHC Commission on Safety and Quality in Health Care
AEDC Australian Early Development Census
AIDS acquired immuno-deficiency syndrome
AIHW Australian Institute of Health and Welfare
ALLS Adult Literacy and Life Skills Survey
AMA Australian Medical Association
ANF Australian Nursing Federation
ANPHA Australian National Preventive Health Agency
ASGS Australian Statistical Geography Standard
CBT Cognitive Behaviour Therapy
CDAMS Committee of Deans of Australian Medical Schools
CDC Centers for Disease Control
CI Collective Impact
CIV Community Indicators Victoria
CNA Community Needs Assessment
COAG Council of Australian Governments
COP Community of Priority
CSDH Commission on the Social Determinants of Health
DALY Disability Adjusted Life Year
DHS Department of Human Services
DHHS Department of Health and Human Services
EBM Evidence-based medicine
GBD   Global Burden of Disease
GIS   Geographic Information Systems software
HiAP Health in All Policies
HIV human immuno-deficiency virus
IMR Infant mortality rate
IPCC Intergovernmental Panel on Climate Change
LE life expectancy
 Abbreviations xi

LGA local government area

MDG Millenium Development Goal
NACCHO National Aboriginal Community Controlled Health Organisation
NGO non-government organisation
NHHRC National Health and Hospital Reform Committee
NRMHC National Health and Medical Research Council
NTD neglated tropical disease
OECD Organisation for Economic Co-operation and Development
PAHO Pan-American Health Organization
PBS Pharmaceutical Benefits Scheme
PHAA Public Health Association of Australia
PHC primary health care
PHF Public Health Foundation
PHIDU Public Health Information Development Unit
PHM People’s Health Movement
PHN Primary Health Network
PVAW Prevention of Violence Against Women
RCT randomised controlled trial
SDH social determinants of health
SEIFA Socio-Economic Indexes for Areas
SLA Statistical Local Area
TML Tasmania Medicare Local
UN United Nations
UNAIDS Joint United Nations Programme on HIV/AIDS
UNESCO United Nations Educational, Scientific and Cultural Organization
UNICEF United Nations International Children’s Fund
VAW Violence Against Women
WHO World Health Organization
YPLL Years of Potential Life Lost
xii

Contributors
Editors
Helen Keleher, BA, MA, PhD, FPHAA, Adjunct Professor School of Public Health and Preventive
Medicine, Monash University; Principal, Keleher Consulting.
Colin MacDougall, BA (Hons) MA, PhD, Professor of Public Health and Executive member of the
Southgate Institute for Health, Society and Equity, Flinders University; Principal Fellow (Honorary),
Jack Brockhoff Child Health and Wellbeing Program, Melbourne School of Population and Global
Health, University of Melbourne.

Contributors
Michael Bentley, BSc, MA, DrPH, Research Fellow, University of Tasmania; Adjunct Research
Fellow, Southgate Institute for Health, Society and Equity, Flinders University.
Karen Block, BVSc, BA, MPH, PhD, Research Fellow, Jack Brockhoff Child Health and Wellbeing
Program, Melbourne School of Population and Global Health, University of Melbourne.
Jan Garrard, PhD, Senior Lecturer, School of Health and Social Development, Deakin University.
Melissa Graham, BPH (Hons), Grad Cert High Ed, Grad Dip Epi Biostats, PhD; Senior Lecturer,
School of Health and Social Development, Deakin University.
Paul Laris, MPH, Director, Paul Laris & Associates, Adelaide.
Joshua D. Newton, BA/BSc(Hons), PhD, Senior Research Fellow, Department of Marketing, Deakin
Business School, Deakin University.
Kim O’Donnell, DipT, MPHC, DrPH, Research Associate Health Care Management, Flinders
University; Research Educator, Aboriginal Health Council SA.
 xiii

Preface
This book is about health, what shapes it and how we take action to improve it. Health is not just
determined by the commonly discussed factors of biology, behaviour and the health care system.
Certainly, these are visible and important factors, but in every part of the world, health is determined
by the circumstances in which we live, work, study, love, raise children, shop, play, google, travel and
care for our planet. We call these circumstances the social determinants of health. Public health
and primary health care lead global, national and local strategies to change these social conditions
so more people can live healthier and more satisfying lives. Increasingly, we are recognising the
importance of intersectoral policy, research and practice, which involves a wide range of disciplines
and sectors that influence health, so in this book we aim to speak to a broader audience than health
workers.
This fourth edition of Understanding Health is written for people who are starting a career in
health and the disciplines that contribute to health. It covers what we need to know about public
health and health promotion to start making a contribution to achieving greater fairness, social
justice and health equity. Health is an outcome of social, political, environmental, cultural and
economic forces, so it follows that action to improve health must involve a broad range of disciplines
and sectors. Consequently, this edition of the book takes care to address students and practitioners
from a wide range of disciplines who are interested in how their work can contribute to health and
well-being.
We have edited and written this book to bring together key ideas that we hope will be informative
and valuable to your studies and your practice. The first three editions of this book focused on
understanding health and its determinants. This fourth edition provides an update of important new
developments in determinants thinking and adds new material on how to take action on the social
determinants of health from whatever your field of endeavour with an emphasis on the evidence for
better health and equity. We trust that you enjoy your journey of discovery.
xiv

Outline of this textbook

This fourth edition of Understanding Health has twenty chapters presented in four parts.

Part 1: Understanding Health

Part 1 starts by explaining fundamental concepts of how health is defined and then provides chapters
that explain the determinants of health in more detail than the third edition, as well as updated
chapters on primary health care, public health, and health promotion. Part 1 includes new chapters
on population health and global health with hints on how to build a career in global health should
you be interested in doing so.

Part 2: Measuring Health

There is a saying that what gets measured, gets counted. In your career, no matter what path you
take, you will find that you need to have a sound understanding of evidence and data and how they
are used in public health, and be able to explain them to your colleagues. Part 2 of this book, then,
is focused on explaining how health is measured, with a new chapter on epidemiology as well as
the very popular chapter from the third edition on evidence in public health. We anticipate that
readers will return to these chapters frequently to clarify measurement that supports the theory
and practice of improving health.

Part 3: Shaping and Improving Health

Evidence about the big picture of the social determinants of health is necessary and useful, and
becomes even more useful when it informs more detailed explanations of how and why health is
distributed within and between societies. Part 3 introduces more detail, starting with an exploration
of what shapes behaviours designed to help understand why people behave as they do and how
change happens. Then it explores the social determinants of Indigenous health, which is critical for
understanding health in Australia. A new chapter shows how ecological public health builds on the
new public health foundations of the book to address the ways in which the health of the planet is
one of the most crucial problems shaping human health in the twenty-first century. Human rights
are discussed because they underpin global health, Indigenous health and the daily living conditions
of marginalised populations. In the local and global workforces, there are many examples of rights-
based health programs, as well as increased calls for rights approaches to public health and health
promotion programs and policies. Another new chapter sets out the case for social inclusion, human
rights and culturally safe practice in relation to marginalised populations who, here and overseas,
are increasingly the innocent victims of economic, trade and foreign aid policies.
 Outline of this textbook xv

Part 4: Strategies for Health Practice

Part 4 is about strategies for action. The concepts are tailored to a social determinants approach and
concern with social justice and health equity. Part 4 begins with a new chapter on social marketing
with a social determinants flavour, and then reframes health education from the perspective of
empowerment, program planning and evaluation, and organisational change. Ultimately policy,
whether spoken or unspoken, drives the health sector and those sectors that determine health, so
we introduce what policy is, how it is developed, and how it can be changed. The final chapter brings
together many of the ideas in the book by acknowledging that action to create or destroy health
is done in and with organisations. This chapter presents an agenda and tools for organisational
change towards a fairer and healthier society.
xvi

Key features of this textbook

• Key concepts and Chapter objectives are provided at the beginning of each chapter.
• The authors have used Theory to Practice boxes, Research to Practice boxes and general
Boxes to provide you with strong foundations for thinking about the topic of the chapter
you are reading.
• Chapter summaries are provided at the end of each chapter.
• Discussion topics are provided at the end of each chapter. These are useful for revision
and for tutorial programs.
• Further reading and Useful websites sections are also provided to assist you with further
exploration of the topics, particularly for your preparation of assignments.
• Glossary definitions are provided for key terms and key concepts used throughout the
book.
• For lecturers who adopt the text, the following supplementary materials are available:
–– Instructor’s Manual comprising tutorial activities based around the content in the
textbook
–– Testbank comprising multiple-choice questions and short-answer questions for each
chapter.
Please contact your sales representative for more information.
 xvii

Acknowledgments
Books, like health, also have social, economic and personal determinants! We thank colleagues
who have contributed their expertise to this fourth edition, which contains both new and revised
chapters. Debra James, Camha Pham and all the team from OUP have provided excellent support
and understanding that we also have day jobs, and we thank them sincerely.
We also thank Berni Murphy for her past editorship as well as our peers and colleagues who
have contributed to the book over the course of all of its editions.
In an academic world that is increasingly debating how to measure the impact and quality of
publications, we believe in textbooks as important ways to reach students and practitioners as they
seek understanding and skills at critical times in their careers. We appreciate the feedback from
students near and far, who have enjoyed previous editions, so we dedicate this book to them in the
pursuit of a fairer and healthier world.

Helen Keleher and Colin MacDougall

The authors and the publisher also wish to thank the following copyright holders for reproduction
of their material:
Australian Council for Education Research for extract from Teacher Vol 217, article Ways of
Knowing by Hannah Bell; Canadian Council on Social Determinants of Health for extract from
Communicating the Social Determinants of Health: Guidelines for Common Messaging, 2013; Cengage
Learning for extract from Groupthink: Psychological studies of policy decisions and fiascos by Janis, I.L,
1982. Houghton Miflin; CSIRO for extract from Climate change impacts by K. Hennessy in H. Cleugh,
M. Stafford Smith, M. Battaglia and P. Graham (eds), Climate Change Science and Solutions for
Australia, 2011 and extract from Australian Journal of Primary Health 17(4): 327–333 (http://www.
publish.csiro.au/?paper=PY11044); National Health and Medical Research Council for extract
from Values and Ethics: Guidelines for Ethical Conduct in Aboriginal and Torres Strait Islander Health
Research. Australian Government: Canberra; Oxford University Press for extract from International
Journal of Epidemiology and extract from Journal of Refugee Studies; Palgrave Macmillan for extract
from Econology: integrating health and sustainable development—Guiding principles for decision-
making, by R. Labonte in Debates and Dilemmas in Promoting Health: A Reader by M. Sidell, L. Jones,
A. Peberdy, and J. Katz (eds), 1997; Patan Academy of Health Sciences for extract from website
www.pahs.edu.np; Penguin Random House for Excerpt from Blaming the Victim by William Ryan,
copyright © 1971 by William Ryan. Used by permission of Pantheon Books, an imprint of the Knopf
Doubleday Publishing Group, a division of Penguin Random House LLC. All rights reserved; Professor
Leonard Syme for extract from The importance of the community as an empowered partner for health
and well-being, 2009; Skeptical Science, John Cook for extract from the article Tony Abbott denies
climate change advocated carbon tax in the same breath, 2011, www.skepticalscience.com; Spinifex
Press for extracts from Ngarrindjeri Wurruwarrin: A world that is, was and will be by D. Bell, 2014;
xviii Acknowledgments

The Climate Institute for extract from Australia’s Faith Communities on Climate Change, 2006; The
Guardian for extract from Global Development, online Tuesday 24 September 2013; The Royal College
of Psychiatrists, London for excerpt from Cognitive Behavioural Therapy leaflet, www.rcpsych.ac.uk;
United Nations for extract from Office of the United Nations High Commissioner for Human Rights
at http://www.ohchr.org/EN/Issues/Pages/WhatareHumanRights.aspx and for extract from The
United Nations Convention on the Rights of a Child, 1989, reprinted with the permission of the United
Nations; World Health Organization for extracts reprinted from, A Conceptual Framework for Action
on the Social Determinants of Health by Solar O and Irwin A, 2010/from Early Child Development:
A Powerful Equalizer prepared by Irwin L., Siddiqi A, Hertzman C, 2007/from The Ottowa Charter
for Health Promotion, conference 1986/from WHO director-General addresses health promotion
conference, Dr Margaret Chan, Opening address at the 8th Global Conference on Health Promotion
Helsinki Finland, 2013/from Fact Sheet No 310, 2009, http://www.who.int/mediacentre/factsheets/
fs310/en/.
Image: Corbis/Devon Cummings/Demotix, p.307.
Every effort has been made to trace the original source of copyright material contained in this
book. The publisher will be pleased to hear from copyright holders to rectify any errors or omissions.
PART

1
UNDERSTANDING
HEALTH
Chapter 1 Concepts of Health 3
Chapter 2 Determinants of Health 19
Chapter 3 Primary Health Care 35
Chapter 4 Public Health 50
Chapter 5 Population Health 64
Chapter 6 Global Health 77
Chapter 7 Health Promotion 92
2
 3

Chapter 1
Concepts of Health
Helen Keleher and Colin MacDougall

Key concepts
–– Health
–– Health equity and inequity
–– Theories of health

Chapter objectives
Once you have read and worked through this chapter, you should be able to:
–– describe different concepts of individual and population health, explaining the key
differences between them
–– explain the concepts and theories of health that are most common in health and related
professions
–– identify key theories that underpin concepts of health
–– identify different theories of health used by different professions
–– distinguish between inequity and inequality
–– understand the social gradient in health.

health
INTRODUCTION A resource that
permits people to lead
Health is one of the most fundamental conditions of life. Feeling healthy is core to our individually, socially
everyday lives and is reflected in the common greeting, ‘How are you?’ Rarely does a day go and economically
by when we don’t consider our own health, and inquire about the health of others. productive lives. It
is a positive concept
Of course, people and cultures, groups and societies interpret the concept of the health
emphasising social
in different ways. Moreover, in Australia and around the world, we are seeing rising rates of and personal
poor health. Australia’s National Health Priorities reflect the conditions causing the highest resources as well as
burden—heart disease, cancer, type 2 diabetes, mental health conditions, injury, violence physical capabilities.
4 PART 1 Understanding Health

biological approach against women and children, and dementia. In the developing countries of the world, where
to health four-fifths of the world’s people live, non-communicable diseases such as depression, heart
Explores the role
disease and road traffic deaths are fast replacing infectious diseases and malnutrition as the
of genes and risk
leading causes of disability and premature death. As a result, there is increasing interest
markers and their
interactions with in what can be done to stem the tide of poor health and to better understand the causal
other determinants of pathways to health and illness. A common question asked by health researchers is, ‘Why are
health. some people healthy and others not?’ Researchers and practitioners who are concerned with
biomedical approach poor health also want to make a difference to people’s lives and opportunities by improving
to health health.
Sees health and
This book is about the health of communities and populations including the health of
illness in terms of an
environments around us because we are only as healthy as the world in which we live.
individual’s medically
defined pathology. As a professional whose work affects health, your work is essential to that vision. This
primary health care book, Understanding Health, will lead you into journeys that will enable you to understand
Community-based health, how it is created, and what we can do as a society to improve people’s health.
services based on the In this chapter we explain some of the different ways that professions and cultures think
social model of health,
about health and compare those views to the many different ways in which citizens think
guided by principles
about health. In later chapters of the first part of this book you will read about the approaches
of equity, acceptability,
cultural competence, and practices of primary health care, public health, global health, health promotion and
affordability, and primary prevention, and the determinants of health—those factors that influence health. All
universalism, and these approaches are concerned with the health of the most vulnerable people in our society,
a commitment to and these are also a focus of this book. Once you understand the determinants of health, you
community and
will have a powerful foundation for understanding approaches to advance health and well-
health development.
being for populations.
Primary health care
incorporates essential
health care made
accessible at a cost CONCEPTS OF HEALTH
that a country and
Health is a dynamic concept with multiple meanings that are dependent on the context in
community can afford
with methods that are which the term is used and the people who use it. People see health as essential to well-being,
practical, scientifically but how people define their own health varies according to their own social experience,
sound and socially particularly in relation to their age, personal knowledge, and social and illness experiences.
acceptable as People put a high value on health because while money and power provide the means for
well as essential
people to attain material things that may benefit their lives, no one can actually buy health.
services for health
including water and In other words, health itself cannot be bought and sold in the marketplace, although health
sanitation, housing, services can be both bought and sold. Health is intrinsically tied to people’s sense of well-
shelter, freedom being and therefore occupies a higher order of meaning in people’s lives (Anand 2007).
from violence, and The Greek, Democritus, writing in the fifth century BC, said that ‘without health
adequate food.
nothing is of any use, not money nor anything else’; and the famous philosopher Descartes,
some 2000 years later, wrote: ‘The preservation of health is … without doubt the first good
and the foundation of all the other goods of this life’ (cited in Anand 2007, p. 17).
Koos (1954) captures the complex and mysterious nature of health in his statement that
‘health is an imponderable’. In other words, the state of health is one of the mysteries of life.
 Chapter 1 Concepts of Health 5

It is complex and difficult to describe. In keeping with that we choose not to recommend behavioural approach
a particular definition of health but instead identify a number of different approaches to to health
understanding health and well-being. Underpins the types
of health promotion
The section below explains how different disciplines have different perspectives in how that focus on risk
they understand health. Each perspective affects how those disciplines or practitioners factors and lifestyle
approach their health practices so it is useful to grasp the differences between their behaviours.
approaches: determinants
–– The biological approach: biology is the study of life and living organisms in cells, approach
Sees health and
tissues and organs, so the biological approach to health explores the role of micro-
social problems in
organisms in disease, as well as the study of genetics and risk markers.
the context of broader
–– The biomedical approach studies health and illness in terms of people’s medically social, structural and
defined pathology. cultural conditions
–– The primary health care approach seeks to advance equity, access, empowerment, of our society and
informs public health
community self-determination and intersectoral collaboration.
and health promotion
–– The behavioural approach is focused on changing risk factors and lifestyle approaches.
behaviours. health promotion
–– The determinants approach situates health and social problems in the broader approach
social, structural and cultural conditions of our society and informs public health and The process of
health promotion approaches. enabling people to
take control over those
–– The health promotion approach is the process of enabling people to increase
factors that determine
control over, and to improve, their health. Health promotion work is strongly influenced their health.
by the knowledge derived from the determinants of health approach.
public health
–– The public health approach refers to all organised measures to protect health approach
among populations, and to prevent disease, promote health, and prolong life among Social and political
the population as a whole. Public health uses methods of epidemiology and biostatistics actions aimed at
to inform health protection and prevention efforts. Three more specialised approaches improving health,
prolonging life and
have developed from the broader public health approach:
improving the quality
1 New public health aims to learn from the political and practical experience of of life among whole
historical successes and failures in public health to achieve higher standards of populations through
health, particularly of those who have the least resources, to achieve a more just and health promotion,
socially responsible distribution of resources. disease prevention
and other forms of
2 Ecological public health emphasises relationships between the health of the
health intervention.
planet and the health of populations, demonstrating the essential interdependence of
people’s health with the health of the planet.
3 Population health studies a wide range of other data sources to understand the
health of whole populations, alongside profiling the health of people in local areas.
Further, population health emphasises the dual purpose of improving the health
of the entire population while targeting reduction of health inequities among
population groups. In order to reach these objectives, population health studies the
broad range of factors and conditions that have a strong influence on people’s health
to inform the work of health promotion and primary prevention practitioners.
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Painted meadows. Kerr, S. (Je ’20)
Painting
Oliver, M. I. G. First steps in the enjoyment of
pictures. (Ap ’20)
Painting, Chinese
 Petrucci, R. Chinese painters. (S ’20)
Paints
Jennings, A. S. Paints and varnishes. (Jl ’20)
Palestine
Lock, H. O. Conquerors of Palestine through
forty centuries. (F ’21)
Description and travel
Maxwell, D. Last crusade. (F ’21)
Palmetto. Perry, S. G: (N ’20)
Panama canal
Bunau-Varilla, P. Great adventure of Panama.
(My ’20)
Pan-Americanism
Lockey, J. B. Pan-Americanism. (Ag ’20)
Pan-Islam. Bury, G: W. (Je ’20)
Paper making and trade
Chalmers. T: W. Paper making and its
machinery. (Ag ’20)
Witham, G: S. Modern pulp and paper making.
(O ’20)
Papers and essays for churchmen. Steele, D: M.
(Mr ’20)
Papers on current finance. Foxwell, H. S. (My ’20)
Papers on the legal history of government.
Bigelow, M. M. (Ap ’20)
Parables
Gibran, K. Forerunner. (D ’20)
Paradise Bend. White. W: P. (F ’21)
Paradise mystery. Fletcher, J. S. (Ag ’20)
Paris
Adam, H. P. Paris sees it through. (Ap ’20)
Description
Story, A. M. S. Present day Paris and the
battlefields. (N ’20)
Social life and customs
Edwards, A. H. Paris through an attic. (Jl ’20)
Paris in shadow. Holt, L. (Ja ’21)
Paris through an attic. Edwards, A. H. (Jl ’20)
Parliament and revolution. Macdonald, J. R. (Ag
’20)
Parliamentary reform
Trevelyan, G: M. Lord Grey of the reform bill.
(Je ’20)
Parodies
Castier, J. Rather like.... (Ag ’20)
Powell, C: Poets in the nursery. (D ’20)
Parties
Wolcott, T. H., ed. Book of games and parties.
(D ’20)
Parts men play. Baxter, A. B. (Ja ’21)
Passage of the barque Sappho. Patterson, J: E:
(My ’20)
Passenger. Swinnerton, H. (N ’20)
Passing legions. Fife, G: B. (Ja ’21)
Passing of the new freedom. Beck, J. M. (N ’20)
Passing of the old order in Europe. Zilboorg, G. (D
’20)
Passion. Desmond, S. (Jl ’20)
Passion for life. Hocking, J. (Jl ’20)
Pasteur, Louis, 1822–1895
Duclaux, E. Pasteur. (O ’20)
Pastor of the Pilgrims. Burgess, W. H. (O ’20)
Pastoral epistles. Parry, R. St J: (F ’21)
Patchwork. Myers, A. B. (My ’20)
Paternity of Abraham Lincoln. Barton, W: E. (D
’20)
Paths of inland commerce. Hulbert, A. B. (D ’20)
Pathway of adventure. Tyrrell, R. (Ag ’20)
Patriotism and popular education. Jones, H: A. (S
’20)
Patron and place-hunter. Sanders, L. C: (My ’20)
Patrons of democracy. Sharp, D. L. (My ’20)
Patti, Adelina (Baroness Cederstrom),
1843–1919
Klein, H. Reign of Patti. (N ’20)
Paul, Saint
Baldwin, C: S. God unknown. (O ’20)
Smith, D: Life and letters of St Paul. (Je ’20)
Paul and the printing press. Bassett, S. W. (O ’20)
Pawn in pawn. Sharp, H. M. (Jl ’20)
Pawns. Drinkwater, J: (Ja ’21)
Peabody, Ephraim, 1807–1856
Peabody, R. S. and F. G. New England romance.
(F ’21)
Peabody, Mrs Mary Jane (Derby), 1807–
1892
Peabody, R. S. and F. G. New England romance.
(F ’21)
Peace
 Caldwell, W. E. Hellenic conceptions of peace.
(Mr ’20)
Cooke, R: J. Church and world peace. (F ’21)
Jay, W: War and peace. (Je ’20)
Peace conference, 1919–
Baruch, B. M. Making of the reparation and
economic sections of the treaty. (D ’20)
Bass, J: F. Peace tangle. (D ’20)
Dillon, E. J. Inside story of the peace
conference. (Mr ’20)
Gallagher, P. America’s aims and Asia’s
aspirations. (O ’20)
Harris, H. W. Peace in the making. (Ag ’20)
Haskins, C: H., and Lord, R. H. Some problems
of the Peace conference. (O ’20)
Keynes, J: M. Economic consequences of the
peace. (Mr ’20)
Scott, A. P. Introduction to the peace treaties.
(Je ’20)
Thompson, C: T. Peace conference day by day.
(S ’20)
Peace in the making. Harris, H. W. (Ag ’20)
Peace tangle. Bass, J: F. (D ’20)
Pearson, George Conover, pseud. See Gunion,
P. C.
Peculiar major. Bell, J: K. (Ap ’20)
Peddler. Rowland, H: C. (N ’20)
Peel, Lady Georgiana Adelaide (Russell),
1836–
Peel, G. A. Recollections. (S ’20)
Peggy in Toyland. Marshall, A. (N ’20)
Penance of Magdalena. Chase, J. S. (Ag ’20)
Pengard awake. Straus, R. (Ja ’21)
Penitentiary Post. Pinkerton, K. S. and R. E. (Ag
’20)
Pennsylvania
Description and travel
Wharton, A. H. In old Pennsylvania towns. (F
’21)
Penny plain. Douglas, O. E. (D ’20)
People of destiny. Gibbs, P. H. (O ’20)
People of the ruins. Shanks, E: B. (N ’20)
Perils of respectability. Fiske, C: (S ’20)
Periwinkle’s island. Elias, E. L. (N ’20)
Perpetual light. Benet, W: R. (Mr ’20)
Persia
Description and travel
 Hale, F: From Persian uplands. (D ’20)
Social life and customs
Mirza, Y. B: When I was a boy in Persia. (Jl
’20)
Persian literature
Browne, E: G. History of Persian literature
under Tartar dominion. (F ’21)
Persian poetry
Jackson, A. V. W. Early Persian poetry. (Ag ’20)
Personal beauty and racial betterment. Dunlap, K.
(Ja ’21)
Personal prejudices. Sturgis, E. M. (N ’20)
Personal recollections of Andrew Carnegie. Lynch,
F: H: (F ’21)
Personality
Webb, C. C: J. God and personality. (My ’20)
Personnel administration. Tead, O., and Metcalf,
H: C. (D ’20)
Peter Jameson. Frankau, G. (My ’20)
Peter Kindred. Nathan, R. (My ’20)
Peter’s adventures in Meadowland. Vincent, F. S.
(N ’20)
Le petit nord. Grenfell, A. E., and Spalding, K. (Ap
’20)
Petroleum
Panyity, L: S. Prospecting for oil and gas. (F ’21)
Ross, V: Evolution of the oil industry. (Ja ’21)
Philadelphia
Description
Morley, C. D. Travels in Philadelphia. (My
’20)
Philately
Johnson, S. C. Stamp collector. (My ’20)
Philosophy
Bergson, H. L: Mind-energy. (N ’20)
Blood, B: P. Pluriverse. (Ja ’21)
Cushman, H. E. Beginner’s history of
philosophy. (Ap ’20)
Dewey, J: Reconstruction in philosophy. (N ’20)
Hoernlé, R. F. A. Studies in contemporary
metaphysics. (Ap ’20)
Joad, C. E. M. Essays in common sense
philosophy. (Ag ’20)
Merz, J: T. Fragment on the human mind. (Ag
’20)
Richardson, C. A. Spiritual pluralism and recent
philosophy. (D ’20)
Royce, J. Lectures on modern idealism. (Jl ’20)
Philosophy, Hindu
Carrington, H. Higher psychical development.
(N ’20)
Philosophy of mysticism. Watkin, E: I. (O ’20)
Philosophy of play. Gulick, L. H. (Je ’20)
Philosophy of speech. Willis, G: (O ’20)
Photography
Gamble, W: Photography and its applications.
(Jl ’20)
Hammond, A. Pictorial composition in
photography. (S ’20)
Photography, Aerial
Ives, H. E. Airplane photography. (Mr ’20)
Physical education
Camp, W. C. Handbook on health and how to
keep it. (My ’20)
Jensen, A. Massage and exercises combined. (N
’20)
Physician in France. Herringham, W. P. (My ’20)
Physicians
Biography
Kelly, H. A., and Burrage, W. L. American
medical biographies. (N ’20)
Physiology and national needs. Halliburton, W: D.
(Ja ’21)
Pianoforte
Instruction and study
Brower, H. M. Self-help in piano study. (F ’21)
Pic, the weapon-maker. Langford, G: (O ’20)
Piccadilly in three centuries. Dasent, A. I. (F ’21)
Pictorial composition in photography. Hammond,
A. (S ’20)
Picture-show. Sassoon, S. (Je ’20)
Pierre and Joseph. Bazin, R. F. N. M. (Je ’20)
Pilgrim fathers
Burgess, W. H. Pastor of the Pilgrims. (O ’20)
Crawford, M. C. In the days of the Pilgrim
fathers. (Jl ’20)
Griffis, W: E. Young people’s history of the
Pilgrims. (Je ’20)
Lord, A. Plymouth and the Pilgrims. (D ’20)
Marble, A. R. Women who came in the
Mayflower. (Jl ’20)
Mathews, B. J. Argonauts of faith. (Ag ’20)
Pilgrim maid. Taggart, M. A. (My ’20)
Pilgrimage. Gorell, R. G. B. (O ’20)
Pinion and paw. Eng title of Way of the wild. St
Mars, F. (O ’20)
Pink gods and blue demons. Stockley, C. (Ag ’20)
Pioneers of land reform. Spence, T:, and others. (S
’20)
Pipefuls. Morley, C. D. (D ’20)
Piping and panning. Robinson, E. M. (N ’20)
Pirates of the spring. Reid, F. (Ap ’20)
Place, Francis, 1771–1854
Wallas, G. Life of Francis Place. (Je ’20)
Place in the world. Turner, J: H. (My ’20)
Place of science in modern civilization, and other
essays. Veblen, T. B. (My ’20)
Plainsman, and other poems. Carpenter, R. (F ’21)
Planning and planting of little gardens. Dillistone,
G: (Ja ’21)
Plant propagation
Bailey, L. H. Nursery-manual. (Je ’20)
Plants
Saunders, C: F. Useful wild plants of the United
States and Canada. (Je ’20)
Play
 Gulick, L. H. Philosophy of play. (Je ’20)
Plays. Galsworthy, J: (Je ’20)
Plays. Glaspell, S. (Ag ’20)
Plays and pageants of citizenship. Payne, F. U. (D
’20)
Plays for merry Andrews. Kreymborg, A. (F ’21)
Plays of the 47 workshop. 47 workshop. (D ’20)
Plays of the Harvard dramatic club. Harvard
university. Dramatic club. (D ’20)
Pleading and practice
Works, J: D. Juridical reform. (Ap ’20)
Pleasures of collecting. Teall, G. C. (N ’20)
Plunderer. Oyen, H: (Je ’20)
Pluralism
Blood, B: P. Pluriverse. (Ja ’21)
Richardson, C. A. Spiritual pluralism and recent
philosophy. (D ’20)
Pluriverse. Blood, B: P. (Ja ’21)
Plymouth, Mass.
Lord, A. Plymouth and the Pilgrims. (D ’20)
Plymouth and the Pilgrims. Lord, A. (D ’20)
Pocket guides to public speaking. Kleiser, G. (My
’20)
Poems, Books of
Adams, F. P. Something else again. (D ’20)
Aiken, C. P. House of dust. (N ’20)
Ananda Achārya. Snow-birds. (D ’20)
Ault, N. Dreamland shores. (Ja ’21)
Baker, K. Blue smoke. (My ’20)
Barker, H. G. Songs in cities and gardens. (Mr
’20)
Barney, D. Chords from Albireo. (Ag ’20)
Barr, A. E. Songs in the common chord. (Ap ’20)
Barrett, W. A. Songs from the journey. (Je ’20)
Benét, S. V. Heavens and earth. (F ’21)
Benet, W: R. Moons of grandeur. (D ’20)
Benet, W: R. Perpetual light. (Mr ’20)
Bennett, R. After the day. (F ’21)
Benshimol, E. Tomorrow’s yesterday. (N ’20)
Bodenheim, M. Advice. (N ’20)
Boni, A., ed. Modern book of French verse. (Ag
’20)
Bowman, A. A. Sonnets from a prison camp. (Je
’20)
Bradford, G. Prophet of joy. (O ’20)
Braithwaite, W: S. B., ed. Anthology of
magazine verse for 1919. (Ap ’20)
Braithwaite, W: S. B., ed. Book of modern
British verse. (My ’20)
Bridges, R. October. (O ’20)
Brown, A. F. Heart of New England. (N ’20)
Buck, H. S. Tempering. (Je ’20)
Bunker, J: J. L. Shining fields and dark towers.
(Mr ’20)
Burke, T: Song book of Quong Lee of
Limehouse. (F ’21)
Burt, M. S. Songs and portraits. (O ’20)
Bynner, W. Canticle of Pan. (Jl ’20)
Carpenter, R. Plainsman, and other poems. (F
’21)
Clark, A. Margaret book. (Je ’20)
Cone, H. G. Coat without a seam. (Jl ’20)
Conkling, G. W. Wilderness songs. (Jl ’20)
Conkling, H. Poems by a little girl. (Je ’20)
Contemporary verse anthology. (F ’21)
Coutts, F. B. T: M.- Spacious times and others.
(Je ’20)
Cromwell, G. Poems. (My ’20)
Crowell, J. F. Outdoors and in. (O ’20)
Davis, F. P., ed. Anthology of newspaper verse
for 1919, and year book of newspaper poetry.
(F ’21)
De La Mare, W. J: Collected poems. (Ja ’21)
Doyle, A. C. Guards came through, and other
poems. (My ’20)
Eliot, T: S. Poems. (My ’20)
Farrar, J: C. Forgotten shrines. (Jl ’20)
Flexner, H. Clouds and cobblestones. (D ’20)
France, A., pseud. Bride of Corinth. (F ’21)
Frothingham, R., comp. Songs of dogs. (N ’20)
Frothingham, R., comp. Songs of horses. (N ’20)
Fyleman, R. Fairies and chimneys. (N ’20)
Gayley, C: M., and Flaherty, M. C:, comps.
Poetry of the people. (S ’20)
Georgian poetry, 1918–1919. (My ’20)
Gibson, W. W. Neighbors. (F ’21)
Gorell, R. G. B. Pilgrimage. (O ’20)
Graves, R. Country sentiment. (Jl ’20)
Guiterman, A. Ballads of old New York. (Mr ’20)
Guiterman, A. Chips of jade. (F ’21)
Hardy, T: Collected poems. (D ’20)
Herbert, A. P. Bomber gipsy. (Jl ’20)
Hillyer, R. S. Five books of youth. (Ag ’20)
Hughes, A. M. Diantha goes the primrose way.
(D ’20)
Hughes, G. Broken lights. (D ’20)
Huxley, A. L. Leda. (O ’20)
Ingpen, R., ed. One thousand poems for
children. (F ’21)
Jesse, F. T. Happy bride. (D ’20)
Johnson, R. U. Collected poems. (Mr ’20)
Jones, H. Well of being. (Je ’20)
Jones, J. H:, jr. Heart of the world. (Ag ’20)
Kemp, H. H. Chanteys and ballads. (D ’20)
Kerr, R. W. War daubs. (Je ’20)
Kip, A. L. Poems. (Ag ’20)
Knibbs, H: H. Songs of the trail. (D ’20)
Kossovo: heroic songs of the Serbs. (Ag ’20)
Kreymborg, A. Blood of things. (F ’21)
Lawrence, D: H. New poems. (Ag ’20)
Ledwidge, F. Complete poems of Francis
Ledwidge. (Ap ’20)
Lee, H. S. High company. (O ’20)
Le Gallienne, R: Junk-man. (N ’20)
Leonard, W: E. C. Lynching bee. (F ’21)
Lincoln, E. C. Rhymes of a homesteader. (My
’20)
Lindsay, N. V. Golden whales of California. (Jl
’20)
Lomax, J: A. Songs of the cattle trail and cow
camp. (My ’20)
Low, B: R. C. Broken music. (F ’21)
MacDonnell, J. F. C. Cairn of stars. (Jl ’20)
Markham, E. Gates of paradise. (Jl ’20)
Masefield, J: Enslaved. (S ’20)
Masefield, J: Right Royal. (F ’21)
Masters, E. L. Domesday book. (Ja ’21)
Masters, E. L. Starved Rock. (Ag ’20)
Maynard, T., comp. Tankard of ale. (O ’20)
Millen, W: A. Songs of the Irish revolution and
songs of the newer Ireland. (Jl ’20)
Miscellany of American poetry, 1920. (O ’20)
Montague, J. J. More truth than poetry. (D ’20)
Moore, T: S. Little school. (S ’20)
Morgan, A. Hail, man! (My ’20)
Morley, C. D. Hide and seek. (D ’20)
Napier, M. Songs of the dead. (D ’20)
Nichols, R. M. B. Aurelia, and other poems. (O
’20)
Noguchi, Y. Japanese hokkus. (D ’20)
Noyes, A. Collected poems. (D ’20)
Noyes, A. Elfin artist. (O ’20)
Percy, W: A. In April once. (D ’20)
Phillpotts, E. As the wind blows. (S ’20)
Potter, M. C. Rhymes of a child’s world. (N ’20)
Powell, C: Poets in the nursery. (D ’20)
Prisoner of Pentonville. (Jl ’20)
Raskin, P. M. Songs and dreams. (O ’20)
Ridge, L. Sun-up. (F ’21)
Roberts, C. E. M. Poems. (Mr ’20)
Robinson, E. A. Lancelot. (Ag ’20)
Robinson, E. A. Three taverns. (N ’20)
Robinson, E. M. Piping and panning. (N ’20)
Ryan, A. Whisper of fire. (Ap ’20)