The Healthy Socialist Life in Maoist China, 1949–1980

Studies in the history of medicine and health in Mao's China after 1949 have been a burgeoning subfield of Chinese history and medical history over the past two decades. In these histories, medicine and health have been inseparable from politics in ideological commitment and operational schemes, which have been reflected in health work principles and mass movements. In current scholarship, researchers have made substantial progress in exploring empirical studies of the politics of medicine and health. However, one simple but fundamental theoretical question has long been understudied—“What constituted health in socialist China and beyond?” (223). Aiming to fill this gap, Rene Krusche's book analyzes how crucial aspects of daily life have been redefined, measured, and institutionalized and how health as concept and practice has been narrated and developed in the sociopolitical and industrial contexts of China.The book is composed of six chapters which are divided into three parts. Part 1, “Nutritional Government” (chapters 1 and 2), addresses the significance of nutrition in maintaining health in the context of China's modernization and nation-building. According to Krusche, the government disseminated knowledge about nutrition to build an awareness of the function of food on the body among professionals and laypeople to establish empirical scientifically estimated nutritional regimes to strengthen health and serve production. This nutritional knowledge was implemented through meal plans in regulated, standardized, and structured spaces—public canteens. Food was of nutritional, ideological, and political significance.Part 2, “Physical Government” (chapters 3 and 4), investigates why and how both physical education/exercise and resting/sleeping serve as ways of strengthening the body for the sake of production. Krusche points out that knowledge about fitness was propagated and implemented through radio calisthenics and running in collective and individual training schemes, respectively. Knowledge about adequate sleep and rest were communicated to populations and integrated into daily life to deal with fatigue caused by the intensity and rhythms of production.Part 3, “Disease Government” (chapters 5 and 6), analyzes two noncommunicable civilization diseases—obesity and hypertension. Krusche argues that obesity was defined as a disease when fatness and overweight were believed to bring about harmful moral and production danger to the individual and society. Similarly, the framing of hypertension as a disease and the government's dedication to disseminate knowledge about its prevention to the population occurred in “a production-driven socialist society” (211).Krusche's Healthy Socialist Life makes a significant contribution to the field in that it develops an innovative theoretical framework. In current scholarship, nationalism and nation-state building are the two contexts used for analyzing progress in health and medicinal outcomes in the modern era. Foucault's concepts of biopower and governmentality have been classical tools for addressing the power relationship between individual bodies and institutions. Inspired by but not confined to these concepts, Krusche focuses on a trinity of health practices—nutrition, physical activity, and rest—and so-called civilization diseases brought about by an epidemiological transition through the macro perspective of governmentality. She further meticulously identifies a set of relationships for each theme. Her discussion of “nutritional government” focuses on knowledge and implementation, which refer to shapes and space in the book. “Physical Government” examines exercise and rest as “two opposites of activity and nonactivity” for the purposes of health and production. “Disease Government” investigates physical plights caused by the opposites of a sedentary life and the fast rhythms of new lifestyles. These logically woven relationships basically cover the health routine associated with daily life in socialist China.Krusche also gives an in-depth analysis of the history of the body in the specific sociopolitical, economic, and medical contexts of Mao's China, where production was the ultimate goal for the nation through industrialization and the agricultural collectivization campaign. Under such a circumstance, the human body first became a machine that required fuel—nutrition. As a part of the modernized and industrialized world, the physical body requires both activity/exercise and regular periods of stillness to both survive and work within the new social and labor structure (81). Further to the machine metaphor, the human body was meticulously and constantly measured, assessed, institutionalized, and categorized in every aspect of daily life. This process presents a Chinese-style biopolitics in the socialist era when state power has penetrated into daily life.Within this theoretical framework, the book also discusses the roles of various factors in shaping health routines for daily life, including the state, experts, professionals, and populations. Obviously, state authorities dominated this whole process, promoting healthy lifestyles, providing foreign expertise, training professionals, and supplying populations with institutionalized space. However, Krusche highlights the limits of governmentality and argues that the state was not omnipotent as usually supposed. Instead, she argues that total control of daily habits and individual bodies concerning eating, sleeping, and exercising was hard for the government to achieve.In addition to individual factors like physique, habits, and bodies, the book could also have taken institutional factors into serious consideration. In particular, the resource distribution scheme embedded in the division of urban and rural areas limited the state's capacity and efforts of governmentality. Compared with peasants, employees in state-funded agencies had more privileges in relation to accessing nutritional food, performing collective physical exercises, and maintaining vigilance over weight and blood pressure. While the book notes the epidemiological transmission's impact on disease governmentality, it could have further analyzed the historical changes from Mao's socialist era to the postsocialist era. This shift brought about institutional changes, the role and capacities of the state authority in health care, as well as medical and health resources that could be accessed. Typical examples involve the reform of medical and health welfare schemes for work units from the 1980s. Analysis of historical changes would have illustrated the dynamics of governmentality in different sociopolitical, economic, and medical contexts in contemporary China.All in all, Krusche's book will further inspire empirical studies of the history of medicine and health in institutionalized settings like work units in China after 1949. The Healthy Socialist Life in Maoist China, 1949–1980 will help readers further understand the biopolitical and governmentality reflected in the recent COVID pandemic through the perspective of historical continuity and will be of value to researchers and students who are interested in Chinese history, the history of medicine and health, and medical anthropology.