History and culture of tanning in the United States

This chapter traces changes in the perception of tanning and tanning behavior primarily within the United States (U.S.) from the later part of the nineteenth century to the early part of the twenty-first century. Originally seen as a hallmark of the working class/disadvantaged groups and associated with disease and ill health, societal perceptions of the tan evolved over time to reflect the opposite: wealth, health and beauty. These core beliefs regarding the value of tanning and ultraviolet (UV) radiation exposure have proven extremely difficult to modify despite substantial efforts by the public health community to do so. In an attempt to understand why millions of Americans continue to engage in high-risk, intentional UV exposure such as use of indoor tanning facilities, the beliefs and behaviors related to tanning are considered within the context of the historical medical and societal factors, especially the role of fashion and advertising, which helped to shape current opinion.