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| Hygiene and Health |
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Hygeia was the goddess of health in Greek mythology. The word hygiene, derived from her name, is defined in the dictionary as the system of principles for “the preservation of health and prevention of disease.” It is associated with sanitary practices and preventive medicine, whereas clinical medicine deals more with efforts to correct health problems. When I began medical school exactly fifty years ago, there was a feeling that hygiene had accomplished most of the preventive objectives to be attained in public health, at least in the West. It had a glorious history of conquering or preventing epidemic outbreaks of the most dreaded plagues of mankind, including smallpox, typhus, cholera, yellow fever, and the black plague. Of course, these diseases and a few others were still problems in the developing world, but in principle we knew how to deal with them, or so it was thought. Today it is clear that in 1958 we were only on the threshold of an era in which new kinds of epidemics were beginning to threaten the health of the public. Conditions like coronary artery disease, diabetes, obesity, and others began flooding our health system in spite of the best efforts of top-notch clinicians to stem the tide. In addition, there was resurgence of some older epidemic diseases, and of course, HIV infection made its appearance. We now know that a “system of principles for the preservation of health and prevention of disease” remains crucial. Indeed, today the need for this hygienic system is broader, deeper, and more urgent than ever. It is impossible to cover the hygienic front in a short article, but let me sketch the growing need for well-applied hygienic health principles. We still have infectious diseases to contend with, so the time-proven principles of clean air, clean water, clean food, and clean hands remain essential. With HIV infection added to many older sexually transmitted diseases, responsible sex is more important than ever. Synthetic chemicals are far more pervasive in our everyday lives than was true in 1950. Most of them have beneficial purposes, but in spite of our vaunted scientific knowledge, we know little about their long-term effects on health. What we know is sobering. Some are similar enough to natural body chemicals to interact easily with vital life processes, and their impact is often damaging to our immune systems and to our health. Wholesome nutrition is more complicated today than it was a century ago. Food choices have become more difficult, with thousands of food products available today that did not even exist then. Many of these foods have a negative impact on long-term health. Air quality has become more problematic in many regions. The prevalence of asthma has risen as air quality has deteriorated, and most health authorities think these problems are linked. Smoking adversely affects the health of millions of people and those around them. Water quality is under increasing pressure around the world. The hygienic challenges we face as individuals and as a society are enormous. Yet, they can be met. The key is to care, and to live as simply, cleanly, and honestly as possible. |