Patterns of health and disease change over time Essay Example
Patterns of health and disease change over time Essay Example

Patterns of health and disease change over time Essay Example

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  • Pages: 8 (2024 words)
  • Published: August 7, 2017
  • Type: Case Study
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The social sciences often struggle to formulate clear definitions, especially in the health sector. Numerous terms associated with wellbeing and illness such as healthy, fit, poorly, 'one degree under', low, below par, diseased or even phrases like 'sick as a parrot' are frequently used. Intriguingly, we usually understand these phrases when used colloquially. However, healthcare professionals might perceive these terms differently than laypeople do. To reduce potential confusion, I have adopted a medical perspective on health; defining it as a condition of wellness free from disease.

The World Health Organisation (WHO) characterises health as 'a condition of absolute physical, mental, and social welfare, not just the lack of disease or weakness'. This implies that if we don't possess 'total well-being', it's deemed as poor health. However, common people perceive health differently. It is viewed more as a comparative concept rather th

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an an ultimate one. Consequently, the perception of good health varies across different individuals and occupations. For instance, how an astronaut perceives good health could be dissimilar from a fashion model's view or that of a lumberjack or a stockbroker (Dubos and Pines, 1980).

The text highlights that different ways of life necessitate varying levels of physical activity, diverse food requirements, and unique stresses. Additionally, it acknowledges that not all individuals are equally susceptible to every disease. Jones (1994) added that individuals who feel unwell, such as women experiencing period pains, may not find the general definition of health comprehensive or accurate. Seeking medical attention is crucial to receive an official confirmation.

Furthermore, people have different interpretations of health and illness. Herzlin (1973) conducted a notable study involving 80 middle-class men and women in France. The participants

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were asked to provide their own definitions of health and categorized them into three distinct groups.

1 - Lack of illness

2 - Strong health

3 - State of balance

Creating a globally accepted definition of health and properly measuring it can be quite challenging. Regardless, attempts are made to do so due to practical needs. Health is usually evaluated using two parameters: morbidity, indicating illness, and mortality, denoting death. However, it's intricate to quantify morbidities because of the subjective aspect involved in recognizing them. This complexity often results in a heavier dependence on mortality when researching health inequalities both within and between societies.

As humans have socially evolved, some diseases have become more prominent and others less so. Sociological historians such as Powles (1973) and McKeown (1979) suggest that the history of human disease can be categorized chronologically. The initial category is the pre-agricultural era where death primarily occurred due to environmental hazards and safety risks. Following this is the agricultural era, during which airborne, waterborne, and foodborne infections like dysentery became widespread, along with rat-borne or mosquito-borne diseases like plagues and malaria. Lastly comes the contemporary industrial era marked by unique lifestyles leading to new sets of health issues.

1) The Era of Hunter-Gatherers

Prior to the advent of farming, communities depended on hunting, fishing, and gathering for their sustenance. It is assumed that during this phase, while life expectancy was relatively low, overall health was generally good. Adult mortality often resulted from the pursuit of food and resource competition. Death frequently occurred due to murder, tribal disputes, accidents during hunting activities, exposure to harsh weather conditions and malnutrition.

McKeown (1988, p40) posits that "the lack of adequate nutrition constrained population

growth and adversely affected health in two manners: it instigated attempts to manage population numbers by reducing birth rates or by eliminating or neglecting undesired individuals." Nevertheless, these approaches were insufficient in preventing food shortages; death from starvation, undernourishment and illnesses related to poor diet were commonplace. While infections did play a role in impacting health negatively as well they weren't as common until later historical periods.

The evolution of cereal cultivation contributed to population settlement, ensuring more people could be nourished. However, this condensed living arrangement resulted in over-dependence on cereals for food, causing an underdeveloped immune system and exposure to infectious diseases that eventually caused fatalities.

2 - The shift from farming to manufacturing is often intricate.
3 - As virulence diminishes over time, organisms turn less deadly.
4 - Alterations in domestic life, especially housing advancements, have led to diminished contact with infectious agents and lessened the chances of infection transmission.

5 Genetically induced resistance of humans to infections - explained through the concepts of Darwinian evolution. Humans have evolved and advanced.

Improved lifestyles lead to increased resistance, as there is an increase in standards of living and better nutrition. It is important not to rely solely on one food group.

The advent of medical procedures, including the application of antibiotics, healthcare facilities, and medication, coincided with the evolution of an agrarian society roughly 10,000 years ago. This change in living habits facilitated the farming and taming of flora and fauna, resulting in established communities able to support bigger populations. Nonetheless, this also gave rise to conditions conducive for the spread of infectious illnesses brought about by microorganisms or 'germs' that can be disseminated through different pathways such

as air, water, contact, or vector organisms like bugs.

To sum up, there is a clear correlation between the occurrence of disease and the accessibility of food resources. Enhanced availability of food and nutrition is associated with a decrease in diseases. On the other hand, insufficient food supplies and malnutrition can contribute to rising infectious diseases. From a historical perspective, the plague was a significant infectious disease that led to mass fatalities across Europe; it spread through fleas carried by black rats. During an intense epidemic referred to as the Black Death around late 1340s, it's estimated that approximately one third or half of England's and Western Europe's population were eradicated.

McKeown asserts that the transition to agriculture brought about two significant changes in eating habits. Hunter-gatherer societies primarily relied on meat, fish, fruits, and vegetables as food sources. Even though the ratios varied across different communities, roughly 66% of their intake was plant-based. They didn't consume grains or dairy products. However, with the dawn of farming came new additions to human diets such as cheese, milk and eggs which resulted in an excess of food thereby promoting population expansion. Yet without proper control measures like fertility regulation or deliberate culling; this growth persisted until resource scarcity for survival re-emerged.

The modern industrialized world has witnessed a decline in mortality rates from infectious diseases. Conditions like tuberculosis, measles, scarlet fever, and whooping cough have significantly decreased, despite not being completely eradicated.

During the mid-20th century, there was a noticeable change in the primary causes of death in modern Western communities. Conditions such as cancer, heart disease, and strokes replaced infectious diseases as major causes of mortality. The prominence of

these diseases today might be because they weren't frequently seen in earlier periods, likely due to early deaths from other factors. However, it's generally believed that these are predominantly new illnesses resulting from living conditions associated with industrialization.

According to medical historian Thomas McKeown (1988, p154), individuals from the Third World adopting a Western lifestyle are susceptible to developing Western diseases. This claim is supported by noting changes in dietary habits such as decreased fiber and increased fat, sugar, salt consumption; along with higher usage of alcohol, tobacco and illicit drugs; also lesser physical activity contribute significantly to these health issues. As per McKeown's analysis, the growth of Third World populations combined with their shift from rural to urban environments tends to exacerbate these behaviors.

Currently, it's recognized that degenerative diseases lead to most deaths. The common advice is that health strategies should concentrate on dealing with risk elements linked to chronic ailments, like tobacco use, excessive alcohol consumption, lack of physical activity and a high-fat diet. With the accomplishment of this strategy, it's anticipated that individuals can maintain robust health into their old age.

In the West, enhanced health conditions are frequently credited to progress in science and medicine. The comprehensive comprehension of human anatomy has allowed scientific advancements in creating more effective drugs, vaccines, and painkillers. Moreover, it is thought that such scientific breakthroughs have fostered proficient doctors' education and surgeons besides facilitating advanced hospital infrastructures. All these cumulative enhancements have significantly aided in reducing death rates.

However, this perspective lacks backing from medical historians. McKewon argues that the decline in the mortality rate, which commenced in the 18th century, mostly stemmed from three non-medical elements: enhancements

in nutrition, public hygiene, and birth control.

Nutrition is important for maintaining good health.

McKeown asserts that the primary and most impactful element leading to enhanced diets was progress in agriculture. This evolution began to disseminate throughout Europe from the late 1600s onwards. The adoption of novel crops such as potatoes and maize, coupled with improved agricultural methods like advanced crop rotation systems and superior manuring techniques, resulted in a rise in food supply and boosted nutrition levels among people.

Sanitation in public spaces.

Beginning from around 1870 in England and Wales, and subsequently in other nations, the improvement of public sanitation emerged as a crucial factor that increasingly became influential. This encompassed the introduction of less polluted, piped water services and enhancements in waste management systems. Such proactive steps in public health diminished the hazards related to exposure to diseases, predominantly those transmitted through water like typhoid and cholera. Moreover, progress made in milk distribution methods such as sterilisation and bottling also had a substantial impact.

McKeown posits that the deterioration in health trends can be ascribed to three elements. A key element is the reduction in birth rates and family size within middle-class families, a trend initiated in the 1870's. McKeown estimates that absent this decline, England and Wales' present population would stand at approximately 140 million instead of its current 50 million. Consequently, he contends that without this restrictive effect on population growth, advances made in healthcare might have been negated.


Medicine.

Contrary to popular belief, McKeown doubts that medical care or immunizations had a significant effect on mortality before the 20th century. He concludes that they contributed little to the reduction of deaths from infectious

disease before 1935 (McKeown, 1979 p77). In other words, although immunization, surgery, and medical treatment have had a welcome impact on suffering, morbidity, and mortality in the later part of the twentieth century, their impact has been relatively late.

The most notable advances in mortality rates have been primarily due to preventive medicine, specifically public hygiene measures. The role of the modern medical profession and curative interventions in these improvements has been relatively minor, especially in recent times. McKeown's comparative studies of Sweden, France, Ireland, and Hungary reveal a similar trend, which aligns with the conclusions drawn in the USA.

McKeown concludes that while certain types of medical intervention, like routine treatments such as fractures repairs, have undeniably shown success, it is incorrect to assume that the significant improvements in morbidity and mortality rates over the past three centuries can primarily be attributed to advancements in medical knowledge and its implementation. Both lay individuals and medical professionals have greatly overestimated medicine's role in current health.

Nick Hart, among other critics, challenges the assertions made by the medical field. Despite this, it has successfully persuaded both individuals and government officials that its impressive standards and accomplishments in healthcare, as opposed to public sanitation measures, have contributed to prolonged and healthier lives. N. Hart argues our personal well-being continues to be dependent on these standards and successes (N. Hart, 1985, p1).

Although the medical profession firmly believes that contemporary health care facilities and practices such as high-tech hospitals, surgeries, and clinics are key to preserving public health, some have challenged this view by contending that our comprehension of the efficacy of clinical treatments is still not comprehensive. The absence of

thorough recording and evaluation of treatment results within the NHS leads to a lack of confidence in the effectiveness rates of different procedures and interventions. As a result, we remain unsure about how significantly medicine affects our nation's health.

In comparison, according to Lupton (1994), western societies in the late twentieth century are marked by an augmented disenchantment with scientific medicine. However, contradictory to this, there is also a growing reliance on biomedicine to offer solutions to both social and medical issues.

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