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Medical Care Perspectives
Health, Disease and the Environment
The emerging idea is that each person can exercise more control over their own risk of injury and disease. Each person also has an ethical obligation to contribute to the wellbeing of his or her community. The community as an obligation to provide better education and resources directed toward healthier lifestyles. The community in turn can expect a higher standard of self-responsibility. Risky human behaviors must eventually decline, or better, disappear.
Each person has some control over their life course and some ability to prevent injury and disease. Often, diseases emerge because of ignorance or careless disregard for risky behaviors. On the other hand, some people are specially concerned about health risks and focus on small issues, using casually gathered misinformation. Although their intentions are admirable, their methods fail to achieve the right results. Affluent countries tend to create dependent citizens who fail to act responsibly and instead, dependent people expect that the government will rescue them from all misadventures.
The obstacle in the path of all idealist solutions is human nature, a nature full of tendencies that interfere with the pursuit of rational solutions to human problems. I have outlined these tendencies in several books.
If you stand back and take a global view of human societies, you will appreciate the following description: Human health depends on the proper supply of food, air and water. Infection, injury and toxicity are environmental problems. There is a consensus that smoking, overeating, drinking and accidents are preventable hazards. The control of environmental pollution has been attempted by a host of smart, well-informed people with limited success. A proper biological method of medicine begins by recognizing and solving problems in food, air and water supplies. A steady flow of molecules from the environment enters the body of each individual through the air breathed and the food and liquids ingested. This body-input determines health and disease in whole populations over the long-term and the moment to moment functional capacity of the individual. A person's performance can change dramatically with changes in this molecular stream. The quality and composition of air, food, and water changes continuously. The illusion of food continuity in the supermarket conceals changes in the growth, contamination, storage, spoiling, transportation, and merchandising of food products. To understand environmental reactivity we must deal with changes, variability and inconsistencies, and we must seek adaptive, flexible responses to changing circumstances.
The control of some infectious disease through improved hygiene and immunization is one of the great health achievements of the 20th century. While the concern that new viral infections may emerge as lethal epidemics is well publicized, the reality is that infectious diseases are constantly evolving, disabling and killing increasing numbers of people. New viral epidemics may add to the disease burden, but the existing threats are available right now.
We can attribute half of all diseases that lead to premature disability and death to people eating too much of the wrong food and exercising too little. Cancers often arise from repeated prolonged carcinogen exposure, delivered in air and food. Smoking cigarettes is an example of personal, indoor air pollution that causes cancer. The air we breath contains chemicals and complex aerosols that can cause disease.
This website attempts to provide a perspective and an overview, with an emphasis on removing the causes of disease rather than treating the effects. We emphasize basic biology and recognize that human health depends on the proper supply of food, air and water. The improvement in the diversity and availability of foods has been a mixed blessing with major problems emerging to negate the potential benefits. Food is the most intimate part of the environment because we ingest it.
Air is the second most intimate part of the environment, because we inhale it. When something goes wrong, it makes good sense to look at the flow of substances through the nose and mouth for the source of the problem. We look not only at the composition of the food but also, and more importantly, at the interaction of the ingested molecules with body. Adverse reactions to food are common and produce many disturbances by a variety of mechanisms.
While people live longer in North America, there is growing evidence that the wellness quotient of the average citizen deteriorates and the prospect of chronic degenerative disease haunts the aging population. It is easy to point to persisting, increasing, debilitating health problems such as depression, family violence, suicide, obesity, diabetes, disability from degenerative diseases, dementias, cancer and an increasing incidence of ill-defined illnesses. At least half of the adult population in the US and Canada report chronic symptoms such as headache, fatigue and joint and muscle pain. Aging citizens are vulnerable to a variety of debilitating if not tragic illnesses. The rising incidence of two disabling and chronic illnesses Diabetes 2 and Alzheimer's dementia is a major concern especially as 70 million middle aged people in North America will approach the peak incidence of these diseases in the next 20 years.
The biologist sees living creatures connected to and interacting with their environment. It is normal for a biologist to think in terms of populations, food supply, seasons, weather and social-behaviors. Biologists do field studies that reveal patterns of adaptation to specific changes in the environment. Anyone who has worked with animals or fish in closed environments knows how critical environmental conditions and diet are in determining both the behavior and the physical status of the residents. When a fish in an aquarium displays disturbed behavior, you do not call a fish psychiatrist and prescribe Prozac; you check the oxygen concentration, temperature and pH of the water. You have to clean the tank and change the fish diet.
Often patients with mild symptoms are progressing toward a major illness, but they may suffer in an ill-defined state for months or years. As illnesses progress, more specific features tend to emerge-dysfunction and tissue changes become more obvious, and medical diagnoses become more useful.
A heart attack or stroke, both calamitous events with obvious features, fit the medical model well and tend to be diagnosed reliably and treated in a standard fashion. These are end-point events - the underlying pathology takes years to develop and increasing dysfunction is often ignored as the pathology progresses toward a dramatic conclusion. Other processes may remain ill defined; chronic fatigue, muscle pains, headaches and cognitive dysfunction may make life miserable for many years before a more definable disease such as arthritis becomes apparent.
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