Medical treatment used to respond to illness or to injury. Today, it helps us prevent the things that made us ill or killed us. Mothers rarely perish while giving birth; the infant mortality rate is down. Immunizations and antibiotics protect us from deadly diseases so efficiently that we forget they ever threatened us. Some aspects of the aging process are now treatable. Pharmaceuticals extend life and enhance its quality. How much further can science take us?
Government plays an active role in urging us to protect our own health. The govern- ment's 700-page report called Healthy People 2000 (1990) explains that "the health of a people is measured by more than death rates. Good health comes from reducing unnecessary suffering, illness, and disability. It comes from an improved quality of life. Health is thus measured by citizens' sense of well being. The health of a Nation is measured by the extent to which the gains are accomplished for all the people." The report calls for "mobilizing the considerable energies and creativity of the Nation in the interest of disease prevention and health promotion."
The government cajoles us: Make sure you're fully immunized; exercise regularly, eat fruit, vegetables, and fiber. Know what the leading causes of death are in order to plan for a healthy life. Health and Human Services Secretary Tommy Thompson tells us that "good health is literally a walk away." Are we paying attention?
We know that food nourishes us and new evidence shows it can help prevent disease, even the scourge of cancer. But regular food may not be enough. We're told: Take vita- mins and supplements, eat superfoods, buy organic. Dr. Thomas Perls, director of the New England Centenarian Study and co-author of Living to 100, tells us the real key to longevity: "Good genes."
We know that it is far more economical to practice prevention — to pay now rather than pay later. Then again, perhaps genetic engineering will eventually do away with all of our health concerns. Or will it be the stuff of horror movies?
Despite what science has done for us, a growing number of people do not believe that science has all the answers when it comes to preventing illnesses, curing diseases, or even just making life more pleasant. They complain that doctors no longer make house calls, and patients are handed from specialist to specialist as though they were diseases, not whole persons. Modern managed medical care is cold and distant, but alternative practitioners listen, care, and get results. Believers have spearheaded one of the most significant public health developments of the end of the 20th century — the boom in complementary and alternative medicine (CAM), coupled with the move to integrate popular alternative healing methods into standard Western medical practice.1 Alternative therapies are currently sought out by individuals who have AIDS, arthritis, back pain, cancer, and other medical conditions conventional medicine cannot cure.
The age of the miracle cure is upon us. Entrepreneurs, drug companies, and hucksters have been quick to exploit the unwillingness of an aging population to succumb gracefully to the pain, discomfort, distress, and inconvenience of illness and old age.
We open our chapter with a discussion of the alternative medicine phenomenon ("Vali- dated by science, tested by the American people," claims the cover of the alternative health magazine The People's Pharmacy). We then look at trends in the American diet and exercise. We will see how new vaccines make for increasingly complex immunization schedules, and how federally funded community health centers are proliferating to meet the health care needs of underserved Americans.
We conclude our prevention chapter with a discussion of the Human Genome Project. We will see how the events of September 11th made bioterrorism the latest prevention watchword.
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