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Preventive medecine: changing for the better PREVENTIVE MEDECINE: CHANGING FOR THE BETTER
In a highly fluid society such as we now have in the West nothing stays still for long and change is possible. Twenty years ago hardly anyone of influence was talking or writing about lifestyle, but today specialist health magazines, articles in other magazines and newspapers, health food stores, books and self-help groups attract the serious attention of millions of people every year. People are at last starting to realize that they can't go on abusing themselves and that simple changes can make a real difference to their life-expectancy in the future and their general well-being in the here-and-now.
Things are already changing for the better, especially in the US where change, both for good and evil, happens quickly. Both in the US and in the UK the consumption of tobacco, eggs, butter and cream is down and recreational exercise is greatly in fashion. Non-smokers have been vociferous to assert their right to breathe clean air, and no-smoking areas in public places are now the norm rather than the exception. There is an increasing awareness of the family's role in promoting health and more effort is being put into the support of families in troubled situations. Of course, it is still a drop in the ocean compared with what could be done but it is a start.
Public views are changing on sexual promiscuity and the 'anything goes' attitudes of the sixties and early seventies are now gone. AIDS and genital herpes have made both the homosexual and the heterosexual communities less promiscuous and, given the current falling family size throughout most western countries, the problem for the future in the West looks like being under-population not the reverse. Public criticism of violence on TV and sex and violence on
videos for home consumption has had some effect on programming, and even the rise in violent street crimes associated with drug abuse, prostitution and pornography has slowed, if not reversed, in the US.
These valuable and positive changes have come about mainly for the following reasons. First, there has been a growing disenchantment with the ultra-permissive society which so obviously produced so much disease, and second there has been a slow but steady realization that even a rich country like the US can no longer afford to pick up the pieces of such self-destructive activities. Expenditure on personal and community health care now represents so large a proportion of the total national expenditure that even the ordinary person in the street is getting the message loud and clear. The total ill-health cost of smoking and alcohol abuse alone in the US runs at over 100 billion dollars a year. Such mind-blowing figures impress even the most sceptical. A new development in the US is a refusal by some managements to increase their company's risk of having to pay out under workmen's compensation or employer liability laws by declining to employ individuals who have unhealthy lifestyles.
Even among the general public concern is growing along these lines. Non-smoking life-insurance policyholders, for example, are starting to ask why they should pay increased life-insurance premiums to cover the other policy-holders who choose to smoke. Forward-thinking insurance companies are now offering reduced premiums to non-smoking and non-drinking individuals to take into account their reduced health risks and car-crash potentials.
With a growing realization that we have finite resources; with the slowly dawning truth that fossil fuels will run out in our grandchildren's lifetime; and with a greater reluctance to generate wealth simply to squander it on insatiable 'health-care' systems, people all over the westernized world are beginning to question the old notions of absolute freedom and are starting to think more about social responsibility. Just as a heart-attack patient reaches his or her 'teachable moment' in the coronary care unit (the realization dawns that he or she has just missed knocking on the pearly gates), so too society is starting to realize that its 'teachable moment' is close.
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