•World Health Organization (WHO) estimates that “24% of the global burden of disease and 23% of all deaths can be attributed to environmental factors.”
•For children 0-14 years of age, environmental factors cause 36% of all deaths.
•In the developing world, 25% of deaths can be attributed to environment, while in the developed world – only 17% of deaths.
What are the Major Environmental Factors?
•Contaminated water – nearly 30% of environmental affects come from water polluted by feces. Diarrhea alone claims the lives of 2.5 million children, annually.
•Poor indoor air – 4 million people annually die from acute respiratory infections (ARI)
•Malaria – 1 to 3 million people die annually, 80% of them are children. Other less lethal diseases (dengue and yellow fever) affect millions.
Early Theories of Disease
•Humoral Theory – oAncient Greek medicine was based on their understanding of the cosmos: everything organized through the elements:
Earth
Air
Fire
Water oHippocrates’ teachings influence Western medicine for decades oImbalances, or “bad humor” caused by lifestyle (i.e. poor diet, poor spirits) o Bloodletting (draining out)
• Miasma Theory – oBased on Greek ideas that places of bad air caused disease oMiasmas are invisible poisonous vapors from decomposing matter found in (contaminated water, swamps, grave sites, etc) oPrevention: sanitation improvements, fragrances
John Snow and Modern Epidemiology
•John Snow: British physician, believes that cholera is spread through contaminated drinking water oChallenges miasma theory paradigm oAt first, theories are ignored
•Maps pattern of disease (epidemiology)
•Removes broad street pump handle (*foundation of public health)
New Ideas: Occupations
•Percival Pott: English Surgeon, studied the dire circumstances of London’s chimney sweep boys oPott links high rates of scrotal cancer (otherwise fairly rare in society) to the occupation of chimney