During the year which has just passed, the centennial anniversary of the founding of our denomination was celebrated. A peculiar and priceless gift to the newly founded church came during its early days in the form of instruction as to the manner of living which would bring the greatest amount of energy to carry on life's work and lessen sickness and suffering. The principles which were to guide the church in a program of preventing and treating sickness were to be taught also to the world.
In looking back through the years of health education, both within the church and in the world in general, we observe marked changes and developments in the scope of the work. These changes have come about as the needs of the people have changed. Scientific discoveries, in the field of medicine and in other branches of science, have given new tools with which to carry on the work of health education. Changes in the social, economic, and political field have necessitated a shifting of emphasis. Increased facilities of travel have brought new problems.
A century ago sanitation as we know it today did not exist. Facilities for personal cleanliness such as may be found in every modern home had not come into existence. Methods of laundering clothing were laborious and inadequate; consequently, frequent changing of wearing apparel was not practiced. Poorly heated houses necessitated the wearing of heavy clothing which could not be readily cleaned. Coiffures of the time were elaborate. Regular shampooing of the hair was not considered necessary, or even desirable. All these factors contributed to uncleanliness and the spread of disease.
Community sanitation presented an equally unhealthful situation. The relationship between methods of sewage disposal and typhoid was not understood. Frequently streams from which drinking water was taken were also used as the means of carrying away refuse. Legislation covering such matters as garbage disposal, water and food inspection, and care of refuse did not exist. Sanitary conditions, particularly in urban areas, were generally deplorable. It was quite natural, therefore, that the early efforts in health education should largely revolve around the need for establishing sanitary methods.
Through education the advantages of personal hygiene have been generally accepted and incorporated into the daily living of a large percentage of our population. As the relationship between disease and hygiene became known, the public expected and readily accepted legislation designed to control means of spreading disease. A trip to a country where such an educational program does not exist, and where sanitary measures are not enforced by law, would readily convince an observer of the great progress made within the United States in the field of sanitation.
The second field of endeavor lay in the area of communicable disease prevention. Through the work of Pasteur, Jenner, Koch, Trudeau, and other early scientists, methods of immunization and control were perfected. It became the work of the health educator to acquaint the individual with the necessity of availing himself and his family of the protection which the medical profession was able to give. Thus was added communicable-disease control to the task of improving sanitary facilities.
A look at the records of this and other countries will prove beyond a doubt that health education pays. The infant death rate, which is considered the most sensitive index of the health status of a people, has sharply declined. For the United States as a whole, a decrease of over 35 per cent during the past forty years is observed. Maternal death rates have similarly declined. The incidence of such diseases as diphtheria, typhoid, and smallpox has greatly decreased. A hundred years ago the exceptional individual, was the one who had not had smallpox ; today smallpox occurs very infrequently. A report of the United States Public Health Service, under date of December, 1943, shows that the incidence of smallpox in States carrying on a good program of public health is as low as 8 cases per ioo,000 population.
Life expectancy has increased from 40 years to 62. More people are reaching the age of maturity, which partially accounts for the greater incidence of diseases of middle and later life, such as cancer and heart disease.
Dr. Haven Emerson, an outstanding authority on public health, noted that today 50 per cent of deaths occur among people under 6o years of age; whereas, approximately ma years ago 50 per cent of deaths occurred in the group under five years of age.
If doubt still exists as to the effectiveness of health teaching as a means of reducing the incidence of sickness and death, a statistical comparison between areas where a program of public-health education is followed and areas where little or no work of this nature is carried on, will reveal many interesting facts. Within our own United States we find that smallpox is 16 times greater in States where vaccination is not required of children before entering school, as compared to States in which vaccination is a prerequisite to school attendance. Infant death rates by States also vary according to quality and quantity of public-health activity, from 29 deaths per 1,000 live births, to 98 deaths per 1000 live births.
It has been estimated that in the United States the expenditure in maintaining an adequate health program should be at least two dollars a person. In China, on the other hand, only eight cents a person a year is spent for this purpose. The death rates of China are approximately three times those of the United States. The infant mortality rate of China (157 deaths per 1,000 live births) compares most unfavorably with the United States' rate of 39.9.
Conditions similar to those of China are found in some of the South American countries. The infant death rate ranges from 95.6 per 1,000 in Uruguay to 267 in Bolivia, and the tuberculosis death rate, from 46.6 in Colombia to 276 in Chile. The tuberculosis death rate for the United States is 40.
What is the next big challenge to the health educator? For those laboring where sanitation and communicable-disease control is well established, the next step is teaching that health means more than a temporary postponement of death. Decrease in gross mortality rates will not be spectacular in the years to come. But health means fullness of living, and in this respect progress can be great. Health means mental and emotional, as well as physical, well-being. Health in its fullest degree comes only when a well-balanced diet is provided. From a study of the physical examinations of military men it has been shown that only ,one person in ten is adequately nourished. To show the importance of congenial and satisfying living and working conditions, to teach the requisites of good nutrition, to point the way to mental health—these are the next steps to be taken.
The health educator who can approach these problems from a religious point of view has the only effective solution to offer. As man came from the hand of the Creator, the diet which would best nourish him was outlined. Through the Spirit of prophecy further instruction has also been given on this point. Nearly half of all hospital beds in the United States are occupied by nervous and mental patients. This condition can be changed only when the causes are removed.
Living in crowded areas, intemperance in matters of eating and working and recreation, lack of faith in God—these are the evils which need to be corrected. However carefully and scientifically the approach may be made, if the religious factor is disregarded, the problem can only be partially solved.
For many, whose field of labor lies in foreign areas today, the outstanding health problems will be those which were most acute in our national and individual plan fifty or a hundred years ago—sanitation and communicable-disease control.
Truly it is a privilege to bring relief from physical suffering to one's fellow men; to bring to them knowledge which will prevent suffering is an even greater privilege. This opportunity is not to be confined to a few, but rather it is God's purpose that every member of the church should assume the responsibility of first becoming familiar with the principles affecting the functioning of the human body, and health preservation, incorporating these principles into his daily life and then teaching these simple lessons to others. These opportunities open the door, and point the way to a better life here and eternal life to come.
