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Preventive medecine: stress reduction as measure to prevent diseases and illnesses PREVENTIVE MEDECINE: STRESS REDUCTION AS MEASURE TO PREVENT DISEASES AND ILLNESSES
Occasionally the forced introduction of one preventive measure has unexpected beneficial effects elsewhere. The best example was the introduction of the 55 mph speed limit in the US in 1974. During the 1970s life expectancy went up by 2.7 years in the US and much of this was the result of the slower driving and reduction in car accidents. In 1973 the death rate was 4.17 deaths per 100 million miles travelled; by 1976 this figure had dropped to 3.3-an all-time low. So what started as a way of saving fuel because of the oil crisis ended up substantially reducing road deaths.
Unfortunately, not all illnesses and diseases are as clear-cut as are accidents. The vast majority of modern illnesses are still poorly understood. This makes preventing them difficult, if not impossible. It is probably this confusion within the medical profession over the causes of many conditions that has held back so many preventive efforts in the past. These debates among the professionals have confused the public who, in turn, have often wished a plague on all their houses and gone on living as normal until the facts are incontrovertibly established.
All of this has given prevention a bad name but the medical profession is not wholly to blame. The 'simple' diseases have all been conquered and we are now left with highly complex conditions which involve many factors-the majority of which are beyond the influence of medicine in its present sense. Almost any real advance in preventive medicine now involves major social rethinking on a scale every bit as adventurous as the major sanitation programmes of the last century. The difference is that no one wanted foul drinking water and open sewers but convincing people they don't want junk food, cigarettes and alcohol is a task of a very different order-because they do want them. The complexity of the modern world is now so great that any mass change in public behaviour would have repercussions on employment, social structure and many other areas as well as simply health.
As the prevention of many conditions is so difficult because of a lack of knowledge of how to achieve it, it has been very difficult to get the ball moving in much simpler areas such as screening for disease. In the current tight economic climate no one wants to waste money on preventive programmes that do not in fact prevent anything. Decision-makers and consumers would rather carry on with curative medicine they know works, even if it is obvious that this is a second best to preventing the illness in the first place. Money is cheerfully allocated to curative services but not to preventive ones. This attitude is commonplace throughout the western world and is especially obvious in the US and other countries where health insurance pays most medical costs. It has arisen mainly because modern medicine sees itself as being about curing people or at least dealing with their symptoms, but also partly, as we have seen, because the effectiveness of many preventive measures is difficult to prove. This situation will almost certainly change in the next decade or two as costs of this kind of 'health' care spiral out of most societies' abilities to pay for them. There is also growing interest among ordinary men and women in a more holistic approach to living generally and this too will hasten a serious interest in prevention. But until the medical profession accepts this approach, no real change will occur.
There are, fortunately, signs that this is happening. With the present interest in 'alternative' medical practices such as osteopathy, acupuncture, herbal medicine, homoeopathy and healing, increasing numbers of people are by-passing the orthodox profession to go straight to an alternative practitioner. Many, if not most, of these stress the importance of prevention so it cannot be long before this rubs off on orthodox doctors. The current fashion for all things 'natural' and the growth of interest in do-it-yourself health all favour a growth of preventive medicine and a reduced reliance on the medical profession as suppliers of health. The current medical system in the West is a sickness service not a health service, but things could change very fast. Medical unemployment is now a serious problem in almost every western country so doctors are having to make greater efforts and change their ways of thinking about prevention, or more people will go elsewhere.
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