Spiritual_Wellness_Holistic_Health_and_the_Practic

232 Philosophical Foundations of Health Education
and perpetuating factors — genetic, environmental and individual — are all involved.
Instead of single factor, linear cause - and - effect etiology, the newer the concept of an
ecological casual web of disease seems closer to the truth — as crudely illustrated in
Figure 21.1 .
Epidemiologists (medical detectives) tackle the problem of the causation, and
prevention and control, of communicable and noncommunicable diseases in population
groups, within a broad ecological framework, relative to the agent - host -
environment complex. Tuberculosis is a classic example of the way ecological
variables may be involved in the causation, and prevention and control, of a communicable
disease, with the TB germ as the necessary , but not the suffi cient , cause
in the infection equation (Engel, 1962). And coronary heart disease (CHD) is a
dramatic example of the way ecological variables may be involved in noncommunicable
disease causation and prevention and control. Although the etiology of
CHD is not known, apparently genetic, environmental, and individual factors are
involved, as related to risk factors such as obesity, diet, blood cholesterol and triglyceride
levels, cigarette smoking, lack of physical exercise, high blood pressure,
emotional stress, personality type, and age and sex. The compound probability for
the coronary prone person is much higher if two or more of these risk factors are
present.
Human, disease is a universal phenomenon. At this juncture, the goal of eradication
of all human disease is a utopian dream. The very processes and goals of living
involve disease, and new times bring new killers and disablers. A comparison of the
major killers in 1900 vs. 1970 in the affluent developed countries (DCs) underscores
this key fact. For example, in the United States today [1971] about two out of three
people who die are killed by heart disease, cancer, or stroke — far different major killers
than in 1900.
Ecology of Longevity
Will science eventually conquer aging and death? Will man ’ s life expectancy at birth
be 100 years by the year 2000? Will scientists soon discover some X factor that will
increase man ’ s potential life span to anywhere from 150 to 1,000 years?
Man has not yet discovered the Fountain of Youth, although he is still searching
(McGrady, 1968). We know very little about the enigma of human aging and death
from so - called natural causes. We have a plethora of aging theories (e.g., biological
clock theory, wear and tear theory, cumulative poisoning theory, evolutionary theory).
But we have few hard facts to back them up. Man ’ s potential life span — the
maximum number of years man can live even under the most favorable circumstances
— apparently has not changed for at least the past 10,000 years. Human aging
and death take no holidays; they are universal phenomena. Death lurks ahead in the
shadows for each one of us. Self - awareness brought death awareness, as Dobzhansky
(1967) has pointed out. And death awareness profoundly affects our views about life
and health, as Tolstoy brings home to us so dramatically in his fascinating story “ The
Death of Ivan Ilyich. ”