THE MALNUTRITIONS OF POVERTY AND WEALTH

By D. H. C. GIVEN

THE complete Health story of modern Civilization has never been written. Nutritional and digestive disorders belong to its later chapters, but if one is to see them in their true perspective it is necessary to review what has gone before. The key to its interpretation is a knowledge of man's physiological requirements for the attainment and maintenance of good health.

I acquired this knowledge as the result of eight Years' study and practice of Health Promotion in a primitive labouring community of mixed Asiatic races on H.M. Naval Base, Singapore. With the aid of this key One can read our health story as clearly from history as from our records of mortality. It will be found that the one corroborates the other. Our health today is exactly what civilization has made it.

Man's health requirements are defined in the following torMula GOOD HEALTH RECIPE. _ (a): BASIS—a sound Health Heritage from healthy stock. For

this we have to depend on our parents and forbears. .

(b) Souza) Bony-BumerNa—three .essential ingredients : (1.) Food—which must be right as regards quantity—meaning that a balance must be struck between energy intake (food) and-energy output '(work) ; and as regards quality —Nature supplies this important attribute.

(ii.) Work or exereisat—Exercise is essential for the mainten- ance of physical harmony, perfect functioning of organs, co-ordination of function, and the fitness of the athlete. (A wrong balance between these two ingredients carries heavy penalties. Food and exercise are complementary to one another and must be studied as partners.) Fresh air and sunshine—indispensable for the proper nutrition and growth of the body..

(A defect in one or other ingredient not only affects the present generation, but also undermines the Health heritage of generations to come. This means deprecia- tion of stock, which expresses itself in subnormality— low vitality and poor physique—and a predisposition to disease and premature death.) • '-

(c) HEALTHY ENVIRONMENT. (An', insanitary ' environment is responsible for a host of deadly infective diseases, but it does not necessarily de-value the Health Heritage if the body- building ingredients are up to standard.) Man's health requirements, therefore, are moistly the free gifts of God. Nature provides practically all the ingredi- ents.

England discarded the formula nearly two centuries ago, and the world followed her lead. The, penalties are cumulative ; today they are colossal. We can trace clearly from our history how a formula productive of ill- health was evolved in four phases—the first three telling a long story of " wrong-doing that created :massive stock impoverishment ; whilst, during- the fourth phase, " wrong-living " became general. . . The story began in 1760 with the Agricultural Revolu- tion and the wholesale. enclosure of conunoris-, thereby destroying the peasant village and creating poverty on the land. From this we have „never recovered. . The best stock left the land and is still leaving it. The residue is paying the penalty of " stock impoverishment. 7..

The story is contirinea even more ruthlessly in the Industrial Revolution of 1785-1840-7-the blackest era in our health history. The resultant- destruction of life and health soon created public alarm that led to a great awak- ening. A new era dawned with the' abolition of child labour, and the introduction Of measures aimed at over- coming the diseases of dirt and polluted water supplies. We compensated • and we compromised, but we only • alleviated. We did not abolish the causes - of stock impoverishment.

Lastly, we reached a state of affairs directly referable . to wrong living, whereby the-balance between food taken and work done is upset. This phase began about 1880— an era of prosperity for the confectioner and pastrycook. Thenceforth diseases, formerly the monopoly of the " idle rich," were brought more and more within reach of the masses. This popularizing is. unprecedented in the annals of past civilizations ; and diseases acquired new destruc- tive properties.

Dental disease is as old as civilization ; so probably are appendicitis and many other " surgical " diseases but the new feature is the ever-increasing prevalence of nutritional and digestive disorders among all classes of the population. A new element in their production is food-refinement, a practice that is being increasingly copied from us by primitive races, with disastrous consequences.

The worker today 'has a machine to work for him, a 'bus to take him to and from work, and he lives on cheap luxury fare. This means overwork of one set of organs (the digestive and excretive), and underwork of another set (the circulatory and muscular), with consequences harmful to both. It implies also deficient s.eration of the blood, and a shortage of oxygen to combust surplus waste-products with results comparable with those from thewus.$ of an overrich mixture in the petrol engine.

Refined foods, because of their greed for oxygen, accentuate the oxygen shortage. They are too combustible, and it is to this that they owe their stimulating properties. Moreover, the appetite they create is an artificial one. Hence the gradual accumulation of unburnt " clinker " in the blood, " carbonization," which is the fens et origo of septic infection, of surgical and dental diseases, of diabetes, cancer, and a host of so-called metabolic disorders.

Be it noted that this last phase has been superimposed on a long history of stock impoverishment Nature steps in to right a wrong. It would seem that, for the success of the universal scheme, poor stock must be eliminated. Hence influenza, respiratory and infectious . diseases, tuberculosis, rheumatic fever and rheumatic heart disease, comprehensively defined as " The Diseases of Poverty." Hence, also, the no less numerous or less sinister " Diseases of Riches."

Thus, life today has 'become a compromise between two extremes, poverty and riches. Together, their specific disorders account for 80 per cent. of all deaths-43 per cent. poverty, 37 per cent. riches.* Modern civilization is founded on the religion of money, which is reponsible for what Dean Inge has aptly defined as " Fatty degeneration of the Conscience."

Consider the most popularly terrifying of all diseases.

Cancer is the story of a cell gone mad. Breaking away from its normal habitat, it starts a wandering career, living and growing at the expense of other organs. Now a body cell does not lose its sanity without considerable provocation extending over a prolonged period-20, 40, even 60 years. Is it assuming too much to conclude that wrong living provides the provocative agent,. whilst abuse or disuse ,of an organ determines the location ? It is significant that 75 per cent. of the cancer attack on man falls upon the much-abused digestive organs (60 per cent. in woman).

* Refers to the Census Year 1921, when 1920, 1922 were included for the mean of three years. (Registrar General's Decennial Supplement, England and' Wales, 1921.) Within 10 years the excess has passed from the side of Poverty to Riches. Despite the handicap of 170 years of underfeeding, farming occupations still held the palm for health. One hundred and seventy years ago, 70 per cent. of our population lived and worked on the land. The occupation of agricultural labourer is one of the few that succeeds in overtaking its birth handicap. As compared with the more prosperous farmer, the labourer suffers a much higher mortality from the diseases of poverty during the early 'years of life. He reaches terms of equality at 35, and thenceforth begins to win back his losses. In the final reckoning, their respective mortality ranks, in open competition with 162 other occupations, as ninth and eleventh. No other occupations conform so closely to the requirements of the good health recipe.

- We can no longer close our eyes to the fact that modern civilization, unless we change its direction, will drive mankind to destruction.

We must begin with the restoration of physical and emotional harmony. This implies three things—more work, plain fare, and good will among men.