Abstract

PIP: 3 factors are always involved in causation of infectious disease: the causal organism, an adverse environment, and nutritional status. As knowledge of degenerative and mental illnesses advances, their relationship to environmental problems becomes clearer. Health in the human being as in all living things is the product of ecological equilibrium. In countries with high mortality rates, the majority of deaths occur in the early years of life. Countries enjoying low mortality rates are those that have protected themselves against environmental deterioration. The Roman civilization, the 1st to have large cities, built aqueducts to protect the water supply from contamination. With the disappearance of the Roman Empire the concern for purity of the water supply also disappeared, and the cities of the Middle Ages became breeding grounds for epidemics. In the early 19th century John Snow demonstrated the role of water in the transmission of cholera and thereafter the concern with potable water and sewage disposal was reborn. The Industrial Revolution eventually allowed sufficient accumulation of wealth to permit improved nutrition. Environmental sanitation and improved food supply produced a new ecological equilibrium, and Western Europe began to have lower and lower mortality rates. Paralleling the decline in deaths a new spirit of responsible parenthood and delayed marriage was lowering birth rates. Population growth, which never exceeded 1%, had the additional escape valve of emigration to America and Australia. The true cause of environmental degradation is man. When human beings were few their contaminants were readily obsorbed by the environment, but as they proliferate the environment is increasingly unable to absorb their pollution by natural processes. Industrial fumes, deforestation, and polluted rivers are only the symptoms of contamination. In the developed countries, technological innovations minimizing industrial pollution and lower population growth are helping to combat environmental degradation, but in Latin America, population control has not yet taken hold and antipollution measures are not implemented because of their high cost. High fertility has always characterized Latin American since colonial days, but until the 20th century it was balanced by high mortality. Largely because of the progressive control of disease, the population increased from some 87 million in 1920 to 212 million by 1960, and may arrive at 650 million by 2000. In just 30 years Latin America was able to reduce mortality to under 10/1000, a process requiring 300 years in the developed world. In Latin America mortality reduction was achieved by medical means and not by environmental improvements. Despite the obious problems caused by rapid population growth, most governments in the region persist in supporting pronatalist policies and legislation.