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This "miasmist approach" to public health starts from a belief, not a basis of fact or empiricism. There are certainly circumstances in which malnutrition makes

This "miasmist approach" to public health starts from a belief, not a basis of fact or empiricism. There are certainly circumstances in which malnutrition makes someone more susceptible to infectious disease, but what evidence is there that this is a significant contributor to infectious disease in countries like the US? What evidence is there that an otherwise healthy immune system could be "boosted" with proper nutrition and elimination of environmental toxins to the point that it would have a meaningful impact on infectious disease? No one's against nutritional public health measures or elimination of environmental toxins to improve public health. The fact is lifestyle interventions are ALWAYS first-line recommendations by medical doctors for things like obesity, but Americans are stressed out, overworked, inactive, eating garbage food, and have clamored for easy solutions like taking a pill for a long time rather than making lifestyle changes. There's been no neglect of "living a healthy life", it's just that Americans don't want to do it because it requires lifting a finger. There are many positive public health impacts HHS and the Trump admin could have, but they are talking out of both sides of their mouth when they claim "MAHA" while cutting food access entitlements, rolling back environmental regulations for clean air and water, and of course "drill baby drill". RFK Jr. made a deal with the devil to be HHS secretary.

alejohausner 1y ago
I know I'm coming to the discussion late, but actually there is good evidence that improvements in nutrition, working conditions, and sanitation are a big factor in improving resistance to infectious diseases. Look at "The Questionable Contribution of Medical Measures to the Decline of Mortality in the United States in the Twentieth Century", by Mckinlay and McKinley (1977). I know it's an old paper, but it has some fascinating and, to me, very persuasive time series. Those plots show mortality from various infectious diseases over the 20th century. Example: death rates (per 1000) from scarlet fever dropped from 0.1 in 1900 to effectively 0 in 1940. There is NO VACCINE for scarlet fever. Example: death rates from measles (lately very much in the news) dropped from 0.12 in 1900 to 0 in 1960 (a vaccine for measles was introduced in 1960). A similar trend exists for many other infectious diseases: huge drops in mortality PRECEDE the introduction of vaccines or antibiotics for the disease. Surely we can't credit vaccines with such a drop in death rates. I don't see how anybody could come to such a conclusion.
- bettercaust 1y ago
  No one is contesting the role of nutrition, working conditions, and sanitation in infectious diseases generally. What I asked was: what evidence is there that this is a significant contributor to infectious disease in countries like the US? (I should clarify that I'm referring to present-day US, because we're discussing in context of MAHA which is present-day US) Yes, measles death rates had dropped precipitously (fortunately), however incidence (new cases) had only dropped a little. It wasn't until the vaccine was introduced that incidence dropped to nearly zero[1]. Yours is a common anti-vaxx talking point, and one that seems to neglect that death is not the only negative outcome from measles. It's understandable to take the talking point at face value when it appears to be scientifically-supported, though this is a good example of how a talking point uses a cherry-picked fact and reframes the issue for a presupposed conclusion (that vaccines are unsafe or ineffective), because the origin of that talking point had no interest in comprehensively informing people but converting them to believers. [1] https://ourworldindata.org/grapher/measles-cases-and-death-rate https://ourworldindata.org/grapher/measles-cases-and-death-r...
  - alejohausner 1y ago
    Yes, the measles vaccine is effective. It reduces cases of measles. But the paper in question says that deaths were reduced to almost zero before the vaccine was introduced. The graph that you linked to shows the same thing. For me the paper shows not just that good sanitation and nutrition help reduce deaths from many infections diseases, but that they are the primary agent in that reduction. I thought it was a very cool paper, although you don’t seem moved in the same way as me. When I was a child, my parents weren’t upset when I got measles (I was, because it meant missing a trip to the seashore). It meant that you were going to be miserable for a week, but would be immune afterwards. So I became one more case, but not one more death.
    - bettercaust 1y ago
      I mean, that good sanitation reduced infectious disease incidence and mortality was something I was already aware of so I've already been "moved" so to speak. As for nutrition, the paper cites one researcher who concludes nutrition was a major factor, and it probably was a factor, though the magnitude of its impact is not firmly established by that one researcher.
somenameforme 1y ago
There's endless studies looking at the relationship between exercise and just about everything. It can do everything from substantially reduce your risk of cancer [1] to dramatically reducing your risk of getting a cold [2] and resulting in equally dramatically less severe symptoms if you do catch one. And nobody really knows why this is, though there are plentiful hypotheses. And exercise is just one aspect of living healthy, though a very important one. You find similar strong associations between 'clean' eating and all other sorts of aspects of a living a healthy life. Not only does it have effects but rather dramatic ones. I'd think most people would probably see this in their daily lives as healthfulness has dramatic effects on both physical and psychological wellbeing. [1] - https://www.cancer.gov/about-cancer/causes-prevention/risk/obesity/physical-activity-fact-sheet https://www.cancer.gov/about-cancer/causes-prevention/risk/o... [2] - https://www.bbc.com/news/health-11664660 https://www.bbc.com/news/health-11664660
- somenameforme 1y ago
  Also, excuse the double reply, but there are simple solutions to also help push society in the right direction. For instance requiring employers over 'x' employees (let's say 1000) to provide free access to a specified minimal set of exercise equipment and grant employees at least 'x' hours per week of paid exercise time which must be spent within this area exercising at a reasonable intensity (in other words not taking an hour break to go play on your phone in the gym). Other things would be to offer a 100% tax credit for things like gym memberships. If this actually incentivized people, then it'd probably pay for itself through better health outcomes for society. It could also be paid for by adding a health tax, such as already exists on cigarettes, to e.g. highly processed foods, candy, and cola. Similarly, the FDA should have some sort of an accreditation that restaurants and other food services can apply for that confirms some standard of minimal healthfulness of their food. This accreditation would be extremely critical since, in general, just dumping salt and sugar into food makes it more addictive, which increases margins, so when you go for health - you do so at profit loss. Such an accreditation could help combat this by giving people something to look for.
  - bettercaust 1y ago
deleted 1y ago
[deleted]

alejohausner 1y ago

I know I'm coming to the discussion late, but actually there is good evidence that improvements in nutrition, working conditions, and sanitation are a big factor in improving resistance to infectious diseases. Look at "The Questionable Contribution of Medical Measures to the Decline of Mortality in the United States in the Twentieth Century", by Mckinlay and McKinley (1977). I know it's an old paper, but it has some fascinating and, to me, very persuasive time series. Those plots show mortality from various infectious diseases over the 20th century. Example: death rates (per 1000) from scarlet fever dropped from 0.1 in 1900 to effectively 0 in 1940. There is NO VACCINE for scarlet fever. Example: death rates from measles (lately very much in the news) dropped from 0.12 in 1900 to 0 in 1960 (a vaccine for measles was introduced in 1960). A similar trend exists for many other infectious diseases: huge drops in mortality PRECEDE the introduction of vaccines or antibiotics for the disease. Surely we can't credit vaccines with such a drop in death rates. I don't see how anybody could come to such a conclusion.

bettercaust 1y ago
No one is contesting the role of nutrition, working conditions, and sanitation in infectious diseases generally. What I asked was: what evidence is there that this is a significant contributor to infectious disease in countries like the US? (I should clarify that I'm referring to present-day US, because we're discussing in context of MAHA which is present-day US) Yes, measles death rates had dropped precipitously (fortunately), however incidence (new cases) had only dropped a little. It wasn't until the vaccine was introduced that incidence dropped to nearly zero[1]. Yours is a common anti-vaxx talking point, and one that seems to neglect that death is not the only negative outcome from measles. It's understandable to take the talking point at face value when it appears to be scientifically-supported, though this is a good example of how a talking point uses a cherry-picked fact and reframes the issue for a presupposed conclusion (that vaccines are unsafe or ineffective), because the origin of that talking point had no interest in comprehensively informing people but converting them to believers. [1] https://ourworldindata.org/grapher/measles-cases-and-death-rate https://ourworldindata.org/grapher/measles-cases-and-death-r...
- alejohausner 1y ago
  Yes, the measles vaccine is effective. It reduces cases of measles. But the paper in question says that deaths were reduced to almost zero before the vaccine was introduced. The graph that you linked to shows the same thing. For me the paper shows not just that good sanitation and nutrition help reduce deaths from many infections diseases, but that they are the primary agent in that reduction. I thought it was a very cool paper, although you don’t seem moved in the same way as me. When I was a child, my parents weren’t upset when I got measles (I was, because it meant missing a trip to the seashore). It meant that you were going to be miserable for a week, but would be immune afterwards. So I became one more case, but not one more death.
  - bettercaust 1y ago
    I mean, that good sanitation reduced infectious disease incidence and mortality was something I was already aware of so I've already been "moved" so to speak. As for nutrition, the paper cites one researcher who concludes nutrition was a major factor, and it probably was a factor, though the magnitude of its impact is not firmly established by that one researcher.

somenameforme 1y ago

There's endless studies looking at the relationship between exercise and just about everything. It can do everything from substantially reduce your risk of cancer [1] to dramatically reducing your risk of getting a cold [2] and resulting in equally dramatically less severe symptoms if you do catch one. And nobody really knows why this is, though there are plentiful hypotheses. And exercise is just one aspect of living healthy, though a very important one. You find similar strong associations between 'clean' eating and all other sorts of aspects of a living a healthy life. Not only does it have effects but rather dramatic ones. I'd think most people would probably see this in their daily lives as healthfulness has dramatic effects on both physical and psychological wellbeing. [1] - https://www.cancer.gov/about-cancer/causes-prevention/risk/obesity/physical-activity-fact-sheet https://www.cancer.gov/about-cancer/causes-prevention/risk/o... [2] - https://www.bbc.com/news/health-11664660 https://www.bbc.com/news/health-11664660

somenameforme 1y ago
Also, excuse the double reply, but there are simple solutions to also help push society in the right direction. For instance requiring employers over 'x' employees (let's say 1000) to provide free access to a specified minimal set of exercise equipment and grant employees at least 'x' hours per week of paid exercise time which must be spent within this area exercising at a reasonable intensity (in other words not taking an hour break to go play on your phone in the gym). Other things would be to offer a 100% tax credit for things like gym memberships. If this actually incentivized people, then it'd probably pay for itself through better health outcomes for society. It could also be paid for by adding a health tax, such as already exists on cigarettes, to e.g. highly processed foods, candy, and cola. Similarly, the FDA should have some sort of an accreditation that restaurants and other food services can apply for that confirms some standard of minimal healthfulness of their food. This accreditation would be extremely critical since, in general, just dumping salt and sugar into food makes it more addictive, which increases margins, so when you go for health - you do so at profit loss. Such an accreditation could help combat this by giving people something to look for.
- bettercaust 1y ago

deleted 1y ago

[deleted]