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POPULATION
HEALTH
scurvy was a deficiency disease that could be prevented and cured the old-fashioned garbage dump in our civilization, greatly decreas-
by ingesting citrus fruit. In 1854 in London, Snow determined that ing the population of rats, flies and other vermin. Engineers working
an outbreak of cholera was linked to a specific public well. He also with biologists and bacteriologists devised modern methods of trans-
showed that another outbreak was related to a water company that porting and treating sewage to turn it into water clean enough to re-
was delivering River Thames water taken downstream from a sewage lease into streams and rivers. Others developed lead-free paint and
outlet. His paper on these incidents is considered the founding event gasoline and are working on cleaning up the effluent from the
of the study of epidemiology. As for Walter Reed, he gets a lot of smokestacks of industry and energy production. Mass production
credit for his work on yellow fever…but it turns out that the real of food is accomplished in factories using machinery and techniques
hero of the determination that mosquitos of the genus Aedes were designed to minimize contamination. The factories are inspected
the carriers of “Yellow Jack” should be Dr. Carlos Finlay, a Cuban and re-inspected for compliance with sanitary standards set by local,
physician. Reed built on Finlay’s work, gave him credit in his papers, state and federal agencies. Breaches of the applicable standards can
and experimentally eliminated other means of transmission. These result in the shutdown of a facility.
studies led to determining that malaria was also mosquito-borne…
and now we have Zika. So, the next time you think that we, as modern physicians, are re-
sponsible for our patients’ continuing good health, you’ll be right…
All of those individuals are important, of course, but they ulti- to a point. But, as Sir Isaac Newton said, you are “…standing on
mately fade in contrast to the group of professionals I mentioned in the shoulders of giants” who did more for population health than
the first paragraph. Collectively, they are nameless, but their activities any modern individual would be likely to accomplish.
in cleaning up our streets, homes, food, land, water and air have
contributed to the health and longevity of those of us privileged to Fred H. Olin, D.V.M., M.D. spent his time as a U.S.
live in the so-called “first world.” Nineteenth century politicians re- Army Veterinary Corps officer performing, along with other
sponded to complaints of butchers and slaughterhouses dumping duties, sanitary inspections of food processing plants with
viscera and bones into the streets by outlawing the practice and re- contracts to serve the Department of Defense. If you have
quiring the offal be hauled off. Sanitary landfills have largely replaced time to sit and listen, just ask him about his adventures doing his duty.
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