Public health and insurance: American addressesNewsholme, Arthur, Sir
History
Public health and insurance: American addresses
Newsholme, Arthur, Sir
Health insurance -- Great Britain; Public health; Public health -- Great Britain
There is a constant excess of sickness among the poor as compared
with the well-to-do. Measures for the relief of poverty, therefore,
may be regarded as within the scope of the physician’s prescription.
This may be accomplished for the moment by monetary or material help;
but unless the causes of poverty are sought out and counteracted, the
assistance given is merely palliative. For nothing is more certain
than that poverty tends to become a self-perpetuating condition.
Thus poverty leads to premature employment of children, with
detriment to their normal growth, followed by diminished efficiency
in adult life. This implies low wages throughout life, and so poverty
is passed on to a second generation.
Evidently timely assistance to induce the parent to delay employing
the boy, until he has been prepared for work, and to ensure his
being put to work which will not be a “blind-alley” occupation, might
have obviated the evil chain of events.
Poverty again when carried to the point of destitution may tempt
to larceny; this may be followed by loss of employment, and so the
temporary unrelieved poverty is liable to become permanent.
Intemperance has been almost wiped out as a cause of disease in
the United States; and we have in the fact that the whole country
has “gone dry” a remarkable example of a “short-cut” towards
social salvation from alcoholism which will be most instructive.
Apart from such universal prohibition of alcoholic beverages, the
physician has to think of an alcoholic patient under his care as
the possible victim of one or more or all of several coöperating
influences conducing to intemperance. The alcoholic habit may have
been gradually acquired as the result of protracted social indulgence
in moderation acting on a person of unstable mental constitution;
it may, especially in wage-earners, have been hastened by the evil
custom of treating. It not infrequently follows overwork, with
the associated feeling of need for stimulants; it accompanies bad
housing, with unsatisfactory sleeping accommodation; and it is aided
by poor and badly cooked food, due to shiftlessness, overwork, or
lack of domestic training of the man’s wife. If there is to be
successful control of alcoholism, action in all the directions
briefly indicated above, and in other directions which will suggest
themselves, is necessary; and although the physician cannot himself
do all this, his efforts should run parallel with social efforts in
these directions.
Even when the “short-cut” of compulsory abstinence has been taken,
the efforts indicated above are still needed; for alcoholism is
not the only resultant of bad social habits, of overwork, of
unsatisfactory feeding, of deficient sleep, and so on.
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