supplement coenzyme Q10, which several studies
have shown can improve the ability of cells to resist
damage and to repair themselves. Cardiovascular
disease prevention is a comprehensive process that
encompasses numerous facets of lifestyle and phys-
iology. The more risk factors an individual can con-
trol, the greater the preventive benefit.
KEY MEASURES FOR PREVENTING
CARDIOVASCULAR DISEASE- Do not smoke.
- Get 30 to 45 minutes of exercise daily.
- Eat appropriate portion sizes.
- Eat more fruits, vegetables, and whole grains and fewer
processed and fried foods. - Get regular BLOOD PRESSUREand blood cholesterol level
checks.
See also AGING, CARDIOVASCULAR CHANGES THAT
OCCUR WITH; ANTIOXIDANT; DIET AND CARDIOVASCULAR
HEALTH; LIFESTYLE AND HEALTH; MEDICATIONS TO TREAT
CARDIOVASCULAR DISEASE; NUTRITIONAL NEEDS; PHYSICAL
EXERCISE AND CARDIOVASCULAR HEALTH; RISK FACTORS
FOR CARDIOVASCULAR DISEASE.
childhood diseases Until the advent of vaccines
in the middle of the 20th century, infectious child-
hood diseases such as DIPHTHERIA and PERTUSSIS
(whooping cough) were the leading cause of
death among children under age 18. Vaccinations
have virtually eliminated some communicable dis-
eases such as SMALLPOX (for which doctors no
longer routinely administer vaccinations) and
POLIOMYELITIS.
ROUTINE CHILDHOOD VACCINATIONSCHICKENPOX DIPHTHERIA
Haemophilus influenzae hepatitis A
type b (Hib) pneumonia hepatitis B
INFLUENZA(the flu) MEASLES
MUMPS PERTUSSIS(whooping
pneumococcal pneumonia cough)
POLIOMYELITIS RUBELLA(German measles)
tetanus
Because of vaccination programs, most Ameri-
cans born after 1970 have not experienced the
infectious childhood diseases that caused illness
for their parents as children. Some vaccinations
are combination products, such as MMR (MEASLES,
MUMPS, RUBELLA) and DTP (diphtheria, tetanus,
pertussis). Some vaccinations confer lifelong
IMMUNITY(protection from INFECTION) while others
require periodic booster vaccines.
There is some concern that the mercury in
thimerosal, used to preserve some vaccines,
exposes young children to levels of mercury that
far exceed established guidelines. In 1999 a num-
ber of US health agencies joined forces to urge
development of thimerosal-free vaccines, which
are now available for most vaccines recommended
for children age 6 years and younger. Efforts con-
tinue to reduce or eliminate thimerosal in all vac-
cines. Parents should ask for their children to
receive thimerosal-free vaccines. When this is not
possible, parents should ask for children to receive
single-agent rather than combination vaccinations
to reduce mercury exposure as much as possible.
For nearly all children the benefits of vaccination
far outweigh the potential risks associated with
mercury exposure.
Children who do acquire the infectious disease
rather than receive the vaccination also develop
immunity, though the course of the disease can
include serious complications and exposes count-
less other people to infection as well. Measles can
cause severe HEARING LOSS, mumps can result in
male sterility, and HEPATITIScan cause LIVERfailure.
Rubella and chickenpox (also called varicella) can
cause BIRTH DEFECTS in unborn children whose
mothers get the disease in PREGNANCY.
See also HEAVY METAL POISONING; PREVENTIVE
HEALTH CARE AND IMMUNIZATIONS.community sanitation Some of the most far-
reaching improvements in public health have
arisen not from laboratory experiments or techno-
logical discoveries but rather from the mundane
aspects of everyday life. Community health DRINK-
ING WATER STANDARDS, sewage treatment and dis-
posal, and garbage collection and disposal
influence health and LIFE EXPECTANCYas much as
any medical intervention.
Ancient Rome provides the earliest archaeolog-
ical evidence of the understanding of these corre-
lations. The city’s design featured elaborate
networks of aqueducts (water conduits), public
toilets and baths, and sewage drainage systems.community sanitation 17