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The author is demonstrating, in his fact-packed book, that in any time and place, the patterns of disease and mortality are more or less related to environing social and economic circumstances. He has used the concepts of "rural" and "urban" in the United States to illustrate this thesis. The person who brought the concept of disease and mortality patterns to our attention is Rene Dubos, in his book, The Mirage of Health (1959). The author cites Dubos but is distressed by his pessimism regarding mankind's ability to exercise any basic control over his disease patterns. They are mainly tradeoffs, the choice of lesser evils, and there will always be a disease pattern. The author is not yet ready to accept this premise, eg, "We can take courage for the effort from the fact that... past successes in the control of infectious disease have made the modern world safe and liveable
Anderson OW. Urban Health In America. JAMA. 1976;236(7):879–880. doi:10.1001/jama.1976.03270080059040
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