The role of behaviour
McKeown also examined health and illness throughout the twentieth century. He argued
that contemporary illness is caused by ‘influences . . . which the individual determines by
his own behaviour (smoking, eating, exercise, and the like)’ (McKeown 1979: 118) and
claimed that ‘it is on modification of personal habits such as smoking and sedentary
living that health primarily depends’ (McKeown 1979: 124). To support this thesis,
McKeown examined the main causes of death in affluent societies and observed that
most dominant illnesses, such as lung cancer, coronary heart disease, cirrhosis of the
liver, are caused by behaviours.
Behaviour and mortality It has been suggested that 50 per cent of mortality from the ten leading causes of death is due to behaviour. This indicates that behaviour and lifestyle have a potentially major effect on longevity. For example, Doll and Peto (1981) reported estimates of the role of different factors as causes for all cancer deaths. They estimated that tobacco consumption accounts for 30 per cent of all cancer deaths, alcohol – 3 per cent, diet – 35 per cent, and reproductive and sexual behaviour – 7 per cent. Accordingly, approximately 75 per cent of all deaths due to cancer are related to behaviour. More specifically, lung cancer, which is the most common form of cancer, accounts for 36 per cent of all cancer deaths in men and 15 per cent in women in the UK. It has been calculated that 90 per cent of all lung cancer mortality is attributable to cigarette smoking, which is also linked to other illnesses such as cancers of the bladder, pancreas, mouth, larynx and oesophagus and coronary heart disease. The impact of smoking on mortality was shown by McKeown when he examined changes in life expectancies in males from 1838 to 1970. His data are shown in Figure 2.2, which indicate that the increase in life expectancy shown in nonsmokers is much reduced in smokers. The relationship between mortality and behaviour is also illustrated by bowel cancer, which accounts for 11 per cent of all cancer deaths in men and 14 per cent in women. Research suggests that bowel cancer is linked to behaviours such as a diet high in total fat, high in meat and low in fibre.
Behaviour and mortality It has been suggested that 50 per cent of mortality from the ten leading causes of death is due to behaviour. This indicates that behaviour and lifestyle have a potentially major effect on longevity. For example, Doll and Peto (1981) reported estimates of the role of different factors as causes for all cancer deaths. They estimated that tobacco consumption accounts for 30 per cent of all cancer deaths, alcohol – 3 per cent, diet – 35 per cent, and reproductive and sexual behaviour – 7 per cent. Accordingly, approximately 75 per cent of all deaths due to cancer are related to behaviour. More specifically, lung cancer, which is the most common form of cancer, accounts for 36 per cent of all cancer deaths in men and 15 per cent in women in the UK. It has been calculated that 90 per cent of all lung cancer mortality is attributable to cigarette smoking, which is also linked to other illnesses such as cancers of the bladder, pancreas, mouth, larynx and oesophagus and coronary heart disease. The impact of smoking on mortality was shown by McKeown when he examined changes in life expectancies in males from 1838 to 1970. His data are shown in Figure 2.2, which indicate that the increase in life expectancy shown in nonsmokers is much reduced in smokers. The relationship between mortality and behaviour is also illustrated by bowel cancer, which accounts for 11 per cent of all cancer deaths in men and 14 per cent in women. Research suggests that bowel cancer is linked to behaviours such as a diet high in total fat, high in meat and low in fibre.
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