Comment has already been made concerning the influence of acculturation to a ‘modern’ lifestyle upon certain aspects of health and disease, in particular the prevalence of metabolic abnormalities such as a poor glucose and/or lactose tolerance (Chapter 4), the blood lipid profile, and the prevalence of chronic bronchitis and tuberculosis (Chapter 6). This chapter examines secular trends in positive health and the prevalence of other diseases, including specific comments on acute infections, atherosclerosis, hypertension and stroke, diabetes mellitus, and carcinomas. The paradox is noted that although acculturation brings increased opportunities for health education and access to ‘high-tech’ medicine, it can also cause an alienation of indigenous populations, with a deterioration of their lifestyle and a reduction of positive health (Chapter 3). The wisdom of traditional healing practices becomes less readily accepted, and growing contacts with the outside world greatly increase the risk of epidemics caused by unfamiliar micro-organisms. Finally, disease may act as a selective agent, reducing the range of genetic variation among circumpolar populations and enhancing the fitness of survivors.

Evidence of positive health

The World Health Organization (1948) defined health not as the mere absence of disease, but as a state of ‘complete mental, physical and social well-being’. In essence, the wellness of an individual on any given day was perceived as lying at some point along a continuum that extended from organic illness to a full realization of that person's mental, physical and social potential (‘good health’, Herzlich, 1973).