Very simple life-saving practices that are non-intuitive
March 14, 2019 5:44 PM   Subscribe

What are examples of simple practices that are hugely beneficial yet either (A) were not discovered until relatively recently (like the last one or two centuries) (such as the Heimlich maneuver) or (B) are not practiced at high frequencies in some lower-income countries, contributing to ongoing mortality (such as hand washing with soap)? Thanks! :)
posted by mrmanvir to Health & Fitness (40 answers total) 22 users marked this as a favorite
Things like wearing seat belts in cars or helmets on motorbikes?
posted by gideonfrog at 5:55 PM on March 14, 2019 [6 favorites]

posted by exogenous at 5:58 PM on March 14, 2019 [4 favorites]

From Episode 287 of the 99% Invisible podcast:

In the past fifty years, the car crash death rate has dropped by nearly 80 percent in the United States. And one of the reasons for that drop has to do with the “accident report forms” that police officers fill out when they respond to a wreck. Officers use these forms to document the weather conditions, to draw a diagram of the accident, and to identify the collision’s “primary cause.”

For the more than 30,000 fatal car crashes that happen each year, information gathered on the side of the road goes from the accident report form into a federal database: the Fatality Analysis Reporting System.

posted by mandolin conspiracy at 6:03 PM on March 14, 2019 [15 favorites]

You sort of covered this but this fits both A and B:
The Idea of Surgeons Washing Their Hands is Only 150 [ish] years Old
posted by SaltySalticid at 6:04 PM on March 14, 2019 [8 favorites]

Oral rehydration therapy
posted by alex1965 at 6:04 PM on March 14, 2019 [14 favorites]

Putting a little bit of disease under your skin can prevent you from dying a horrible death from that very same disease. That's pretty counterintuitive.
posted by phunniemee at 6:05 PM on March 14, 2019 [30 favorites]

AR, Artificial Respiration, also known as Mouth-to-Mouth or the Kiss of Life. It was developed in the 1950s.
posted by Sunburnt at 6:08 PM on March 14, 2019 [2 favorites]

Not letting babies sleep on their tummies has reduced incidence of SIDS by around 90%.
posted by the duck by the oboe at 6:17 PM on March 14, 2019 [16 favorites]

Mouth-to-mouth was apparently so unintuitive that it was first developed in the 1700s and then...discarded?
posted by the agents of KAOS at 6:18 PM on March 14, 2019

Not letting babies sleep on their tummies

To emphasize how recent this is, when my kids were born in 1979 and 1981, we were told to absolutely not put them down on their backs because of SIDS.
posted by FencingGal at 6:21 PM on March 14, 2019 [27 favorites]

Vitamin deficiencies for sure. Scurvy, rickets, pellagra, vitamin A deficiency are all very inexpensive to treat, and in some cases, the cures have been discovered and discarded or forgotten repeatedly.
posted by tchemgrrl at 6:24 PM on March 14, 2019 [12 favorites]

Not sure if this is what you are looking for, but kids today are being taught that if they have to sneeze or cough, to do it in the crook of their elbows. I've seen posters: "Sneeze like a Vampire!" Even Sesame Street is teaching it. I'm sure it is cutting down a lot on the transmission of germs. To me, it is counter-intuitive because my mother always told me NOT to use my sleeves, but to use my hands (if I can't get to a tissue in time).
posted by NoraCharles at 6:24 PM on March 14, 2019 [12 favorites]

Obviously some of this is highly dependent on the public health situation where you live. Filtering water through pretty simple cloth filters can keep people from getting guinea worm parasites.
posted by jessamyn at 6:38 PM on March 14, 2019 [3 favorites]

posted by zippy at 6:47 PM on March 14, 2019 [5 favorites]


Smallpox has existed for at least 3,000 years and was one of the world’s most feared diseases until it was eradicated by a collaborative global vaccination programme led by the World Health Organization. The last known natural case was in Somalia in 1977. Since then, the only known cases were caused by a laboratory accident in 1978 in Birmingham, England, which killed one person and caused a limited outbreak. Smallpox was officially declared eradicated in 1979.

The polio vaccine was developed in 1955, and the oral polio vaccine (which was even easier to administer) was developed in 1961, but is no longer administered in the US:

Oral polio vaccine is safe and effective, and because it is administered orally, it can be given by volunteers. Its method of action ensures that person-to-person spread of the virus can be interrupted.
posted by mandolin conspiracy at 6:53 PM on March 14, 2019 [3 favorites]

Food fortification. Like water fluoridation, it's been a subtle but hugely beneficial public health measure, and has only been around for less than a century at most in the US -- this article cites the various major waves as "iodization of salt in the 1920s, fortification of milk with vitamin D in the 1930s, enrichment of flour and bread in the 1940s, and the widespread addition of calcium to a variety of products beginning in the 1980s," and credits them with "contribut[ing] significantly to the virtual eradication of goiter, rickets, beriberi, and pellagra."
posted by Rhaomi at 6:58 PM on March 14, 2019 [9 favorites]

Mouth to mouth is no longer routinely recommended. Compression only CPR has better outcomes, partly because bystanders are more willing to do hands only CPR, partly because giving rescue breaths properly is not easy even for trained rescuers.

But CPR itself, the idea that you can bring someone back from the dead by pounding on their chest, is only about 75 years old. Before that, if you died, you were just dead.

More recently, the idea that post-arrest cooling people down to 34C, improves outcomes, is much newer. It technically needs special equipment so it's not exactly simple, but I've seen ice packs used in a pinch.

Chew up two aspirin in suspected heart attack.

Physical activity as a treatment for nearly every disease. Diet, too. These two are far more efficacious than most pharmaceuticals.

Sanitation: separating drinking water from sewage. Known in the time of Harappa and Mohenjo-Daro, lost and rediscovered repeatedly since then.
posted by basalganglia at 6:59 PM on March 14, 2019 [14 favorites]

Outhouses and shoes for hookworm prevention, as promoted by the Rockefeller Sanitary Commission in the early 1900s.
posted by We had a deal, Kyle at 7:17 PM on March 14, 2019 [2 favorites]

The core idea behind many of these is the germ theory of disease, which, if we are honest, seems pretty bonkers from the historical perspective of how humans experience disease, and thus most western scholars had a sort of vague miasma basis of infection in mind until relatively recently.

Wikipedia describes that there were a few much older false starts that basically had the right ideas but no real evidence or acceptance, and it didn’t really take off until Pasteur’s work in the mid nineteenth century.
posted by SaltySalticid at 7:19 PM on March 14, 2019

I would flip flop the second half of your question but breastfeeding. Breastfeeding is protective for the baby in so many ways and leads to so many improved outcomes but prevelance is generally higher in many low and middle income countries (though it also varies widely).
posted by raccoon409 at 7:45 PM on March 14, 2019 [3 favorites]

Fecal transplants for c diff, maybe?
posted by charmedimsure at 7:50 PM on March 14, 2019 [5 favorites]

Safety measures on ships have come a long way since the days when sailors might not even know how to swim. Life jackets, those thermal suits used in cold waters, etc.
posted by axiom at 8:46 PM on March 14, 2019 [1 favorite]

condoms, mosquito nets
posted by theora55 at 9:16 PM on March 14, 2019 [1 favorite]

Boiling cast iron ingots in your cooking water can prevent anemia. Researchers developed a fish-shaped ingot for this purpose in 2008 and now distribute them in developing countries.

(Some of the suggestions above are not so simple!)
posted by showbiz_liz at 9:32 PM on March 14, 2019 [8 favorites]

Cleanliness in hospitals
posted by xammerboy at 10:17 PM on March 14, 2019

Condoms have been around for a long time. Just not latex ones.
posted by praemunire at 10:19 PM on March 14, 2019

Handwashing with soap or some other cleaner is typically intuitive in the day-to-day. For handwashing with soap to be a simple act, fresh, clean and probably running water needs to be available, which you can't get without stable well-funded infrastructure supported by trained personnel and political will. Not at all so simple in certain environments.
posted by glasseyes at 2:19 AM on March 15, 2019 [1 favorite]

Traffic calming. The typical American city tries to reduce accidents by separating foot and car traffic, which produces high-speed, dangerous car lanes. The Dutch mix foot and car traffic and making streets not look like highways. It basically works by confusing drivers: they're a little unsure, so they slow down.
posted by zompist at 2:30 AM on March 15, 2019 [11 favorites]

Designated drivers. Apparently, involving the Hollywood studios was a big part of getting people to do this. They were asked to mention designated drivers in episodes of programs to normalize the idea. If you watch TV shows from the late 80s, you’ll find characters casually bringing it up.

(Read this in a book that discussed how public health changes have been successfully implemented in a variety of countries - wish I could remember the name.)
posted by FencingGal at 3:58 AM on March 15, 2019 [8 favorites]

Oral Rehydration Therapy
Basically, give a salt/sugar mixture (you can make this at home!) to people with cholera/diarrhea and vastly increase their survival rates.

From Wikipedia:
Oral rehydration therapy was developed in the 1940s, but did not come into common use until the 1970s.[4] Oral rehydration solution is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system.[5] The wholesale cost in the developing world of a package to mix with a liter of water is 0.03 to US$0.20.[6] Globally as of 2015 oral rehydration therapy is used by 41% of children with diarrhea.[7] This use has played an important role in reducing the number of deaths in children under the age of five.[7]
posted by vacapinta at 6:43 AM on March 15, 2019 [3 favorites]

May I recommend the book Taking The Medicine by Druin Burch? It's astounding how recent the discovery that many common medical practices actually had negative effects is.

Along with things like smoking cessation, I don't know if we have data yet, but I wonder how many lives abandoning the low-fat/high-carb diet advice is going to save?
posted by straw at 8:56 AM on March 15, 2019 [2 favorites]

Not necessarily life-saving, but incredibly helpful and incredibly simple: the Epley maneuver for vertigo
posted by suedehead at 9:11 AM on March 15, 2019

Naloxone. Per wikipedia, patented in 1961 but not approved for use until 1971 and not distributed regularly to lay people until 1996. Now several states have standing orders where anyone can get a prescription from a pharmacy no questions asked, there are regular trainings for community members through public health departments and harm reduction organizations, and I have literally reversed overdoses on street corners. People who use drugs regularly tell me that they have reversed tens, sometimes hundreds of their peers with naloxone distributed through community groups.
posted by I am a Sock, I am an Island at 9:31 AM on March 15, 2019 [4 favorites]

The death rate from Cholera can be greatly reduced with the of ordinary salt.

The idea that accidents can be investigated in a systematic way and a cause found probably took hold between WW I & WW II.

The notion that inventions can be discovered/made in a research lab goes back to Thomas Edison.

The use of checklists, now central to safe aviation, was invented after a 1935 bomber crash on a test flight. The idea has spread to other areas including medicine.
posted by SemiSalt at 9:37 AM on March 15, 2019 [2 favorites]

From my personal life, the Valsalva maneuver can be used to manage A. SVT (tachycardia), B. panic attacks, and C. anxiety. It should be learned from a health care professional and you can make yourself faint, but it is extremely useful. You can also stimulate the vagal nerve with very cold water n the face - the Diving Reflex.
posted by theora55 at 11:20 AM on March 15, 2019

Traffic lights and signage at intersections.

Smoke detectors

Testing for STD's

Selecting partners by HIV status.

Vitamin K injections for newborns and people with bleeding illnesses.

Testing for phenylketonuria

Municipal housing inspectors

Mandatory fire extinguishers, sprinklers, defibrillators, personnel with first aid training, hazard lights etc.

The practice of having a mustering point during emergencies so that nobody has to go back and check if people are still inside.

Leaning pillows against the doors of rooms that have been evacuated during a fire in hospitals.

Changing the switchboard to block incoming calls but accept all outgoing calls during disasters so callers can get through to 999 and 911

999 and 911 central dispatch services

Remote links to translation services

Carrying cell phones

Check in locations for hikers so they know when someone goes missing.

Filming police interactions with the public on your cell phone

Hostage negotiation training.

Life jackets and boat drills

Requiring vessels to have sufficient life boats for all passengers and crew.

Unilingual air traffic control.

Rescue diving
posted by Jane the Brown at 6:00 PM on March 15, 2019 [3 favorites]

You already have breastfeeding, but a related one is exclusive breastfeeding in resource-poor environments. In many, many societies it is customary to (a) discard collostrum as unclean or unhealthy, (b) give the baby something else to taste, such as water, tea or honey immediately after birth, or (c) supplement breastfeeding with water, tea, soup, ricewater etc. All of these pose risks babies would just not be exposed to if mothers practiced (and were able to practice, of course) exclusive breastfeeding from birth until the WHO recommended six months.

Kangaroo care offered by either parent is a simple and often lifesaving practice for prematurely born babies that has only in recent years become widely practiced.
posted by tavegyl at 7:37 PM on March 15, 2019

Life jackets / personal flotation devices are an interesting one. Despite much promotion around their importance, in Britain there is still to this day a high rate of fatalities from fishing workers going overboard, usually not wearing a PFD. Apparently there's still a lot of prevailing misunderstanding of just how incapacitating cold water is, and how hard it is to recover on board someone who is incapacitated from immersion in cold water.
posted by quacks like a duck at 12:54 PM on March 16, 2019

For hypothermia - slow, passive warming with blankets. More rapid warming with water bottles, baths, heating pads or heat lamps can trigger cardiac arrest.
posted by bonobothegreat at 5:38 AM on March 17, 2019

Iodized salt reduces thyroid deficiencies. Vitamin D prevents rickets. A clean water supply prevents cholera.
Mosquitoes spread malaria. During the Crimean war, bed legs were put in pots of water to prevent insects crawling up them. Unfortunately this supplied excellent breeding grounds for mosquitoes.
Hospitals are still resisting implementing checklists for surgeons, similar to preflight checks. To prevent cutting off the wrong leg,. Etc. Some sugical teams have started putting their name and job on their caps to identify themselves to patients and to their co-workers when they are masked. It has saved a lot of confusion during operations.
posted by Enid Lareg at 8:48 AM on March 17, 2019

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