Disorders/diseases of nature and nurture: How can public health be best advanced?

Level of health/ill-health is regulated by individual susceptibility, by ha bits and by environmental factors. Since no disorder/disease is caused sole ly by components of nature or of nurture, the health/ill-health experienced must result from various combinations of these components. Observations ha ve shown that some individuals/communities/racial/ethnic groups are more pr one to disorders/diseases than others, and accordingly require selective ta rgeting. To facilitate this, in the US, the UK, and in other regions where there are racial groups, sub-divisions are made of the consituent populatio ns in vital statistics reports. Although alternative proposals, such as sub -divisions respecting socioeconomic status have been proposed, none have ye t demonstrated superiority over the current practice. While challenges in h ealth maintenance and in targeting ill-health are hindered by the still ext ensive lack of knowledge of total risk factors, there is little doubt that the over-riding influencing factors are environmental. (C) 2000 Elsevier Sc ience Inc.