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Hidden Heroes of the Health Revolution: Sanitation and Personal Hygiene


Aiello, Allison E.; Larson, Elaine L.; & Sedlak, Richard (2008). Hidden Heroes of the Health Revolution: Sanitation and Personal Hygiene. American Journal of Infection Control, 36(10 Suppl.), S128-151.


Since the mid-1800s, there has been a significant improvement in the public health of people living in the U.S. and Europe. It's proposed that changes in personal and domestic hygiene practices played an essential, but understated role in achieving this improvement. A corollary of this hypothesis is that sanitation and personal and household hygiene practices are responsible for much of the good health we enjoy today; and any significant decline in hygiene standards will result in increased health problems. This hypothesis will be critically analyzed in this chapter. Before examining the evidence, it's worthwhile to understand the challenges and technologies that apply in such an examination, as well as the recognized criteria for judging the relevance and adequacy of the evidence. “Health” can be measured using indices for “good” health (e.g., lives saved, illness avoided) or, on the other hand, the antithesis of good health (e.g., death, disease). Here we'll “measure” community health by three commonly used guides: 1. General population mortality rates; 2. Infant and child mortality rates; 3. Life expectancy and death statistics.


Reference Type

Journal Article

Year Published


Journal Title

American Journal of Infection Control


Aiello, Allison E.
Larson, Elaine L.
Sedlak, Richard