1981
Staying Healthy: Welfare Services Suggests How
January 1981


“Staying Healthy: Welfare Services Suggests How,” Ensign, Jan. 1981, 10

Staying Healthy:

Welfare Services Suggests How

Q. How often should we have medical and dental checkups?

A. Regular-medical examinations can prevent many diseases. Many times a doctor can tell if a problem is developing long before you feel pain or experience other symptoms. Lives have been saved and much suffering and expense prevented by treating problems early.

Physical examinations at the following frequencies are thought to be adequate for most healthy individuals:

Infants and Children

as recommended by your doctor

Under age 35

every 3 to 5 years

Ages 35 to 50

every 2 to 4 years

Over age 50

every 1 to 2 years

Pregnancy

at the earliest indication or suspicion of pregnancy

Specific health problems

as indicated by the physician

Dental checkup

every 6 to 12 months or as recommended by your dentist

Breast examination

every year

Pap smear

initial examination at about age 20, and annually for two years thereafter. If test results are negative, further pap smear testing can be reduced to once every three years to age 60, if the examinations are consistantly negative. For special circumstances, consult your physician.

(See “Guidelines for the Cancer Related Checkup,” A-A Cancer Journal for Clinicians, July/August 1980, pp. 219, 231.)

Even though a complete physical may not be needed at each of the above intervals, the examination will improve your medical relationship with your doctor and enable him to monitor your health status.

Q. What immunizations should my family have?

A. Immunization programs have done much to reduce communicable disease throughout the world. Poliomyelitis, for example, once a major killer and crippler in the U.S., is largely prevented today because of regular, scheduled immunizations. Smallpox, a disease dreaded the world over for many centuries, has recently been officially eradicated because of universal immunization.

The Church has encouraged members to obtain immunization against diseases that can be prevented by vaccine inoculations. This not only protects individuals, but such cooperation helps safeguard the health of the entire community.

Diseases against which children should be routinely immunized include diphtheria, pertussis (whooping cough), tetanus, polio, measles, rubella (German measles), and mumps. Inoculating children according to the following schedule will provide them with maximum protection against these diseases.

Recommended Immunization Schedule
(From Utah State Department of Health)

Age

Measles

Tetanus

Polio

Rubella

Mumps

2 months

*

*

4 months

*

*

6 months

*

15 months

*

*

*

*

18 months

*

*

4–6 years

*

*

Parents should keep a careful record of immunizations and check them periodically to ensure that all immunizations are complete.

Other common diseases for which there are vaccines include typhoid, cholera, yellow fever, plague, influenza, viral hepatitis, pneumonia, and tuberculosis. If you live in or travel to areas where these diseases are common you should study carefully local recommendations and follow competent advice regarding immunizations for your family.

Q. What about sanitation and cleanliness?

A. It is vital to note that many of the organisms which afflict the human family do not thrive in a clean environment. Eliminate trash and filth, and you eliminate rats. Eliminate accessible food in the house, and you eliminate mice. Wash dishes well in hot, soapy water, and you eliminate all manner of germs. Bedbugs cannot survive in sheets washed regularly. Head lice cannot survive in clean, frequently shampooed hair. Germs cannot survive in sinks and toilets that are properly scrubbed and disinfected. Ants will not stay in a kitchen where there are no food crumbs to carry away.

There are exceptions to this rule, of course, and we must not conclude that frequent illness in a house necessarily is a consequence of an unclean house. Still, it is true that a great many kinds of illnesses, primarily communicable diseases, can be effectively controlled through cleanliness and sanitation.

Q. How can I decide if my family health insurance is adequate for my family?

A. An important part of personal and family preparedness is the ability to purchase necessary health care. These costs routinely place considerable stress on family budgets. However, unexpected catastrophic health problems often ruin families financially who aren’t prepared.

Health insurance is an excellent way for most people to prepare for ongoing and unexpected health care expense. President N. Eldon Tanner has counseled us: “Nothing seems so certain as the unexpected in our lives. With rising medical costs, health insurance is the only way most families can meet serious accident, illness, or maternity costs, particularly those for premature births. … Every family should make provision for proper health … insurance.” (in Conference Report, Oct. 1979, p. 121; or Ensign, Nov. 1979, p. 82.)

Young, growing families are a high risk for unexpected medical needs. Because of the highly unpredictable nature of potential health needs, it is appropriate that health insurance receive high priority when planning family budgets. Families should select insurance wisely, matching coverage with needs and ability to pay. It is important to understand clearly the details (cost, coverage, exclusions, waiting periods, deductibles, reputation of the company, etc.) of a potential policy before purchasing it. Unwise insurance decisions may only increase financial burdens. Through extensive examination of health insurance alternatives and careful budgeting, however, most families can find ways to prepare adequately for ongoing or unexpected health care needs.

Q. How can we keep current with changing first-aid practices ?

A. First-aid practices are changing. New techniques include the Heimlich maneuver and cardiopulmonary resuscitation (CPR), among others. Numerous formerly-accepted techniques are now considered obsolete, such as applying ice on a snake bite, giving the “universal antidote” for poisoning, and applying over-the-counter burn ointments. As new information is made available, individuals may become relatively incompetent at a level of knowledge which at one time was quite adequate. The problem becomes more crucial as the amount of available information becomes greater.

There are several ways of keeping current: The medical sections of responsible news magazines and newspapers are good information sources. A good, current first-aid book can be most helpful. Enrolling in a first-aid course, available in most communities, is another possibility.

Q. I smoked for years before joining the Church. Is my health forever affected?

A. Many studies have been carried out on the beneficial effects to individuals who quit smoking. The most common problem from smoking is death from heart attack. Several studies indicate that when individuals stop smoking the risk of heart attack promptly returns to a level near that of non-smokers. This is even true for individuals who have smoked for many years.

For lung cancer the data are different. Unfortunately, once a person stops smoking, the risk of lung cancer diminishes only gradually. This is probably because the tendency toward lung cancer is likely increased by tars and other substances in tobacco smoke accumulated in the body over a long period of time. In this case, the length of time tobacco was used is an important predictor of cancer risk. However, there is a gradual decline, even in the risk of cancer, in direct proportion to the length of time since former smokers gave up the habit.

Q. What are the health consequences of drinking caffeine drinks other than coffee? What is the position of the Church regarding their use?

A. The full answer to this question lies in the area of medical opinion and reliance on personal discernment. Cola beverages do contain caffeine and thus may be avoided in accordance with the spirit of the Word of Wisdom. The most current Church literature relating to the question is found in a Priesthood Bulletin statement dated February 1972:

“With reference to cola drinks, the Church has never officially taken a position on this matter, but the leaders of the Church have advised, and we do now specifically advise, against the use of any drink containing harmful habit-forming drugs under circumstances that would result in acquiring the habit. Any beverage that contains ingredients harmful to the body should be avoided.”

There is no current Church policy that would preclude a bishop issuing a temple recommend to a person who consumes cola beverages. However, Cola beverages contain caffeine in amounts that are approximately one-half to one-fourth the amount in a cup of coffee, depending upon the size of the bottle. Caffeine is a central nervous system stimulant that certainly tends to become addictive in its use, with the attendant side effects of nervous-system stimulants. Frequent use of cola beverages can lead to an addictive pattern similar to that observed in coffee drinkers.

Q. My husband and I are both somewhat overweight, in spite of efforts to reduce. What can we do to make sure our children don’t become obese?

A. If a child is overweight, you can assume that probably at least one of his parents is overweight as well, and there is an excellent chance one or more of his brothers and sisters weigh too much. Most of this is a result of shared exercise and eating patterns.

Many families attach undue importance to food: they talk about food, cook special foods, and eat too much. Food is often used as a reward for good behavior—for not crying, or for going to the doctor, or for making one’s bed. Food is also used to express love. Some working mothers make a big effort to cook special dinners to make up for not being home during the day. A child is encouraged to eat poorly in an environment where lots of sweet desserts are available and snack foods are left around the house.

One of the easiest and surest ways for a child to become overweight is to teach bad habits by example—eating every place we go or while standing up and moving around, while watching TV or reading the newspaper, or at all times of day. Other bad habits include not engaging in any exercise program, watching sports activities exclusively instead of participating in them, and spending most of our free time watching TV and eating. Parents can also reinforce the overeating habits of fat children by placing special emphasis on their eating behavior.

It’s sad to note that 80 percent of overweight adolescents face obesity in adulthood. It is important, for that reason, to help children develop food habits that will protect them from becoming obese in the future.

Q. How can I lose weight safely?

A. Any diet works in the short run, but usually even more weight is regained afterwards if there is not permanent modification of the eating habits which led to the weight gain in the first place. Diets are temporary solutions, and most people return to their usual eating patterns.

Recognizing true hunger, limiting appetite, and adopting a good exercise program can protect one from weight gain, making reducing diets unnecessary. Any individual can adopt and practice these modified behaviors:

First, write down everything you eat and the approximate amounts. Include snacks and tasting while preparing and clearing a meal. One must identify bad habits before they can be changed.

Second, reduce the desire to eat by limiting your eating to only one room in your home and to restaurants or parties. You will be less likely to think of food when you are elsewhere.

Third, always sit down to eat, whether it’s a meal or just a taste. When eating, don’t watch TV or read. No other activity should be associated with eating.

Fourth, eat three regular meals a day; this reduces the temptation to snack. If you seldom eat between meals, you’ll quit thinking about food all day.

Fifth, eat slowly. You should eat only until you are satisfied, not necessarily until you’ve finished the meal. Eat only when you are actually hungry, not when food is simply tempting. Of course, those on special diets under a physician’s care should follow the diet as directed.

If you evaluate your food habits and implement these suggestions, you can lose weight and keep it off without constantly dieting to reduce.

Q. What are the pros and cons of breast feeding and bottle feeding?

A. Breast feeding really is better, but it is important to remember that some women have difficulty breast feeding and such women should not feel inferior as mothers.

Breast milk and feeding has many advantages:

1. Breast milk is an ideally balanced food for baby, and formulas are only an attempt to approximate breast milk.

2. Breast milk is clean. There are no sterilization or storage problems.

3. Breast milk has immunological properties.

4. Iron in breast milk is more easily absorbed and beneficial to the infant.

5. Upset stomach, intestinal difficulties, and allergies are less frequent in breast-fed babies.

6. Breast feeding helps the uterus of the mother to return to its normal state more rapidly.

7. Breast feeding is much more economical and usually more convenient.

8. Bonding takes place between mother and child during nursing.

9. Breast feeding has other emotional benefits as well.

Mothers who feed their infants often report, “I feel more like I’m giving my baby what it needs.” “It helps me feel fulfilled as a woman.” “It forces me to relax and take time with my baby. I love it and I need the rest.” “It makes me feel important because I know the baby needs me.” “It helps me appreciate more the sacrifices my mother made for me.” “I feel closer to my Father in Heaven and the role I play in creation.”

A pediatrician or other physician should be consulted regarding the appropriate formula for the baby who is not breast fed.

Q. There seems to be a movement toward giving birth at home, rather than in hospitals. What are the advantages and disadvantages?

A. There is little available medical data on the safety of home deliveries. One of the most recent studies suggests that the infant mortality rate is at least twice that of hospital-born babies who have access to resuscitators, oxygen incubators, and other life-support systems. (See Burnet, et. al, “Home Delivery and Neonatal Mortality in North Carolina, 1974–76,” unpublished.) Common sense would seem to indicate that there is also an increased risk to mothers who deliver at home: the leading cause of death among mothers at the present time are hemorrhage, toxemia, and infection. Sudden hemorrhage certainly cannot be treated at home, nor can life-threatening toxemia. Hospital care is the only way to save the life of a mother in such emergencies, and the time it takes to get her to a hospital might be critical in saving her life or preventing serious harm to her or her baby.

Many advocates of home delivery emphasize that the birth process is a natural one and simply a matter of faith. It is true that the Lord expects us to exercise faith when faced with any medical problem, but, as Elder Bruce R. McConkie points out, the Lord also expects us to use our God-given intelligence in preventing and treating medical problems. (See Mormon Doctrine, 2nd ed., pp. 573–4.) The medical problems President Spencer W. Kimball has faced and overcome in his life certainly attest that present scientific knowledge is a companion to faith in saving and protecting lives.

It is also true that the home delivery setting encourages the bonding experience between the infant and the parents, but most hospitals are now making great efforts to effect the same results.

Q. Why has the Church spoken out against quackery and unproven medical practices?

A. The Church believes that man is an agent unto himself and, as in all other aspects of his life, that he should have free choice in determining his health care. The Church becomes concerned, however, when Church members are unknowingly “targeted” as a clientele for unproven medical practices. Of particular concern is the use of ecclesiastical position to influence or solicit Church members to these activities or products. The Church is concerned about practitioners or promoters of health products who attempt to make it appear that the Church endorses their service or product. Occasionally, enthusiastic promoters speak as though for the Church, use familiar Church-related symbols (pictures of Church leaders, buildings, and so on), quote scriptures or Church leaders, or use ritualistic practices that resemble priesthood ordinances. All of these activities are deeply frowned upon by the Church. While the Church is hesitant to speak out on specific unproven practices or products, it does feel an obligation to help its members be well-informed regarding them so they can make objective, reasonable decisions. (See “‘Which Temple Ye Are’” Church News, 19 Feb. 1977, p. 16; and “Health Fads May Hurt,” Church News, 18 June 1977, p. 16.)

Q. Can the effects of fasting be dangerous to health?

A. Practiced in moderation, fasting contributes to good health. It is only when a fast is extended considerably that it may become injurious to one’s health. Lack of essential nutrients, especially water, causes physical problems which, if the fast is extended long enough, will lead to serious illness and eventual death.

There are basically two kinds of fasting—fasting done for religious reasons and fasting done to improve one’s health. The first can usually be accomplished by abstaining from food and water for two consecutive meals. However, some people experience crises in their lives that cause them to turn to prolonged fasting and prayer as they plead with the Lord. Some physicians suggest that such a fast can be safe as long as the individual drinks water and breaks the fast after two or three days.

Fasts of more than a few days’ duration should be undertaken only under the direction of a competent physician. Little children, pregnant women, convalescents, and persons with chronic illness (such as diabetes) should not undertake long fasts and in some cases should not fast at all.

The Lord’s counsel that we use wisdom in all things applies here. Moderate use of fasting can do much to help members draw near to Him who hears and answers prayers.

Q. Working at a desk all day, I get drowsy after lunch and also have to take a nap when I get home from work. Any suggestions?

A. Vitality for living is largely dependent on diet and exercise. Following a nutritionally sound diet will supply the energy needs of the body; and a regular exercise program individualized according to heart rate and age will increase the circulation capacities of the cardiovascular system, thus distributing this energy throughout the body. The publications previously, mentioned will help you plan the program that is right for you.

In addition, be careful about what you have for lunch. A lunch high in calories and low in nutrition will cause feelings of lethargy and drowsiness. One should eat a nutritious meal at midday, but unless you will be involved in heavy physical labor after lunch, make the meal a light one.

Q. I’ve heard that jogging or other strenuous exercise can cause damage to one’s health. Are jogging and exercising really safe?

A. Exercise has been proven to be beneficial to the physical and emotional health of the participant. Exercise can lengthen and increase the quality of life. People who exercise regularly feel better, sleep better, look better, have better muscle tone. Exercise also develops self-discipline and self-control and can aid in building self-confidence and self esteem. It improves mental attitude, allowing a person to think more clearly and to be more capable of dealing with life’s problems.

Competent medical research has shown the endurance is purely a matter of oxygen consumption, and vigorous exercise is the only way we can keep our oxygen-carrying system functioning at an efficient level. Activities such as jogging, walking, cycling, swimming, and other active sports are all effective endurance activities when performed frequently and for the right length of time. Inactivity affects the entire oxygen-delivering system of the body. When the lungs become inefficient the heart grows weaker, the blood vessels become smaller and less pliable, the muscles lose tone, and the body generally weakens leaving it vulnerable to illnesses and diseases.

However, those who exercise, whether by jogging or other endurance activities, need to follow safety precautions; otherwise they may damage their health. Vigorous exercise will not be harmful if one follows these rules:

1. Have a physical examination and receive clearance from a physician.

2. Begin slowly and progress cautiously to find the level that brings the best results. Muscle toning and strengthening is necessary to condition muscles to prevent undue stress and strain when engaging in vigorous activity.

3. Warm up. Begin each exercise session with flexibility exercises (stretching) to prepare the muscles for more demanding exercises.

4. Follow these criteria when doing vigorous exercise for cardiovascular (heart-lung) fitness: (a) Maintain the proper exercise heart rate (based on your age and resting heart rate) for a period of at least 15 minutes. (b) Repeat this activity at least every forty-eight hours.

5. Obtain a good pair of shoes with arch support, a cushioned sole, and a firm heel support. Good shoes are vital to continued activity.

Q. I’d be more motivated to exercise if it were something I could do with my family. Are there exercise programs that lend themselves to family activities? How can we include our toddlers?

A. We know that attitudes and habits learned at an early age largely determine the pattern a person will follow throughout his or her lifetime. This is an important factor for parents to consider as they establish family patterns relative to physical fitness. Taking children on walks or exercising with them when they are still “babes in arms” can set patterns for physical activity. (The February 1975 Ensign pages 64 to 67 carries an article that explains how one family engages in fitness activities.)

The following are some suggestions that have been effective in family fitness programs:

1. Make a commitment based on the fact that physical fitness is important to the family and that it will strengthen the family in many ways.

2. Establish an atmosphere of activity. On gift-giving occasions exchange gifts that will promote activity: Jump ropes, roller skates, ice skates, balls, bicycles, basketball hoops, nets for racquet games, climbing ropes, pull-up bars, and so on. Find an area at a park or a playground for exercise that allows each member to exercise at his or her particular speed necessary to attain fitness but still remain close to the other family members.

3. Schedule a time for fitness. Waking up to music each morning and bringing the family together for activities that stretch and strengthen muscles and condition the cardiovascular system can be a great way to start the day. The time of day is not important, but consistency in keeping to the schedule is.

4. Individualize the program for each family member based on their needs and abilities. Procedures for establishing programs based on individual needs are given in Essentials of Physical Health (stock no. PGWE1340; 35¢ each) and Young Women-Relief Society Physical Fitness, Recreation, and Sports Manual (Stock no. PSYW0092; 65¢ each), available from Church Distribution Centers. Individualizing the program is essential to the success of the family fitness program.

5. Set family and individual goals and chart your progress. Follow the family fitness program in Essentials of Physical Health or the Church physical fitness awards program or other good books and programs available to the family.

Q. What are the dangers of living on so-called “junk foods”?

A. We are what we eat. Our bodies literally are built of the 40-odd nutrients which can only be taken from what we eat and drink.

Persons who rely heavily on prepared snack foods, soft drinks, and other “junk foods”—foods high in calories but lacking in nutrients—may get an abundance of calories but few essential vitamins, minerals, and nutrients. Such persons are frequently overweight, yet are “starving” for calcium, thiamin, potassium, or other vital nutrients.

The results of such eating habits may take time to appear, for the human body is remarkably resilient. But eventually a person may experience obesity, lack of energy, tooth decay, high blood pressure, heart disease, diabetes, and more, depending on the individual.

Clearly, a healthier way to live comes from eating regular, well-balanced meals, including choices from a wide variety of foods. The “Law of the Harvest” applies to human nutrition. Those who eat wisely and well increase the likelihood of reaping good health and emotional well-being. Those who take nutritional shortcuts eventually reap poor health and shortened life expectancy.

Q. We hear of the dangers of food additives. What’s the real story?

A. In some parts of the world fortifying certain foods with missing key nutrients has significantly diminished the frequency of nutritional diseases. For example, the fortification of bread with iron, niacin, and thiamin has almost completely eliminated anemia, pelagra, and beriberi, which were common in the southern part of the United States only a few decades ago.

Since the human body requires some forty different nutrients, no single nutritional supplement will fortify an inadequate diet. Research has not been completed on many nutrients and so we do not know the specific amounts of all nutrients required for good health. For this reason, the best policy is to eat a balanced diet of nutritious foods (milk, meats, fruits, vegetables, breads, and cereals) rather than trying to bolster a poor diet with vitamin and mineral supplements.

There have been many questions asked about other food additives such as preservatives, food coloring, artificial flavorings, and sweeteners. Such additives are highly controlled; extensive research is conducted to verify their safety before they’re cleared for use. Most additives of this type are made from chemicals not unfamiliar to the body already. Occasionally, combinations of chemical or specific additives have been shown to be detrimental and have promptly been disallowed. In many areas of the world where climate, sanitary conditions, and inadequate storage or refrigeration facilities permit easy spoilage, the use of some additives has been a great blessing. Even though consumption of natural, unaltered foods may be preferable, there is little evidence available to suggest harm is being done or health being impaired through use of additives.

Q. What are nutritious but inexpensive sources of protein?

A. World-wide, protein is one of the most expensive types of food. In many countries the lack of protein in the diet is the single most important cause of malnutrition. In North America and parts of Europe, however, the traditional diet contains approximately twice as much protein as one requires for good health. This protein causes unnecessary additions to the food budget. In countries where protein-rich foods are needed, the legumes (including dried beans, peas, and lentils) offer the least expensive source of protein. Unfortunately, expensive protein-rich foods such as meat, milk, and eggs contain many important nutrients the legumes lack and therefore make a desirable addition to the diet.

Meat, except for very lean meat, is high in cholesterol, saturated fat, and calories. The American Medical Association and the American Dietetic Association list these items as top contributors to the cardiovascular diseases so prevalent today. Their findings are in keeping with the counsel in the Doctrine and Covenants to eat meat sparingly (see D&C 89:12–13).

Q. What is adequate sleep? How can one adjust to irregular sleep schedules?

A. There is no question about the importance of adequate sleep. Sufficient sleep allows for complete repair and restoration of body cells; insufficient sleep results in less efficiency in work, increased irritability and nervousness, and increased accidents. Those who tire easily or participate in vigorous physical activity require more sleep than the average.

The question as to what is adequate for any individual has received a good deal of thought and study. The eighty-eighth section of the Doctrine and Covenants [D&C 88] tells us that we should go to bed early so that we may arise refreshed. It also cautions us not to sleep more than needful.

A California Human Population Study reported that people who had 7 to 8 hours of sleep were healthier than those who slept 6 hours or less and those who slept 9 hours or more. Houston aerospace studies found that most people require 7 to 8 hours of sleep in a given 24-hour period of time. We know that newborn babies require up to 22 hours of sleep daily. Between the ages of one and four about 12 hours of sleep are necessary, and between ages four and twelve about 10 hours are required. Teenagers need from 8 to 10 hours, and on the average adults need 7 to 8 hours to maintain good health.

Apparently the time of day one sleeps is not important as long as it is consistent and adequate for one’s needs. Where possible, adherence to the “early to bed and early to rise” lifestyle suggested in the Doctrine and Covenants (D&C 88:124) would be wise and would satisfy daily sleep needs.

Q. I have read of studies that show Latter-day Saints to be healthier than other groups. Can you briefly summarize these findings?

A. For many years vital statistics of the United States have shown Utahns to have the lowest overall mortality rates. And of the three most common causes of death in the United States (heart attacks, cancer, and stroke), Utah has been the lowest or second lowest in the United States for heart attacks and cancer since 1950. Using the excellent record system of the Church and linking Church records with death certificates for the State of Utah, we have been able to demonstrate that the very low rates of heart disease and cancer enjoyed by Utahns are almost exclusively contributed by the LDS citizens of the state. (See Lyon, Klauber, Smart, “Cancer incidence in Mormons and non-Mormons in Utah 1966–1970,” New England Journal of Medicine, 294:129–33, 1976; Lyon, Wetzler, et. al., “Cardiovascular Mortality in Mormons and Non-Mormons in Utah,” American Journal of Epidemiology, 108:357–66, 1978.) This health benefit is also more likely to be found among the active than among the inactive members. (See James Enstrom, “Cancer among Active Mormons” Cancer, 42:1943–51, 1978.) A similar study in Hawaii has also demonstrated decreased cancer and heart disease deaths in Hawaiian Latter-day Saints.

The practical effect of this lessening of death rates from cancer and heart disease has been to give the Latter-day Saints in Utah a longer life expectancy. A Latter-day Saint man in Utah on the average lives seven years longer, and an LDS woman three years longer, compared to the white U.S. population. This increased life expectancy can be attributed in part to the abstinence from tobacco and alcohol; but lower cancer rates are also found in a number of body sites that have no connection with the consumption of tobacco and alcohol—the stomach, colon, uterine cervix, and the female breast, for example. There appears to be unknown but important factors in the LDS lifestyle that predispose Latter-day Saints to longer life. A number of investigations are presently underway to determine what these factors are.

The questions included in this article were answered by the following Latter-day Saint authorities in the field of physical health: Winifred W. Bates, R.D.; Homer S. Ellsworth, M.D.; Isaac C. Ferguson, Ph.D.; James R, Goodrich, M.H.Ed.; John M. Hill, Jr., Ph.D.; Phyllis C. Jacobson, Ph.D.; Joseph L. Lyon, M.D., M.P.H.; Susan Mendenhall, R.D.; Alton L. Thygerson, Ed.D.; and Roger R. Williams, M.D.

Photography by Eldon K. Linschoten

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