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Herbert Pollack, MD, PhD; Donald R. Sheldon, PhD

JAMA. 1970;212(4):598-603.

Abstract
The paramount world health problems appear to be those of nutrition and infectious disease and their interrelationships in a self-reinforcing cause-effect cycle. Three of the major disease entities, dysentery, malaria, and tuberculosis of the respiratory tract are evaluated in terms of caloric energy losses resulting from both increased metabolism in disease and lost productivity. In terms of annual caloric cost of disease, respiratory tuberculosis is clearly the most wasteful disease entity per case; while malaria, because of its high incidence levels, remains the more significant world health problem. Using 1965 disease incidence data even a conservatively based first approximation indicates that the value of present nutritional losses occasioned by a population's disease burden is not trivial. There is potential significance of such calculations to national development planners.

Author Affiliations
From the Department of Medicine, George Washington University Hospital, School of Medicine, Washington, DC (Dr. Pollack), and the Institute for Defense Analyses, Arlington, Va (Dr. Sheldon).

Footnotes
Reprint requests to 400 Army-Navy Dr, Arlington, Va 22202 (Dr. Sheldon).

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