We, the privileged, must not judge matters of disease from our own fortunate perspective. Our vantage point is a highly controlled, almost totally artificial environment. A small part of it we see: massive hospitals, family doctors, specialists, and the technologies wielded by medical practice. We get another view from our history classes that alert us to the wonders of modern medicine: vaccines, antibiotics, heroic surgery, and routine screenings heavy on technology. Then there are the TV shows where physicians regularly save the day. We are led to believe that medicine saves the day, every day. Medicine may do much to restore health and function to the afflicted; medicine does comparatively little to sustain the health of our population.
But much of our health-making environment is invisible to us in everyday life. We live within a true abundance of protective safeguards: a maze of pipes, drains and cables run beneath our feet; thousands of health regulations, inspectors, agencies and programs watch over our food production, processing and service; building codes keep us safe from the insects and rodents that carry diseases; departments and whole industries keep are tasked to filter and disinfect our water, keep our sewage away from us and safely treated; and, teams of biological technicians scour the land keeping an eye on mosquitoes, ticks, flies and various parasites. Our garbage is removed from our living areas.
We breathe filtered and tempered air in our houses, cars, and workplaces. And, as we vacuum up allergens, we remain protected from the expelled air by HEPA filters. We swim in filtered, chlorinated pools. Signs go up at the beaches when the biological contents of the water make it unsafe for swimming. We have other surveillance and reporting systems and plans for reactions to health threats. As individuals, we are trained nearly from birth to wash our hands, teeth, bodies and clothes regularly, and to immediately clean and disinfect wounds. Astoundingly, as compared to so many places, we have the ready means to do so!
We began creating this health-promoting environment quite some time before medicine knew we should, and we did so even against the resistance of physicians. Disease treatment, not public health (prevention), has always been the medical business model.
Our populations are not much plagued by infections, but by chronic inflammation, autoimmunity, atopy, asthma, inflammatory bowel disease, thyroid disease, neurological dysfunction, and other names for immune dysfunction. As a result, few of us die from communicable diseases. Instead we die from iatrogenic damage, or chronic ailments like heart disease, cancer, chronic lower respiratory diseases, accidents, etc. Of course, the above biological costs of our artificial environment are underemphasized and attributed to the inevitable consequences of individual weaknesses (e.g. genetic) or of aging.
There are occasional holes in our bio-shield, and then an outbreak of Salmonellosis or Giardiasis will occur. These diseases are relatively rare, however, as compared to treatable Chlamydia or Gonorrhea.
Now, if we step outside our artificial environment in some climes, we might be infected with the controversial , most-reported, notifiable infection: Lyme disease. Lyme infection has a known incidence that is 18.26 times greater than Hepatitis A, 8.96 times that of Hepatitis B and 34 times Hepatitis C. Further, it is a disease to be taken seriously.
The recommended powerful antibiotics provide a questionable resolution to Lyme disease, while persistent, recurrent, refractory Lyme disease is too often denied by physicians while nonetheless constituting a growing quality of life concern for sufferers.  Lyme disease incidence and chronic Lyme disease prevalence are of great endemic concern. Lyme disease is a cost associated with recreational venturing outside the protections of the built environment. In that sense, Lyme disease is foreign, and 21st century medicine is unprepared to cure this uncivilized affliction.
We are not encouraged to give much heed to such incurable diseases as Lyme (which a formerly marketed vaccine failed to prevent and which vaccine was reputed to cause Lyme arthritis). It is bad for the medical reputation — and it would harm the tourist industry.
We belong to the nations within which modern development originated. Because we take for granted the safety of water, sanitary infrastructure, and basic nutritional needs, we cannot easily grasp their preventive powers. One result of our artificial environment is low morbidity and mortality from serious infectious disease, low prevalence of historical nutritional diseases, and low chronic parasitical burdens. In general, our bodies are under a much lower level of attack from wild diseases.
A second consequence of living in our artificial environment is that we may not be killed as easily by pathogens, or by their deadly vaccine cousins; our inherent resistance is greater. The CDC reported 145 deaths for the year 2009 from diseases on the childhood vaccine schedule, except influenza.  Another CDC report for flu counted 115 childhood influenza-associated deaths for the year between September 2010 and August 2011.  The two reports total 260 childhood deaths or .0006% of U.S. children 5 years or younger. Such a low number could be construed as quite a victory for our vaccination program. This author rejects granting any such powers to vaccines on the grounds of contrary evidence.  Instead, credit should first be given to the positive effects we receive from the protective cocoon of our artificial environment.