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Early 20th Century

In the early part of the 20th century, sun exposure was lauded by the medical community in America for its health benefits, and hospitals had rooftop solariums and outdoor porches so patients could be in the sun.  This view of sun exposure was triggered by the discovery that sun exposure cured rickets, a devastating crippling disease that had affected millions of white children in America and Europe since the dawn of the industrial age.  This health benefit of the sun was traced to vitamin D, a biomolecule produced in the skin by photons from the sun.

Science Progresses

In the normal progression of science, a discovery like this should have led to a flurry of scientific inquiry into other potential health benefits of sun exposure.  However, the  almost simultaneous discovery that sun exposure could induce skin cancer, together with the high prevalence of skin cancer in the migrants from England, Ireland and Scotland to Australia whose white skin was well suited for the weak sun of England but not suited for the strong tropical sun of Australia, resulted instead in a flurry of scientific inquiry into the dangers of sun exposure, principally skin cancer, as Australia became the skin cancer capital of the world.  The first sunscreen became available in 1928, creating the first commercial interest in limiting sun exposure.   The Australian medical community message of sun avoidance gradually spread to the medical communities in Europe and America.  The prevailing health advice regarding sun exposure became avoid sun exposure when possible, seek shaded areas, wear sun-protective clothing and apply sunscreen daily even if it is a cloudy day.

 

Early 21st Century

It was not until the beginning of the 21st century that scientific interest and research turned toward the benefits of sun exposure beyond vitamin D, or, to put it another way, the risks of insufficient sun exposure. It was well known at the time that people in the United States and Europe were experiencing less and less sun exposure every year because of migration of the workforce from outdoor to indoor work and increasing attractions of being indoors such as radio, air conditioning and television, exacerbated by the continuing advice of dermatologists and governmental health authorities to avoid sun exposure when possible.   

The amount of sun exposure received by a person can be determined by measuring the level of the biomolecule 25(OH)D in the person’s blood since more than 90% of this biomolecule is produced by sun exposure.  By the year 2000, the average level of 25(OH)D in Americans’ blood was down to 24 ng/mL, compared with the 46 ng/mL found in the Maasai tribe in Africa still living traditional pastoral lives outdoors.  The average level for White Americans was 27 ng/mL and the average level for Black Americans was 17 ng/mL.   The “sufficient” level was determined to be 30 ng/mL, 20-30 ng/mL was insufficient, below 10-20 ng/mL was deficient and below 10 ng/mL was grossly deficient: 77% of all Americans and 97% of Black Americans were below 30 ng/mL, and 6% of all Americans and 29% of Black Americans were below 10 ng/mL.

 

The reason for the lower levels in Black Americans is the larger amount of melanin in their skins, which blocks more of the sun’s rays.  This suited Black Americans’ ancestors well in the strong tropical sun of Africa but is ill-suited for the weaker sun of the United States.  The amount of melanin in people’s skins evolved to protect against sun-induced skin cancer while not interfering with the health benefits of sun exposure.  So, as some humans migrated from the powerful sun of the tropics to the weaker sun of higher latitudes their skins evolved to have less melanin and eventually become white.  


It has been well known in the United States for more than 100 years that the health of Black Americans was far worse than the health of White Americans, but the reasons for this health inequity were not fully known.  Lack of access to good medical care, lack of access to healthy foods, and weathering (accumulated lifetime stress caused by discrimination, disrespect, poverty and systemic racism) have been known to be reasons for some time, but biological reasons were not known or even suspected until recently.  

 

Advances in science in the 21st century have revealed a wide range of diseases caused by inadequate sun exposure, and Americans with Black skins suffer from these diseases far more than Americans with white skins.  The sun’s rays produce or activate a variety of biomolecules in the human body, including vitamin D, lumisterol, nitric oxide, beta-endorphin, melatonin, serotonin, urocanic acid, glutamate, alpha-melanocyte stimulating hormones which have been implicated in immunologic tolerance and suppression of contact hypersensitivity, limitation of oxidative DNA damage from ultraviolet radiation and increases in gene repair, the potent calcitonin gene-related peptide which modulates a number of cytokines and is linked with impaired induction of immunity and the development of immunologic tolerance, neuropeptide substance P which produces local immune suppression, and very probably many others yet to be discovered, as well as causing various biological reactions such as photodegradation of folic acid, immunomodulation by upregulation of cytokines and increased activity of T regulatory cells that remove self-reactive T cells, , photoadaptation and the effect of sunlight on circadian clocks.


An adequate supply of these biomolecules is essential to the proper functioning of the complex chemistry of the human body.  A shortage of these biochemical manifests as a wide array of diseases including multiple sclerosis, colon cancer, hypertension (high blood pressure),  type 2 diabetes, stroke, rheumatoid arthritis, Alzheimer’s disease, asthma, obesity, preterm birth, stomach cancer, COVID-19 and shorter life expectancy.  Vitamin D supplementation is not an adequate substitute for sun exposure.

The following is a list of some of the major scientific discoveries of the adverse effects of insufficient sun exposure since the beginning of the 21st century.   As these discoveries were made, it became obvious that the incidence of many of these adverse effects occurred more often in Black Americans than in White Americans. Click here for a Special Message to Black Americans.  


In 2002, scientists discovered: 

  • Insufficient sun exposure decreases serotonergic activity in the brain and thereby increases the risk of seasonal affective disorder (SAD).

 

In 2003, scientists discovered: 

  • Insufficient sun exposure increases the risk of multiple sclerosis.  

In 2007, scientists discovered: 

  • Insufficient sun exposure increases the risk of colon cancer by 104%.

   
In 2009, scientists discovered:

  • Sun exposure causes nitric oxide in the skin to be mobilized and move into the bloodstream resulting in significant lowering of blood pressure independent of vitamin D.  The 1998 Nobel Prize in Medicine had been awarded to scientists who discovered the importance of nitric oxide in protecting the heart, stimulating the brain and killing bacteria, but where the nitric oxide came from remained a mystery until the 2009 discovery.

  • Insufficient sun exposure increases the risk of endometrial cancer. 

  • Insufficient sun exposure adversely affects athletic performance.

In 2010, scientists discovered:

  • Insufficient sun exposure increases the risk of tuberculosis by 400%.

 

In 2011, scientists discovered: 

  • Insufficient sun exposure of pregnant women increases the risk of severe lower respiratory tract viral infection in offspring in the first year of life by 500%. 

  • The prevalence of serum 25(OH)D of less than 20 ng/mL was much higher in patients with psoriasis than in persons without psoriasis, raising the possibility that insufficient sun exposure increases the risk of psoriasis, although the recalled sun exposure of the patients and the healthy controls was about the same. 

 

In 2012, scientists discovered:

  • Insufficient sun exposure increases the risk of bladder cancer by 83%.  

  • Insufficient sun exposure of pregnant women is associated with poor mental and psychomotor development in infants. 

  • Insufficient sun exposure of pregnant women doubles the risk that their child will experience language difficulties.  

In 2013, scientists discovered: 

  • Insufficient sun exposure increases the risk of type 2 diabetes by 35%.  

  • Insufficient sun exposure increases the risk of stroke by 82%. 

  • Insufficient sun exposure increases the risk of rheumatoid arthritis by 27%. 

  • Insufficient sun exposure increases the risk of depression by 31% to 121%.

  • Insufficient sun exposure of pregnant women increases the risk that their newborns will die from sudden infant death syndrome (SIDS).  

  • Insufficient sun exposure increases the risk of recurrent urinary tract infections in premenopausal women by 300%.

In 2014, scientists discovered:

  • 12.8% of all deaths in the United States (340,000 deaths per year) were attributable to insufficient sun exposure, establishing insufficient sun exposure as the nation’s #2 public health problem after smoking (480,000 deaths per year).

  • Insufficient sun exposure increases the risk of Alzheimer’s disease by 122%.   

  • Insufficient sun exposure increases the risk of death from breast cancer in breast cancer patients by 376%.   

  • Insufficient sun exposure increases the risk of asthma.  

  • Insufficient sun exposure of women in the first 26 weeks of pregnancy increases the risk of preeclampsia by 67%.  

  • Insufficient sun exposure increases the risk of obesity.  

  • Insufficient sun exposure increases the risk of myopia (short-sightedness).  

In 2015, scientists discovered: 

  • Insufficient sun exposure increases the risk of metabolic syndrome by 64%.   

  • Insufficient sun exposure of pregnant women increases the risk of type 1 diabetes in their male children at ages 5-9 years by 67%. 

  • Sun exposure, through a mechanism separate from vitamin D production, energizes T cells that play a central role in human immunity, confirming the 2011 hypothesis of a separate group of scientists that insufficient sun exposure is associated with poor immune function and increased disease susceptibility.   

  • Insufficient sun exposure increases the risk of atopic dermatitis (eczema).  

  • Insufficient sun exposure increases the risk of age-related macular degeneration (AMD) by 570% in women who have a genetic risk for AMD.  

In 2016, scientists discovered: 

  • Insufficient sun exposure increases the risk of pre-term birth by 132%.

  • Insufficient sun exposure increases the risk of stomach cancer. 

  • Insufficient sun exposure increases the risk of erectile dysfunction (ED) by 30%.

 In 2017, scientists discovered: 

  • Insufficient sun exposure of pregnant women increases the risk of having autistic children by 142%.  

 

In 2018, scientists discovered: 

  • Insufficient sun exposure of pregnant women increases the risk of schizophrenia in offspring by 44%.   

  • Insufficient sun exposure increases the risk of getting breast cancer by 400%. 

  • Insufficient sun exposure increases the risk of juvenile idiopathic arthritis.

  • Insufficient sun exposure of pregnant women increases the risk of childhood obesity.

 

In 2019, scientists discovered: 

  • Insufficient sun exposure increases the risk of acute respiratory tract infection (ARTI) from flu or colds by 83%. ARTI is the primary cause of death from COVID-19.

  • Insufficient sun exposure increases the risk of atrial fibrillation (AFIB) by 23%.  

  • Insufficient sun exposure decreases the diversity of bacteria in the gut, with implications for inflammatory bowel disease.  

In 2020, scientists discovered that:

  • Insufficient sun exposure increases the risk of getting and dying from COVID-19.

 

In 2021, scientists discovered: 

  • Sun exposure produces evitamin D related lumisterol hydroxymetabolites in the human body which inhibit the viral replication machinery of COVID-19, confirming prior studies showing that sun exposure protects against COVID-19. 

  • Insufficient sun exposure increases the risk of opioid overdose death by 90%.  

  • Insufficient sun exposure increases the risk of kidney cancer by 32%.

 

One would have thought that by no later than 2014, this explosion of scientific discoveries of the dangers of insufficient sun exposure would have caused the CDC to change its sun exposure message, but it did not.  It was because of this inaction by the CDC that the Sunshine Health Foundation was founded in 2016.  We met that year with the Chief Scientist of the CDC and the Director of the National Center for Chronic Disease Prevention and Health Promotion.  We told them about all the scientific discoveries up to that time, which already indicated that insufficient sun exposure had become the nation’s second largest public health problem after smoking.   We were astonished at their lack of knowledge, or lack of understanding, or both, of the new science.  They did absolutely nothing to bring it to the attention of the public.  The CDC website continued to advise the American public, including African-Americans, to avoid sun exposure. 


The body of science continues to grow, and we have continued our efforts to get the CDC to acknowledge it, but the CDC has continued to advise the American public to avoid sun exposure.  Click HERE for our communications with the CDC since 2016.


The mission of the Sunshine Health Foundation is to bring all of this 21st century science to the attention of the American public.  We believe the best way to do this, short of an advertising campaign we cannot currently afford, is to continue trying to persuade the CDC to do its job of protecting the health of Americans by stopping the CDC’s anti-sun programs and adopting programs to advise the public on how to get the sun exposure they need for good health and longer, happier lives. 
In May of 2019, the Sunshine Health Foundation hosted a meeting in Washington, D.C. of 21 of the 35 leading scientists of the world responsible for most of the 21st century science.  These scientists concluded that insufficient sun exposure had indeed become a real public health program, and 15 of them authored a paper to that effect which was published in a peer-reviewed scientific journal.  Click here for a summary of that paper. 


Driven by the dermatologists and the CDC, the message of the medical community remains to this day to avoid sun exposure when possible, to seek shaded areas, to wear sun-protective clothing and to apply sunscreen daily even on cloudy days.  This misguided and scientifically-incorrect advice has contributed to the preventable deaths of hundreds of thousands of Americans (1,700,000 deaths since 2015 alone) and millions of preventable cases of life-ruining diseases such as Alzheimer’s disease, diabetes, autism, schizophrenia, rheumatoid arthritis, reduced mental ability of children, depression and most recently long-haul COVID-19.


Click HERE for a detailed description of the 21st century science. 


All of the above is more severe for Black Americans than for White Americans.  Click HERE for Special Message to Black Americans. 

Sunshine Should Be Pursued In Moderation.

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America's second largest public health problem is insufficient sun exposure. It's responsible for 340,000 preventable deaths per year, just behind tobacco and ahead of obesity.

 

The public needs to be aware of insufficient sun exposure risks and increase daily sun exposure to improve health.

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Stop fearing the sun.

Embrace sunshine.

Let's build healthier communities.