Cycles of social reforms have been observed in religion, politics, the economy and other areas of human endeavor. Reforms to clean up society in regard to issues related to health also appear to come in cycles. Reform campaigns during Clean Living Movements include temperance (anti-alcohol), social purity (sexuality), diet, physical exercise, eugenics (heredity), public health, and anti-tobacco and drug campaigns. Interest in these issues rise and fall more or less simultaneously and often follow a religious awakening in which both evangelical sentiments and the development of new sects emerge.
In the United States of America, and to somewhat of a lesser extent in the United Kingdom and other Western European cultures, these health reform movements tend to come in approximate 80-year cycles, ranging from about 70 to 90 years for individual issues. However, the campaign to eliminate polio would not be considered a clean living movements as it was a single issue crusade.
Reformers in these movements first attempt to convince individuals they should not drink, smoke or engage in behaviors or lifestyles harmful to health. When this does not work, public policies to prohibit the behaviors are instituted. After the main thrust of the movement, when reformers have failed to change behaviors even by legislation, a hereditarian, or eugenics movement reaches its prime. Reformers may reason that the root causes must be in the genes. During the cycle's ebb, popular changes or reforms that make sense, such as personal hygiene or sanitation, become institutionalized. On the other hand, a backlash often emerges against unpopular or restrictive reforms, such as prohibition of alcohol.
In the United States, widespread health agitation and subsequent reforms have, within a decade or so, coincided with the religious awakening's of the Jacksonian (1830-1860), the Progressive (1890-1920), and the Millennial (1970-2010?) reform eras.
During the Jacksonian era and out of the second great awakening a crusade against “Demon rum” and other spirits ensued in states east of the Mississippi River and north of the Mason Dixon line. This resulted in state wide prohibition of alcohol in this region beginning in the state of Maine in 1851. However, rampant smuggling across the Ohio River and down from Canada soon ended these state laws as they were unenforceable.
During this era a focus on exercise, non-use of tobacco, and the elimination of coffee, tea, sugar, meat and spice from a diet, called “Grahamism,” – named after reformer Sylvester Graham – was promoted. Eugenic or “hereditarian” concerns that masturbation would lead to insanity and that choosing sick or feeble spouses would lead to further degeneration was discussed. Out of this era Phrenology – the study of shapes and bumps on the head – used to select a healthy marriage partner was popular. New religions that promoted healthy lifestyles such as The Church of Jesus Christ of Latter-day Saints and Seventh-day Adventists emerged.
The Progressive era's health reform movement emerged in the third great awakening. Individual health crusades, as part of an overall Clean Living Movement, included the temperance and the anti-saloon movement which evolved into the prohibition movement. This resulted in the Eighteenth Amendment, or prohibition. An anti-tobacco movement was found during this era and a number of cities had anti-smoking laws in public buildings. Trains, restaurants, and streetcars often had smoking and non smoking sections. However, these laws by the mid twentieth-century were generally ignored. A “purity” or anti-prostitution and social hygiene (sexually transmitted diseases) movement went hand in hand with the elimination of other evils, such as alcohol from society. The purity movement also included the elimination of the double standard of sexuality for men and women. The eugenics movement to improve the human race was intertwined with these other movements. Pre-marital testing to ensure that neither partner had syphilis were passed in many states. In the United States, Eugenic sterilization laws were passed to prevent individuals with severe mental or physical health problems including alcoholism from reproducing were instituted in over 30 states
The Clean Living Movement around the turn of the twenty-first century was characterized by many crusades and counter crusades. Activities that surged in the earlier years of the era were often met with counter-movements about ten years later. For example, “women’s liberation” was countered by a “pro-family” movement; the use of marijuana and other drugs was followed by a “war on drugs”; lowering of the drinking age was followed by a raising of the drinking age; non-marital sexual activity was challenged by a new “purity” movement; and legal rights to obtaining abortions("pro-choice") were met with agitation against abortion ("pro-life").
The baby boom generation of the post World War II era had experimented with different behaviours not tolerated by the older generation. By the mid 1970s more conservative Americans began to react against what they perceived as immoral behaviors. They coalesced into political action that included campaigns against the use of drugs, alcohol, sexual, and other activities. A secular health-reform movement, that to some became a “religion,” also surged out of the youthful generation. Fitness and exercise, diet, alternative religions and medicine, consumers rights, smoke-free environments, and other health reforms became prime concerns of the day. By the early twenty-first century eugenics in the form of bioengineering and reproductive technology led to some parents to attempt to attain a "perfect" or designer baby.
In contrast to the earlier movements, “reformers” of the era were often well-financed large grass-roots, not-for-profit, and even governmental organizations founded, or led, by activists. Some reformers began to blame “the system” rather than encouraging individuals to take personal responsibility for their behaviors. This attitude led to crusades that included litigation against tobacco manufacturers, alcoholic-beverage distributors, and pharmaceutical and other corporations. Behaviors once thought to be “sins” or “bad habits” had now become “diseases.” As of 2006 interest in some of these reform campaigns has abated to some extent.