I'm curious how simple sanitary factors come into play. Something I've always found intriguing is that in Ancient Greece toilets would use shared butt brushes (sponge on a stick) in lieu of toilet paper. In an especially fancy place there might be a bucket of vinegar nearby to clean it off, but in general it was just a quick swirl through some water and onto the next bum.

The thing I find interesting there is that the Ancient Greeks had extremely limited medical knowledge alongside practices like this. And they also lived through less than pleasant times, yet they were often also quite long lived as a quick perusal of your Philosophacrates of choice can readily demonstrate. There's certainly a literal survivorship bias there, but the ubiquitousness of longevity is, if nothing else, interesting. Certainly many of these individuals would have still left their mark had they died at 40 or 50 instead.