I think poor water conditions probably play the biggest part in ill health, especially hole in the head. I think you'll find more people keep their fish in poor conditions than people who feed unsuitable food. I would say that the majority of people who start keeping fish for the first time don't understand the biological side of keeping fish. It all goes back to when you used to win goldfish at fairs, you would bring them home, plonk them in a bowl of water and then a couple of weeks later, the fish would be dead.
As for charcoal, if you look at it logically, charcoal is used to remove impurities from the water. Once it has become saturated, it will start leeching back into the water if it is not replaced. That can't be good for your tank. Personally, I don't use it, I just do a very large water change a couple of days after medicating the tank. Luckily, I haven't had to medicate my tank much at all. This is why I always think a hospital tank is a good idea.