One hundred years ago, your life expectancy would have been in your 40s. Instead, your life expectancy is almost 80 years. What do we owe this almost doubling of life expectancy over a short 100 years? Here is a list of 10 of the greatest public health achievements that have reduced illness and extended our life expectancy. Some of them are exciting and other boring, but we should be grateful for all of them.
Childhood diseases used to be so common that most families had experienced at least one childhood death due to diseases. The great news is that many of those life threatening diseases have been controlled or even eliminated through immunizations (a.k.a. vaccines). This is a huge accomplishment, greatly reducing the suffering of people while increasing life expectancy. Nowadays, we look to vaccines to control seasonal illnesses (such as the flu), emerging illnesses (such as H1N1 "swine" flu) and even cancer (many of which are caused by viruses, like cervical cancer).
Over the past 100 (or so) years, the death rate for motor vehicle accidents has greatly declined. In 1925, 18 people died for every 100 million miles driven. In 1997, that numbers was 1.7. Much of the increased safety is due to safety features, like airbags and seat belts.
Just going to work used to be a dangerous thing. Mining and other industries had little regulations and paid little attention to worker safety. Now, worker safety is a big deal and companies must take precautions to assure the safety of the workforce. This is a huge improvement for public health. For example, in 1907 more than 500 steelworkers died in the state of Pennsylvania while at work. In 1997, 17 steelworkers died at work nationwide.
In 1909, most people would have died of an infectious disease like tuberculosis or influenza. Now, most people die of chronic illnesses like heart disease or from cancer. This shift in causes of death shows how effectively infectious diseases have been controlled. In some ways, high rates of cancer and heart disease (as opposed to infectious disease) is a sign of a developed public health system.
Meanwhile, we are getting pretty good at treating and preventing heart disease and stroke. Granted, these are still major killers in the U.S., but the average age of death from heart disease and stroke keeps going up. We are able to prevent, treat and delay these illnesses to a degree never before seen. One hundred years ago, hardly anyone survived a heart attack or stroke, and now survival and recovery rates are constantly improving.
Despite all the recent scares about salmonella poisoning and other food-borne infections, our food supply is amazingly safer that it was 100 years ago. In the past, people had to can their own food and take special care to preserve foods without the benefits of refrigeration. Something as simple as skipping a step in the canning process could produce bacteria (botulism) that is life threatening. Sure, we still have to be careful, but nothing like before.
Becoming a mom, a century ago, was dangerous business. If there were any complications during birth, maternal death was shockingly common due to the lack of medical aide available. Meanwhile, the babies born were at risk for a host of illnesses (now prevented through vaccines) and other dangers. The act of coming into the world now is much safer, both for the newborn and for the mother due to advances in surgical practices, pre-natal monitoring and other medical technologies.
An unexpected entry on the list from the CDC is "Family Planning." Contraceptives, like "the pill" give women the ability to space pregnancies and regulate their own fertility. This has resulted in a dramatic decrease in the number of births per mother. The benefits include fewer miscarriages, fewer pregnancy complications, fewer abortions and so on. Each reduction in the number of procedures dramatically improves the health of the mother as infection and other risks are minimized. From a strict health perspective, the option of family planning has made an improvement in the health of women.
Possibly the simplest of public health achievements is one you are exposed to every day - fluoride in the water. The simple introduction of fluoride in the public water system has greatly reduced the number of cavities in the entire populations, especially kids. Problems with teeth can quickly develop into dangerous infections like Strep throat or even an infection of heart tissue. Fluoride is a simple, cheap and effective way to reduce cavities.
10. Tobacco Control
Everyone, and I mean everyone, used to smoke. Smoking was common in all social classes and for men and women. Now, people still smoke (some 20% of adults smoke occasionally), but these numbers are nothing like they used to be. That change, which came about through a combination of policy, social awareness and lawsuits, has left the country more healthy.
Ten Greatest Public Health Achievements in the 20th Century, CDC.