People today live about 30 years longer than they did a century ago, and 25 years of our increased longevity are attributable to advances in public health. According to the U. S. government’s Centers for Disease Control and Prevention, the following constitute the top 10 public health achievements in our nation’s history:
- Vaccination: Diseases that once killed hundreds of thousands of people (e.g., measles, diphtheria, mumps, whooping cough, smallpox, rubella, influenza, polio) are now controlled through public health vaccination programs.
- Motor Vehicle Safety: In 1990, motor vehicle crashes caused 44,599 deaths, a death rate of 27 per 100,000 licensed drivers. In 2007, motor vehicle crashes caused 41,059 deaths, a death rate of 20 per 100,000 licensed drivers.
- Safer Workplaces: Work-related health problems, such as coal workers’ pneumoconiosis (black lung), and silicosis – common at the beginning of the last century – have come under better control. Severe injuries and deaths related to mining, manufacturing, construction and transportation also have decreased; since 1980, safer workplaces have reduced the rate of occupational fatalities by approximately 40 percent. Estimated cost of these fatalities equals $146.6 billion annually from medical care, lost wages and lost productivity.
- Control of Infectious Diseases: Clean water and improved sanitation have dramatically reduced the incidence of such infectious diseases as typhoid and cholera, major causes of illness and death early in the 20th century that are transmitted by contaminated water.
- Declines in Deaths from Coronary Heart Disease and Stroke: Risk factor modification, such as smoking cessation and blood pressure control, coupled with improved access to early detection and better treatment, have decreased death rates51 percent since 1972 for coronary heart disease.
- Safer Food Handling: Education of food handlers; inspections of restaurants, food manufacturers and farm collectives; food embargos; and rodent\vermin control have improved food safety.
- Healthier Mothers and Babies: Better hygiene and nutrition, availability of antibiotics, greater access to health care, and technological advances in maternal and neonatal medicine since 1900 have decreased infant mortality 90 percent and maternal mortality 99 percent.
- Family Planning: The hallmark of family planning in the United States has been the ability to achieve desired birth spacing and family size. Fertility has decreased as couples have chosen to have fewer children; concurrently, child mortality has declined, and the age at marriage has risen.
- Fluoridation of Drinking Water: By 1999, fluoridation had reached an estimated 144 million persons in the United States. Fluoridation has played an important role in reducing tooth decay (40 percent to 70 percent in children) and of tooth loss in adults (40 percent to 60 percent). NOTE: Jersey City was the first municipality in the country to add fluoride to its drinking water.
- Recognition of Tobacco Use as a Health Hazard: Recognition of tobacco use as a health hazard and subsequent public health anti-smoking campaigns have resulted in changes in social norms to prevent initiation of tobacco use, promote cessation of use, and reduce exposure to environmental tobacco smoke. During 2000-2004, cigarette smoking and exposure to tobacco smoke resulted in at least 443,000 premature deaths and $96.8 billion in productivity losses annually in the United States.