Transcript comp1_unit7c_lecture_slides

Component 1: Introduction to Health
Care and Public Health in the U.S.
1.7: Public Health Part I
1.7c: Impact and Value of Public
Health
Public Health Progress
In the 20th century, Public Health radically improved
population health, with achievements including
• Significantly increased life expectancy
• Reduction in infant and child mortality
• Remarkable reduction in communicable diseases
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Public Health Progress
• It is nearly impossible to spend a single day in the US without
being affected by public health – consider these daily life
examples:
• food safety
• restaurant inspections
• fluoridated water
• seatbelt use
• unleaded gasoline
• influenza vaccine programs
• trans-fats and other nutritional information
• public health response to the most recent disaster
• Public health in the US has a long record of working in the
public interest; that record is almost entirely positive
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A Terrible Injustice
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A terrible episode mars the otherwise favorable record of public
health in the US
The Public Health Service was one of several sponsors of two
related and horrific studies (physician John Cutler was involved in
both studies) – 1932 – Public Health Service began the infamous Tuskegee Study which
recorded effects of syphilis on black men. Even after penicillin became
the recommended drug treatment in 1947, the men did not receive
adequate treatment. In 1972, an advisory panel found the study "ethically
unjustified” and it was immediately halted
– 1940’s – Experiment which deliberately sought to infect inmates at the
Guatemalan National Penitentiary with syphilis in order to study the
effects of early penicillin treatment
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Public Health has worked tirelessly to improve population health.
While the injustice of these studies must be both noted and
remembered, it is important to also remember the enormous benefits
that Public Health has conferred
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Public Health Achievements
in the 20th Century*
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Vaccination
Motor-vehicle safety
Safer workplaces
Control of infectious diseases
Decrease in coronary heart disease/stroke deaths
Safer and healthier foods
Healthier mothers and babies
Family planning
Fluoridation of drinking water
Recognition of tobacco as health hazard
*Morbidity & Mortality Weekly Report 1999; 48(12):241-3
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Highlights
• Since 1900, the average life expectancy for
Americans has increased about 30 years; 25 of
those years are attributed to public health initiatives
• 1950 - in anti-tuberculosis efforts, more than 2
million X-ray examinations were made by the Public
Health Service
• 1977 - Worldwide eradication of smallpox (as
recently as 1958, two million people a year die from
smallpox)
• 1990’s – only 4.4% of US children have elevated
blood lead levels (in the 1970’s, 88.2% had
elevated blood lead levels)
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Highlights
• A combination of medical progress and public
health efforts have nearly eliminated deaths from
previously-rampant childhood diseases such as
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Measles
Diphtheria
Scarlet fever
Whooping cough
• The battle against communicable diseases has
been so successful that in 2007, of the top 10
causes of mortality,
only two factors (#8 and #10) are not either
chronic disease- or injury-related
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Leading Causes of Mortality in
US, 2007 Data
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Heart disease: 616,067
Cancer: 562,875
Stroke (cerebrovascular diseases): 135,952
Chronic lower respiratory diseases: 127,924
Accidents (unintentional injuries): 123,706
Alzheimer's disease: 74,632
Diabetes: 71,382
Influenza and Pneumonia: 52,717
Nephritis, nephrotic syndrome, and nephrosis: 46,448
Septicemia: 34,828
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