If I had been born just 50 years sooner, my life expectancy would have been 47 years.But life expectancy grew by almost 30 years in the 20th century.
In the last ten years, the age-adjusted death rate in the United States has decreased by another 16%. I can expect to live as many as 20 years longer than my parents did.
|source: CDC, 2011|
The Centers for Disease Control and Prevention (CDC) has some answers.CDC recently released its top ten public health achievements of the last ten years, and there are some surprising accomplishments on the list. Not a single one got a headline. In fact, the release of entire list was overshadowed by the media attention given to the humorous hook a CDC blogger used the same week to educate people about preparing for natural disasters.
The top ten achievements have come in such diverse areas as cancer prevention, maternal and child health, infectious disease control, injury prevention, and cardiovascular disease prevention.Together, they have lowered the death rate during a time when we are being warned that because of our short-sightedness our children may live shorter lives than we will.
Here are some of the things that have happened in the last ten years, and why:
- A 30% reduction in U.S. tuberculosis cases was the result of increased government spending on infrastructure improvements to local public health;
- A decline in smoking prevalence to just over 20% of the population was the result of the impositions of tobacco taxes and restrictions on smoking in public places;
- The government-mandated addition of folic acid to cereal grains led to a 36% reduction in infant neural tube defects, and a savings of $4.7 billion in direct medical costs;
- Safer cars, safer roads, and government-mandated seat belt use reduced the death rate from motor vehicle accidents by 26%, and the injury rate by 36%;
- The age-adjusted death rates from heart disease and stroke declined by over 35% and 31%, respectively, because of declines in the prevalence of risk factors, government regulations on quality of care and FDA approvals on new, safe medications;
- Death rates from colorectal cancer in both men and women declined by over 20% because of insurance mandates covering early detection and screening programs.
With villains like these, who needs friends?For the past hundred years and more, public health has been one of our government’s crowning achievements. It has accounted for much of the increase in life expectancy from 1900 to 2000. It may be the reason I’m writing – and you’re reading – these words today.
In the 20th century, the private sector did not find a cure for most cancers or cardiovascular disease. It did not eliminate viruses and bacteria from our lives. It did not eradicate environmental pollution, or prevent devastating climate change. It could not even cure the common cold, though such a cure would have been worth billions to the fortunate company that did.It did, however, develop effective drugs to manage chronic conditions, surgical techniques and treatment protocols to improve care quality, strategies for mitigating the effects of environmental contamination, and tools for unlocking the mysteries of the genetic code. It did these things in partnership with public health, using assistance from the government.
So why do so many state and federal policy leaders want to pull the rug out from under public health when we need it the most? A report of the National Association of County and City Health Officials (NACCHO) documents the loss of 29,000 local public health people between 2008 and 2010, and a recent news release by the Association of State and Territorial Health Officials (ASTHO) notes that federal and state funding cuts jeopardize many of the most successful public health initiatives.Attacking public health isn’t getting governments off the backs of the people, because reality is the other way around. Public health practitioners do the heavy lifting, carrying people on the backs of governments.
We need to celebrate our public health accomplishments – especially those of us who have lived beyond the 47 years of life we could have expected had we been born in 1900.We need to remember that each extra year is a gift to us, not just from our creator, but from the people who work for our governments.
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