Prior to 1950, life expectancy was limited by the existence of communicable diseases that generally affected children (many people did not survive childhood; therefore overall life expectancy was low). These diseases were transmitted principally by people, by water, and by food. Because of this, public health initiatives focused on just six areas were the primary causative factors in increasing life spans. These were:
- implementation of sanitation methods (toilets),
- providing clean water (removing contaminants, killing organisms with chemicals),
- improved hygiene (washing hands in particular),
- food safety efforts and access to a wide variety of foods,
- widespread availability of warm, dry homes, and
- the development of medicines to prevent (vaccines) and treat (antibiotics) disease.
Thanks mainly to these public health initiatives, people in America can expect to live well into their 70’s and 80’s today. One would think that the combination of public health initiatives aimed at prevention, and medical advancements aimed at treatment, would have ushered in a golden age of health in America. While it is true that there is no comparison between the health status of people in the late 1800’s and those of the early 2000’s, the picture is not as good as it could be. Health care expenses in America are nearly double that of other developed countries, and chronic disease has replaced communicable disease as the new epidemic in America.
While the health care industry has been attempting to address this issue with very expensive technology and services, what we just learned is that public health initiatives, rather than technology, had the biggest impact in the past. Perhaps we can learn from these experiences and apply those lessons to the modern world? Let’s chat about that next time!