Getting Healthier Every Day: 5 of the Biggest Contributions to Public Health

Goodlifer: Getting Healthier Every Day

Most people in the US have their own opinions and perspectives of its healthcare system. While Obamacare is seen as an attempt to “socialize” medicine, it is still not a completely social system — that is, the healthcare isn’t free. While healthcare in the US today seems to be in disarray, a broader perspective illustrates how far the country has come over the past century. Here are some of the biggest contributions in widespread healthcare.

Access to Family Planning Services: Family planning services offered by low cost or free clinics have provided large scale health benefits, especially for mothers. Smaller family sizes, longer intervals between the birth of children, and increased opportunities for counseling before conception has led to fewer infant and maternal deaths, prevention of unwanted pregnancies and transmission of STDs. Technology advancements have also led to significant reductions in infant neural tube defects and expanded screening of newborns for metabolic and other heritable disorders.

A White House nurse prepares to administer the H1N1 vaccine to President Barack Obama at the White House on Sunday, Dec. 20, 2009. (Official White House photo by Pete Souza)

A White House nurse prepares to administer the H1N1 vaccine to President Barack Obama at the White House on Sunday, Dec. 20, 2009. (Official White House photo by Pete Souza)

Prevalence of Vaccines: From 1999 to 2009, the age-adjusted death rate in the US declined from 881.9 per 100,000 people to 741.0, a record low and a continuation of a century-long trend. One of the biggest contributors to a decline in hospitalizations, deaths and healthcare costs in just this past decade have been the development of new vaccines for various diseases. Vaccines against rotavirus, herpes zoster and tetanus among others can now be prevented with proper immunization. Recent economic research indicates that child vaccination with the current immunization schedule prevents approximately 42,000 deaths and 20 million cases of disease, leading to approximately $14 billion in direct healthcare cost savings.

However, while many would argue that vaccines are an invaluable advancement to public health, others argue that they are unnecessary in a modern society. Many also fear that their altruistic goals are jeopardized by their connections to a for-profit pharmaceutical industry and for this reason, the percentage of children vaccinated in the United States has started to fall, in many places it has fallen dramatically. And despite many people’s fear of falling below the point of herd immunity, the communities in which people have been refusing to vaccinate their children have remained relatively health and outbreak free. While the use of vaccines is debated, one certainty is more research will be necessary to draw any concrete conclusions.

Prevention of Cardiovascular Disease: Since 1921 and 1938, respectively, heart disease and stroke have been the first and third leading causes of death in the US. In the early 1900s, medical professionals began to commit substantial resources to uncovering the factors that led to stroke and in the 1960s, a similar push began to better understand the causes of coronary heart disease. Medical research has lead to improved treatments, medication and quality of care, as well as reductions in risk factors such as uncontrolled hypertension, elevated cholesterol and smoking.

Food and Water Standards: In the years since 1900, scientific research has led to identification of essential micronutrients and increases in nutritional content of food. Stricter standards for privately sold foods have today nearly eliminated major nutritional deficiency diseases such as rickets, goiter and pellagra in the US. Beginning in 1945, the fluoridation of drinking water allows for inexpensive prevention of tooth decay among the general population, regardless of socioeconomic status or access to care, leading to reductions of 40% to 70% in tooth decay among children and 40% to 60% in adults.

Decreases in tobacco use have prevented millions of deaths and saved billions of dollars in healthcare costs. (photo by Paul:74, Creative Commons)

Decreases in tobacco use have prevented millions of deaths and saved billions of dollars in healthcare costs. (photo by Paul:74, Creative Commons)

Recognition of Tobacco as a Hazard: Studies linking tobacco smoking to lung cancer and other health issues in a 1964 Surgeon General’s Report has lead to implementation of federal, state and local public health policies that have substantially reduced tobacco use. From 1965 to 2009, smoking rates among adults declined from 42.4% to 20.6%. Experts believe these decreases in use have contributed to millions of smoking-related deaths prevented since the 1960s and savings of billions in healthcare costs.

The past century has seen many dramatic leaps in large-scale public health, and rapidly advancing technology evidences many more breakthroughs may soon be on the horizon. Researchers at Dartmouth are currently working on methods of supplying treatments that disrupt the sequences that lead to malignancies forming in cells, a potentially major step forward in cancer prevention. At Philips Pharmaceuticals, scientists are developing pills that target cancers and viruses with exceptional precision, ameliorating or eliminating many side effects of treatment. Regardless of how distressing modern healthcare issues may seem, keeping in mind the exceptional advances in medicine our world has seen in the past several decades, there is plenty of reason for optimism regarding our ability to overcome society’s large scale health challenges.

While advances to public health outreach and the treatment of disease have been monumental in improving the general health of the public, rates of disease are on the rise and general health is in decline. This is because the most important thing people can to do stay healthy is to make smart choices about what they put into their body and be vigilant about not letting that body fall into disrepair. This is one area where society has been far too relaxed in making improvements to public health and something scientists cannot create a vaccine to prevent. If someone is going to stay healthy, it will ultimately be a regimen of daily choices that achieve this goal, not a one time breakthrough.

Top photo by Mercy Health, Creative Commons

About author
Charlotte Kellogg is a freelance writer and aspiring graduate student from the Seattle area who, now that her loans are paid off, is currently considering whether to go abroad or go to graduate school. She hopes to someday work for the PEW Research Trust. Check out more from her at
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