April 6-12 is National Public Health Week. In honor of Friday's theme of "Building on 20 Years of Success" and the week's overall theme of Healthiest Nation 2030, we present this list, adapted from Chapter 2 of Introduction to Public Health, Second Edition, by Raymond L. Goldsteen, DrPH, Karen Goldsteen, PhD, MPH, and Terry Dwelle, MD.
Public health has had many accomplishments since its successes in infectious disease control in the 19th and early 20th centuries. In 1999, the CDC developed a list of the 10 greatest public health achievements in the United States since 1900. The average life span has increased by more than 30 years in the United States, and the CDC attributes 25 years of this gain to public health measures. These 10 achievements selected by the CDC were “based on the opportunity for prevention and the impact on death, illness, and disability."
2.Motor vehicle safety. Improvements in motor vehicle safety have resulted from engineering efforts to make both vehicles and highways safer, and from successful efforts to change personal behavior (e.g., increased use of safety belts, child safety seats, and motorcycle helmets, and decreased drinking and driving). These efforts have contributed to large reductions in motor vehicle-related deaths.
Photo credit: Compliance and Safety, LLC; shared under a CC 3.0 license.
3.Safer workplaces. Work-related health problems such as coal workers’ pneumoconiosis (black lung) and silicosis—common at the beginning of the century—have come under better control. Severe injuries and deaths related to mining, manufacturing, construction, and transportation have also decreased; since 1980, safer workplaces have resulted in a reduction of approximately 40% in the rate of fatal occupational injuries.
Photo credit: James Heilman, MD; shared under a CC 3.0 license.
4.Control of infectious diseases. Control of infectious diseases has resulted from clean water and improved sanitation. Infections such as typhoid and cholera transmitted by contaminated water, a major cause of illness and death early in the 20th century, have been reduced dramatically by improved sanitation. In addition, the discovery of antimicrobial therapy has been critical to successful public health efforts to control infections such as tuberculosis and sexually transmitted diseases (STDs).
5.Decline in deaths from coronary heart disease and stroke. Decline in deaths from coronary heart disease and stroke have resulted from risk-factor modification such as smoking cessation and blood pressure control, coupled with improved access to early detection and better treatment. Since 1972, death rates for coronary heart disease have decreased 51%.
6.Safer and healthier foods. Since 1900, safer and healthier foods have resulted from decreases in microbial contamination and increases in nutritional content. Identifying essential micronutrients and establishing food-fortification programs have almost eliminated major nutritional deficiency diseases such as rickets, goiter, and pellagra in the United States.
7.Healthier mothers and babies. Healthier mothers and babies have resulted from better hygiene and nutrition, availability of antibiotics, greater access to health care, and technologic advances in maternal and neonatal medicine. Since 1900, infant mortality has decreased 90%, and maternal mortality has decreased 99%.
8.Family planning. Access to family planning and contraceptive services has altered social and economic roles of women. Family planning has provided health benefits such as smaller family size and longer intervals between the birth of children; increased opportunities for preconceptional counseling and screening; fewer infant, child, and maternal deaths; and the use of barrier contraceptives to prevent pregnancy and transmission of HIV and other STDs.
Photo credit: Jenny Downing; shared under a CC 2.0 license.
9.Fluoridation of drinking water. Fluoridation of drinking water began in 1945, and in 1999 reached an estimated 144 million persons in the United States. Fluoridation safely and inexpensively benefits both children and adults by effectively preventing tooth decay, regardless of socioeconomic status or access to care. Fluoridation has played an important role in the reductions in tooth decay (40%–70% in children) and of tooth loss in adults (40%–60%).
10.Recognition of tobacco use as a health hazard. Recognition of tobacco use as a health hazard and subsequent public health antismoking 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. Since the 1964 Surgeon General’s report on the health risks of smoking, the prevalence of smoking among adults has decreased, and millions of smoking-related deaths have been prevented.
For more information on the history and fundamentals of public health, read: