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10 noteworthy public-health achievements of the 21st century

Last month, the Centers for Disease Control and Prevention published a list of the most “noteworthy public health achievements” of the first decade of this century. The list was compiled from a survey of its own public-health scientists.

The CDC did something similar in 1999, when it published an article that highlighted the 10 biggest public-health achievements of the 20th century — ones that played a major role in extending U.S. life expectancy by 62 percent over that century, from 47.3 years in 1900 to 76.8 in 2000.

U.S. life expectancy has risen even more since then — to 78.2 in 2009, according to the CDC. That’s good news, of course, but not something to get smug about. As another recent report noted, the United States ranks 37th in the world for life expectancy, despite the fact that we spend more per capita on health care than any other nation.

Still, it’s important to remind ourselves from time to time about our public-health successes. Here’s the CDC’s list of our most notable public-health achievements of the past decade, with a brief excerpt from each item. (FYI: They’re not ranked in any order.)

  • Vaccine-Preventable Diseases: “The past decade has seen substantial declines in cases, hospitalizations, deaths, and health-care costs associated with vaccine-preventable diseases. …. The impact of two vaccines has been particularly striking. Following the introduction of pneumococcal conjugate vaccine, an estimated 211,000 serious pneumococcal infections and 13,000 deaths were prevented during 2000-2008. Routine rotavirus vaccination implemented in 2006 now prevents an estimated 40,000-60,000 rotavirus hospitalizations each year.”
  • Prevention and Control of Infectious Diseases. “Improvements in state and local public health infrastructure along with innovative and targeted prevention efforts yielded significant progress in controlling infectious diseases. Examples include a 30% reduction from 2001 to 2010 in reported U.S. tuberculosis cases and a 58% decline from 2001 to 2009 in central line-associated blood stream infections. … [I]n 2004, after more than 60 years of effort, canine rabies was eliminated in the United States.”
  • Tobacco Control.By 2009, 20.6% of adults and 19.5% of youths were current smokers, compared with 23.5% of adults and 34.8% of youths 10 years earlier.”
  • Maternal and Infant Health. “The past decade has seen significant reductions in the number of infants born with neural tube defects (NTDs) and expansion of screening of newborns for metabolic and other heritable disorders. Mandatory folic acid fortification of cereal grain products labeled as enriched in the United States beginning in 1998 contributed to a 36% reduction in NTDs from 1996 to 2006 and prevented an estimated 10,000 NTD-affected pregnancies in the past decade, resulting in a savings of $4.7 billion in direct costs.”
  • Motor Vehicle Safety. “From 2000 to 2009, while the number of vehicle miles traveled on the nation's roads increased by 8.5%, the death rate related to motor vehicle travel declined from 14.9 per 100,000 population to 11.0, and the injury rate declined from 1,130 to 722; among children, the number of pedestrian deaths declined by 49%, from 475 to 244, and the number of bicyclist deaths declined by 58%, from 178 to 74.”
  • Cardiovascular Disease Prevention. “During the past decade, the age-adjusted coronary heart disease and stroke death rates declined from 195 to 126 per 100,000 population and from 61.6 to 42.2 per 100,000 population, respectively, continuing a trend that started in the 1900s for stroke and in the 1960s for coronary heart disease.”
  • Occupational Safety. “Significant progress was made in improving working conditions and reducing the risk for workplace-associated injuries. For example, patient lifting has been a substantial cause of low back injuries among the 1.8 million U.S. health-care workers in nursing care and residential facilities. … Following widespread dissemination and adoption of [a best practices patient-handling program that includes the use of mechanical patient-lifting equipment] by the nursing home industry, Bureau of Labor Statistics data showed a 35% decline in low back injuries in residential and nursing care employees between 2003 and 2009.”
  • Cancer Prevention.“From 1998 to 2007, colorectal cancer death rates decreased from 25.6 per 100,000 population to 20.0 (2.8% per year) for men and from 18.0 per 100,000 to 14.2 (2.7% per year) for women. During this same period, smaller declines were noted for breast and cervical cancer death rates (2.2% per year and 2.4%, respectively).”
  • Childhood Lead Poisoning Prevention. “Findings of the National Health and Nutrition Examination Surveys from 1976-1980 to 2003-2008 reveal a steep decline, from 88.2% to 0.9%, in the percentage of children aged 1-5 years with blood lead levels [greater than or equal to] 10 µg/dL.”
  • Public Health Preparedness and Response. “During the 2009 H1N1 influenza pandemic, [improvements in] public health interventions prevented an estimated 5-10 million cases, 30,000 hospitalizations, and 1,500 deaths.”

You can read the entire report in the CDC’s June 24 Morbidity and Mortality Weekly Report.

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