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Welcome to 21st Century Health: Four Reasons Americans Can Be Grateful for Their Health

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The editors at Top Masters in Public Health decided to research the topic of:

Welcome to 21st Century Health: Four Reasons Americans Can Be Grateful for Their Health

Increased Life Expectancy

- In 1900, the average life expectancy in the US
- Men: 46.3; women: 48.3.
- By 1930, men: 58; women: 62
- In 2009, men: 75.7; women: 80.6.

Access to Antibiotics

- Before:
- 90% of children with bacterial meningitis died. Survivors had severe and lasting disabilities, including deafness to mental retardation.
- Strep throat could be fatal disease and cause lasting heart damage
- Ear infections sometimes spread from the ear to the brain
- Other serious infections, from tuberculosis to pneumonia to whooping cough, were caused by aggressive bacteria that reproduced with extraordinary speed and led to serious illness and sometimes death.
- Major Accomplishments:
- 1920s, British scientist Alexander Fleming accidentally discovered penicillin. For his discoveries, he won the Nobel Prize in Physiology and Medicine.
- 1941, researchers learned that low levels of penicillin cured serious infections
- By the late 1940s, antibiotics were accessible for the general public.
- With the success of penicillin, the race to produce other antibiotics began.
- Today
- doctors can choose from dozens of antibiotics now on the market.
- At least 150 million antibiotic prescriptions are written in the United States each year.

Vaccines continue to eradicate diseases worldwide

- Before (and Today):
- 20th-Century Annual Morbitiy is the annual average of the incidence of the disease in the three years before the vaccine was licensed.
- Data from the year 2000 is provisional.
- Today:
- In 1997, coverage among children aged 19-35 months ranged between 81% to 90% for recommended vaccines.
- in 1997, Coverage among children aged 5-6 years has exceeded 95% each school year since 1980 for DTP; polio; and measles, mumps, and rubella vaccines
- As of 2011, 14 states had achieved a vaccination coverage rate of 80% or more for recommended vaccination series among children aged 3 and younger
- 95% of parents say their kids have received all recommended vaccinations, in 2010
- However, the CDC reports that only about 73% of children receive all recommended vaccination in the US
- sources:
- Major Accomplishments:
- The first vaccine against smallpox was developed in 1796, followed by rabies, typhoid, cholera, and plague vaccines in th 19th century, but they were not widely used until the 20th century
- Since 1900, vaccines have been developed or licensed against 21 other diseases
- can provide list if desired
- Ten of these vaccines have been recommended for use only in selected populations at high risk because of area of residence, age, medical condition, or risk behaviors. The other 11 have been recommended for use in all U.S. children

Decreased Infant Mortality

- Before
- approximately 100/1000 infants died before age 1 year at the beginning of the 20th century
- If turn-of-the-century infant death rates had continued, then an estimated 500,000 live-born infants during 1997 would have died before age 1 year; instead, 28,045 infants died
- Major accomplishments
- In 1912, the Children's Bureau was formed
- advocated maternal and infant welfare services (prenatal, natal, and postpartum home visits by health care providers)
- By the 1920s, new focus on infant and mother and prenatal-care programs
- from 1930 through 1949, infant mortality rates declined 52%
- due to use of antimicrobial agents, fluid and electrolyte replacement therapy and safe blood transfusions;
- from 1970 to 1979, infant mortality declined 41%
- due to implementation of Medicaid and other federal programs in the late 60s
- 1990s, a greater than 50% decline in SIDS rates due to "back to sleep" education and implementation
- Today,
- Since 1900, infant mortality has decreased 90%,
- From 1915 through 1997, the infant mortality rate declined greater than 90% to 7.2 per 1000 live births

Better Maternal Health

- Before: 1900-1930 high numbers of preventable maternal deaths due to poor obstetric care At the beginning of the 20th century, for every 1000 live births, 6 to 9 women in the United States died of pregnancy-related complications,
- obstetric care was provided by under-trained medical personnel
- Most births occurred at home assisted by midwives or general practitioners
- Inappropriate and excessive surgical and obstetric interventions (e.g., induction of labor, use of forceps, episiotomy, and cesarean deliveries) increased during the 1920s.
- 40% of maternal deaths caused by infection
- half following delivery and half associated with illegally induced abortion
- History: During 1939-1948, maternal mortality decreased by 71%, here's why:
- institutional practice guidelines and guidelines defining physician qualifications needed for hospital delivery privileges were developed
- during 1938-1948, the proportion of infants born in hospitals increased from 55% to 90%
- Medical advances: the use of antibiotics, oxytocin to induce labor, safe blood transfusions and better management of hypertensive conditions during pregnanc
- The legalization of induced abortion beginning in the 1960s contributed to an 89% decline in deaths from septic illegal abortions during 1950-1973
- Today, maternal mortality has decreased 99% in 1900
- 1900 through 1997, the maternal mortality rate declined almost 99% to less than 0.1 reported death per 1000 live births