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The Health Status of Americans in the 21st Century: How we got here Life Expectancy in the history Roman Empire – 22 Middle Ages in Europe – 33 American Revolution – 36 1900 – 47 Currently – women 79 and men 72 39% of women living today and 21% of men can expect to celebrate their 85th birthday Projections for 2050 – women 85.6, men 79.7 Leading Causes of Death in the U.S. in 1900 Leading Causes of Death, U.S. 2010 Leading Causes of Death in North Carolina, 2011 Click here for YPPL Calculator Click here for YPLL (75) by State Three Eras of Public Health In America Age of Environment 1875 -1930 Age of Medicine 1931-1960 Age of Lifestyle 1961 - Today Ten Great Public Health Achievements of the 20th Century Age of the Environment (1875-1930) City Health Department Control of infectious disease Pasteurization of Milk Public Health Campaigns Development of Sanitary Sewers Safer and healthier food Safer workplaces Fluoridation of drinking water Ten Great Public Health Achievements of the 20th Century Age of Medicine (1931 – 1960) Antibiotics Sulfa Drugs Penicillin Anti-TB Drugs Open Heart Surgery/CABG Vaccines for Diphtheria, Whooping Cough and Polio Radiation and chemotherapy for cancer Flouridation of drinking water Ten Great Public Health Achievements of the 20th Century Age of Lifestyle (1961 – Present) The first Surgeon General’s Report on Smoking and Health Recognition of the importance of exercise and health Recognition of the preventive nutrition Re-emergence of behaviorally-related infectious disease Motor Vehicle Safety Oral Contraception/family planning Click here to read about the Ten Great Public Health Achievements --- United States, 2001— 2010 Causes of All Deaths in the U.S., 2010 Cardiovascular Disease 32% Other Causes 36% Diabetes 3% COPD 5% Cancer 23% The Burden of Chronic Disease More than 1.7 million Americans die of a chronic disease each year Chronic diseases account for 75% of the $1.8 trillion we spend on healthcare More than 125 million Americans live with chronic conditions, and millions of new cases are diagnosed each year Actual Causes of Death in the United States, 2000 Mokdad, AH, et al (2004). JAMA, 291, 1238-1246. Causes Tobacco Poor Diet/Physical Activity Alcohol Consumption Microbial Agents Toxic Agents (pollutants) Motor Vehicles Firearms Sexual Behavior Illicit Drug Use Number 400,000 300,000 100,000 90,000 60,000 43,000 29,000 20,000 17,000 Percentage 18.1% 16.6% 3.5% 3.1% 2.3% 1.8% 1.2% 0.8% 0.7% Lifestyle The sum of decisions made by individual that impact their health. These decisions may affect health negatively by creating self-imposed risk or positively by creating protective factors. 5/4/2017 Percentage of premature deaths preventable by intervention strategy 10% 16% 50 % 24% Lifestyle Genetics Environment Medicine