13 novembre, 2006 16:28

Public-health advances get credit for increase in average life span

Did you know that during the 20th century, the health and life expectancy of persons residing in the United States improved dramatically? Since 1900, the average life span of persons lengthened by more than 30 years; 25 years of this gain is attributable to advances in public health.

This life span increase occurred through much hard work in public health and is exemplified by the following list of great public health achievements in the United States. These were chosen by Centers for Disease Control based on the opportunity for prevention and impact on death, illness and disability in the United States. Eight of the 10 achievements are listed; the other two, tobacco and control of infectious diseases, will be discussed at a later date.

Motor-vehicle safety - Injuries are the leading cause of death for young people. Significant improvements include engineering efforts to make vehicles and highways safer, successful efforts to change personal behavior (increased use of safety belts, child safety seats and motorcycle helmets), and legislation (such as Colorado’s graduated driving laws for new teen drivers). Pueblo is now working on teen drinking and driving through the Coalition on Underage Drinking.

Safer workplaces - Since 1980, safer workplaces have resulted in a 40 percent reduction in the rate of fatal occupational injuries (mining, manufacturing, construction and transportation). There is still progress that needs to be made, considering the recent deaths of coal miners in the U.S. and the tragic death of a highway worker in Pueblo.

Decline in deaths from coronary heart disease and stroke - This decrease has resulted from risk-factor modification, such as smoking cessation and blood pressure and high lipid control. Most recently, restrictions against exposure to secondhand smoke have been shown to decrease heart attacks (including Pueblo’s Heart Study). Since 1972, U.S. death rates for coronary heart disease have decreased 51 percent. In Pueblo, death rates are higher than Colorado overall. This is probably due to higher rates of smoking, diabetes and less access to health care for the underinsured.

Safer and healthier foods - Since 1900, safer and healthier foods have resulted in decreased microbial contamination and increased nutritional content. Food-fortification programs have almost eliminated diseases, such as rickets, goiter and pellagra (all rarely heard of today) in the U.S. Folic acid is helping to decrease congenital neural tube defects in newborns and calcium helps to prevent osteoporosis. The Health Department works diligently to prevent and control food borne illness by inspecting food facilities and investigating outbreaks of disease.

Family planning - Access to family planning and birth control has altered social and economic roles of women. Health benefits include smaller family size and longer intervals between the birth of children; increased opportunities for prepregnancy counseling and screening; fewer infant and maternal deaths; and use of barrier contraceptives to prevent pregnancy and transmission of sexually transmitted diseases and HIV. The health department has a family-planning clinic that serves low-income women and teens, who otherwise could not afford Pap smears and birth control.

Healthier mothers and babies - Better hygiene and nutrition, availability of antibiotics, greater access to health care, and technologic advances in maternal and neonatal medicine have led to safer pregnancies and healthier babies. Since 1900, infant deaths have decreased by 90 percent and maternal deaths by 99 percent. Excellent prenatal care to low-income women is offered through Parkview, St. Mary-Corwin, Pueblo Community Health Center and Southern Colorado Family Medicine.

Fluoridation of drinking water - 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 to 70 percent in children) and of tooth loss in adults (40 to 60 percent). In Pueblo, the city drinking water is fluoridated, but wells in the county have no or low levels of fluoride in the water. Fluoride drops are available by prescription for young children who have wells with low levels of fluoride.

Vaccination - Vaccines are available to protect children against 15 life-threatening or debilitating diseases. Rates of all vaccine-preventable diseases are down more than 97 percent due to these vaccines. Unfortunately this success is at risk, as more parents are not having their children vaccinated. There have been serious infections from pertussis (whooping cough) in children in Pueblo and Colorado.

The health department’s mass flu clinic is scheduled from 9 a.m. to 4 p.m. Saturday at Centennial High School. Free flu and pneumonia shots and flu mist will be available for ages 6 months and up, while supplies last. This exercise is to simulate vaccinating a large number of people in a short amount of time, which is necessary to be prepared if an actual public health emergency were to occur. For this exercise to be a success, people need to come on this day to get their shot. The more citizens who come, the more experience first responders and volunteers will gain in handling crowds and simulating the real thing.

I want to thank the numerous volunteers and the Medical Reserve Corps members for their willingness and time to assist the health department at this exercise.

- Dr. Christine Nevin-Woods, director of the Pueblo City-County Health Department, has both a medical degree and a master's degree in public health and preventive medicine.