The Health Status of Americans in the 21 st Century: How we got here

Life Expectancy in the history Roman Empire – 22 Middle Ages in Europe – 33 American Revolution – – 47 Currently – women 79 and men 72 39% of women living today and 21% of men can expect to celebrate their 85 th 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

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Three Eras of Public Health In America Age of Environment Age of Medicine Age of Lifestyle Today

Ten Great Public Health Achievements of the 20th Century Age of the Environment ( ) 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 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% Cancer 23% COPD 5% Diabetes 3% Other Causes 36%

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 More than 1.7 million Americans die of a chronic disease each year The Burden of Chronic Disease

Actual Causes of Death in the United States, 2000 Mokdad, AH, et al (2004). JAMA, 291, CausesNumberPercentage Tobacco400, % Poor Diet/Physical Activity300, % Alcohol Consumption100,0003.5% Microbial Agents90,0003.1% Toxic Agents (pollutants)60,0002.3% Motor Vehicles43,0001.8% Firearms29,0001.2% Sexual Behavior20,0000.8% Illicit Drug Use17,0000.7%

9/17/2015 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.