1. Component 1: Introduction to Health Care and Public Health in the U.S. 1.7: Public Health Part I 1.7c: Impact and Value of Public Health

2. Public Health Progress Component 1/Unit 7cHealth IT Workforce Curriculum Version1.0/Fall 2010 2 In the 20 th century, Public Health radically improved population health, with achievements including Significantly increased life expectancy Reduction in infant and child mortality Remarkable reduction in communicable diseases

3. Public Health Progress Component 1/Unit 7cHealth IT Workforce Curriculum Version1.0/Fall 2010 3 It is nearly impossible to spend a single day in the US without being affected by public health – consider these daily life examples: food safety restaurant inspections fluoridated water seatbelt use unleaded gasoline influenza vaccine programs trans-fats and other nutritional information public health response to the most recent disaster Public health in the US has a long record of working in the public interest; that record is almost entirely positive

4. A Terrible Injustice A terrible episode mars the otherwise favorable record of public health in the US The Public Health Service was one of several sponsors of two related and horrific studies (physician John Cutler was involved in both studies) - –1932 – Public Health Service began the infamous Tuskegee Study which recorded effects of syphilis on black men. Even after penicillin became the recommended drug treatment in 1947, the men did not receive adequate treatment. In 1972, an advisory panel found the study "ethically unjustified” and it was immediately halted –1940’s – Experiment which deliberately sought to infect inmates at the Guatemalan National Penitentiary with syphilis in order to study the effects of early penicillin treatment Public Health has worked tirelessly to improve population health. While the injustice of these studies must be both noted and remembered, it is important to also remember the enormous benefits that Public Health has conferred Component 1/Unit 7Health IT Workforce Curriculum Version1.0/Fall 2010 4Component 1/Unit 7c4Health IT Workforce Curriculum Version1.0/Fall 2010

5. Public Health Achievements in the 20 th Century* Vaccination Motor-vehicle safety Safer workplaces Control of infectious diseases Decrease in coronary heart disease/stroke deaths Safer and healthier foods Healthier mothers and babies Family planning Fluoridation of drinking water Recognition of tobacco as health hazard *Morbidity & Mortality Weekly Report 1999; 48(12):241-3 Component 1/Unit 7Health IT Workforce Curriculum Version1.0/Fall 2010 5Component 1/Unit 7c5Health IT Workforce Curriculum Version1.0/Fall 2010

6. Highlights Since 1900, the average life expectancy for Americans has increased about 30 years; 25 of those years are attributed to public health initiatives 1950 - in anti-tuberculosis efforts, more than 2 million X-ray examinations were made by the Public Health Service 1977 - Worldwide eradication of smallpox (as recently as 1958, two million people a year die from smallpox) 1990’s – only 4.4% of US children have elevated blood lead levels (in the 1970’s, 88.2% had elevated blood lead levels) Component 1/Unit 7Health IT Workforce Curriculum Version1.0/Fall 2010 6Component 1/Unit 7c6Health IT Workforce Curriculum Version1.0/Fall 2010

7. Highlights A combination of medical progress and public health efforts have nearly eliminated deaths from previously-rampant childhood diseases such as –Measles –Diphtheria –Scarlet fever –Whooping cough The battle against communicable diseases has been so successful that in 2007, of the top 10 causes of mortality, only two factors (#8 and #10) are not either chronic disease- or injury-related Component 1/Unit 7Health IT Workforce Curriculum Version1.0/Fall 2010 7Component 1/Unit 7c7Health IT Workforce Curriculum Version1.0/Fall 2010

8. Leading Causes of Mortality in US, 2007 Data Heart disease: 616,067 Cancer: 562,875 Stroke (cerebrovascular diseases): 135,952 Chronic lower respiratory diseases: 127,924 Accidents (unintentional injuries): 123,706 Alzheimer's disease: 74,632 Diabetes: 71,382 Influenza and Pneumonia: 52,717 Nephritis, nephrotic syndrome, and nephrosis: 46,448 Septicemia: 34,828 Component 1/Unit 7Health IT Workforce Curriculum Version1.0/Fall 2010 8Component 1/Unit 7c8Health IT Workforce Curriculum Version1.0/Fall 2010