State of our state - U.S. health statistics

American Fitness, Sept-Oct, 1990 by Jan Paul

STATE OF OUR STATE

How many times each day are we asked, "How are you?" And how often do we answer, "Fine!"

If you read a report from the turn of the century that said heart disease, cancern, stroke and accidents accounted for only 40% of all deaths and a report from today that said they were responsible for over 70% of all deaths, it might be easy to conclude our grandparents were healthier than we are. In 1900, however, heart disease, cancer, stroke and accidents werent't the top four killers. What our grandparents feared most were influenza, pneumonia, smallpox and polio, all of which are now controlled and/or eliminated by drugs and immunization. The true state of our health can only honestly be determined by looking at what has changed within each group.

In 1900, few women smoked. So birth abnormalities connected with smoking during pregnancy were virtually non-existent. And while morphine and laudanum, the favoriete painkillers of the day, no doubt caused some abnormalities, they were not generally used by women as "recreational" drugs. Today, 14% of premature infants who do not survive are born to women who smoke, and the devastation of "recreational" drugs on infants is almost too mind-bogling to calculate.

On the other hand, in 1900 an infant who reached age one could expect to live 47.3 more years. Today a one-year-old can expect to reach the ripe old age of 74.9 years, an increase of 40%. While reaching that first birthday was, and still is, a health milestone, it never has been a guarantee of a long life. For many years infectious diseases were the prime threat to the health of all children. Smallpox, polio, diphtheria and pneumonia were among the most feared, but whooping cough, scarlet fever and measles were hazards in their own way because of the debilitating side effects and long-term residual weaknesses. How many cases of deafness, blindness and consumption followed bouts with these and other non-fatal childhood diseases?

Improved sanitation, effective immunization and antibiotics have reduced or eliminated the incidence of infectious diseases dramatically. In fact, in the last quarter century, the death rate in young children has declined 53%, largely because of improved immunization techniques and prectices. However, some people confuse control with elimination. Polio is eliminated, right? Wrong. Stop immunizations and in a short time polio would be as common as it was before immunization was possibile. This out-of-sight, out-of-mind syndrome, however, creates an atmosphere of apathy among parents. Many believe that since the disease isn't visible, it means immunization is no longer necessary. Both of these attitudes, fear and complacency, can pose a serious public health problem--witness the current measles outbreak in many parts of the country.

Today, the leading killer disease among children is cancer--primarily leukemia. But the No. 1 child killer isn't even a disease. Today more children die each year from accidents and acts of violence than any other cause. Accidents aren't only a plague of children. Accidents are high on the list of causes for adolescents and young adults as well. In fact, accidents are a significant part of an alarming trend of deaths among these older youths.

Accidents are also the prime killer of adults aged 25 to 45. Our love affair with machines, particularly the automobile, is killing us faster than any other facet of our modern lifestyle. Total deaths for adults under 45, however, have declined about 33% since 1950, largely because of better understanding and treatment of cardiovascular disease. Cancer deaths also show a downward trend, perhaps because leukemia, the prime cancer of younger age groups, is statistically far less prevalent in adults.

In 1900, 45 though 64 years of age was considered old age. Further, more people didn't attain their 65th birthday than did. Today, 27% more reach age 65 than did 30 years ago, and the largest percentage of this increase can be directly related to a reduction in heart disease mortality through better medications and treatment techniques. In 1900, who ever seriously dreamed of bypass and transplant?

Today, 12% of the population is over 65, and a person attaining that age can expect to live another 16.9 years. This age group, besides being virtually a non-statistic until about 1945, has a different type of health problem--chronic disease. Three-fourths of all deaths in the over-65 group are from heart disease, cancer, stroke and diabetes. However, since 1950, the age-adjusted death rate has decreased 17%, and the decline in heart-disease mortality has accounted for half of this decline.

So, how are you? As a nation we are healthier and live longer today than ever before. Modern technology and lifestyle have, in most cases, reduced the health hazards to which we are exposed so that in only one area, accidents, we are liable to be less healthy than our ancestors. In fact today, only 5.4 persons per 1,000 die annually compared to 14.4 per 1,000 in 1915--the earliest year for which definitive data is available.