Top Ten Greatest Public Health Interventions

Hi all,

This week's blog is about the top ten greatest public health interventions of the 1900s. Too bad one of them wasn't an instant snow remover or a fireplace I can use in my apartment. It's the snow-pocalypse out there! Anway, hopefully this blog will keep someone occupied as we wait out the blizzard.

The Top Ten Interventions are:
1. Vaccination
2. Motor Vehicle Safety
3. Safer Workplaces
4. Control of Infectious Diseases
5. Decline in Deaths from Coronary Heart Disease and Stroke
6. Safer and Healthier Foods
7. Healthier Mothers and Babies
8. Family Planning
9. Flouridation of Drinking Water
10. Recognition of Tobacco Use as a Health Hazard

Wow! Public Health sure has accomplished alot in the last century. What really shocked me is that since 1900, average life expectancy has grown by more than 30 years! Public Health is responsible for 25 of those years which is truly a feat to be proud of.

One of the most interesting things about this list is that almost everyone has been effected by most if not all of the interventions. We all benefit from the flouridation of drinking water, healthier foods, and safer workplaces. Also, infant and child mortality declines were helped by maternal health reforms and vaccination campaigns which have eradicated or severely lessened many diseases that were previously devastating. As any high school graduate can tell you, education programs regarding motor vehicle safety and tobacco as a health hazard are unavoidable. Also, when purchasing a new car, we often take for granted the anti-lock brakes, side-impact air bags, and seat belts that have saved so many lives. Next, as a woman, I particularly value the family planning interventions that were integral in both improving women's health and facilitating the women's liberation movement. Finally, since cardiovascular disease is currently the number one killer in the United States, any interventions that reduce the number of people dying from these diseases are important to all Americans.

Today, I will take just two of these interventions and elaborate on how they are particularly powerful: Vaccinations and Healthier Mothers and Babies.

Since the first time my pediatrician explained the reason I had to get a certain shot before entering a new school, I have found vaccinations to be extremely interesting. It seems amazing that just 100 years ago, I would have known people suffering from measles, mumps, and small pox whereas today those diseases sound as antiquated as the Bubonic Plague. It is even more impressive that a disease that was a part of the normal elementary school experience when I was younger, chicken pox, is now joining that list. Last year, I was extremely impressed with the speed and precision with which the H1N1 vaccine was developed and produced. It is fascinating to think of what infamous global pandemics could have been avoided if today's vaccination technology had been in place (the Spanish Flu, the small pox plagues that decimated Native American populations, etc.).

Today, many activists have been campaigning against vaccines due to concerns about a link between vaccination and autism. However, the Lancet journal article that initially sparked this concern was recently retracted due to inappropriate research methods. This means there is absolutely no proof supporting this claim. If vaccination rates were to drastically decline in the future, the public health of the US population would be seriously at risk.

Interventions regarding healthier mothers and babies also have a strong impact on the population level. The past century has seen tremendous improvements in this area. However, my interest in this intervention is mostly centered on the work still to be done. The US is 45th on the list of countries with the lowest infant mortality rates. This is well behind almost every European country and many countries that could be considered "less developed" than the US. The high infant mortality rate in this country is mainly due to a health disparity. African-American infants and infants with low SES have much higher rates of infant mortality than almost all other American groups. In fact, the infant mortality rate in East Baltimore is worse than many extremely impoverished nations. In the next century, I believe public health interventions will be integral in eliminating this disparity.

One Public Health intervention that I was surprised not to see on the list is air quality improvement. Although this is still an uphill battle, the 20th century saw key legislation, supported by public health experts, to improve the quality of the air. The most important of these may have been the ban of leaded gasoline. Since the switch to all unleaded fuels, air quality has improved dramatically. Also, indoor air quality has been improved by indoor smoking bans that have been quickly gaining popularity throughout the country. Although initially laws simply segregated smokers and nonsmokers within a restaurant, today many cities ban smoking indoors altogether. Maybe this intervention will have a place on the top ten for the next century.

That's all for this week. Stay warm!