100 years ago, the leading causes of death in the US were infectious diseases like pneumonia and tuberculosis. Life expectancy was only 47 years. Now, chronic diseases like heart disease and cancer are leading causes of death, and life expectancy has increased to 77 years. This shift occurred due to public health improvements in sanitation, hygiene, and the development of antibiotics and vaccines. Currently, the US population faces health challenges from an aging population and increasing diversity. [END SUMMARY]

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Chapter 10
Current Societal Health Trends

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Introduction
 A century ago, physical inactivity was not a
contributing factor to any of the major
problems experienced by the populace of the
United States
 Fast forward 100 years…….

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Historical Context for Health in
the U.S.
 100 years ago
 Mortality statistics
 Mortality rate--the number of people who die in a
given number of people
 Infant mortality rate--100 out of 1000 died within one
year
 Maternal mortality rate--six to nine per 1000 live births

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Historical Context for Health in
the U.S.
 100 years ago
 Life expectancy statistics
 47.3 years in the U.S.
 31years in the world
 Causes of mortality
 Infectious/Communicable diseases such as
pneumonia, influenza, tuberculosis, and dysentery

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Health of the U.S. Population
Today
 Currently
 Infant Mortality--6.9 out of 1000 live births die
within one year
 Life Expectancy--77.5 years
 Causes of Mortality--Chronic, degenerative
diseases such as heart disease, cancer,
cerebrovascular disease, and respiratory disease

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Leading causes of death by
percentage of total deaths in 1900
 Pneumonia and influenza
 Tuberculosis
 Diarrhea and enteritis
 Heart disease
 Cerebrovascular disease
 Accidents
 Cancer
 Senility
 Diphtheria

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Leading causes of death by
percentage of total deaths in 2004
 Heart disease
 Cancer
 Cerebrovascular disease
 Respiratory disease
 Accidents
 Diabetes
 Alzheimer’s disease
 Pneumonia and influenza
 Kidney disease
 Septicemia

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Health of the U.S. Population
Today
 First Health Revolution
 Improvement in general standard of living,
nutrition, basic sanitation, hygiene, and water
quality
 Resulted in a significant decrease in morbidity
and mortality due to communicable diseases

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Health of the U.S. Population
Today
 Pharmacologic Revolution
 Discovery of antibiotics
 1928--Alexander Fleming discovered penicillin
 1930’s--Sulfa drugs
 1940’s--Streptomycin, and other antibiotics
 Vaccines

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Current Influences on
Population Health
 Two Major Demographic Trends
 Population of the country is more diverse
 Aging of the population

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Current Influences on
Population Health
 Demographic Trends
 Diversity of our country
 Different racial, ethnic, and cultural groups have
different rates of prevalence for individual diseases
and illness
 Varying health beliefs that affect prevention or
treatment of health conditions
 Health providers must be attentive to issues relating to
cultural, lifestyle, and genetic factors in different
segments of the population

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Current Influences on
Population Health
 Demographic Trends
 Aging of the Population
 In 1900, the 65-plus age group was only 4%
 By 2050, the 65-plus age group will be over 20%
 The 75-plus age group has been growing also
 This leads to an increased prevalence of chronic and
degenerative diseases

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Solutions to Health Problems
 Five categories of health determinants
 Health behavior
 Environment
 Interventions and policies
 Access to care
 Biology

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Five Categories of Health
Determinants
 Health Behavior
 The most important category
 The category over which individuals have the
most control
 Nurses’ Health Study

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Five Categories of Health
Determinants
 Environment
 Negative physical environment:
 Pollutants, toxic substances, infectious agents, and
unsafe conditions
 Social environment:
 Influence and health habits of coworkers, friends,
families, and institutions such as churches and
schools

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Five Categories of Health
Determinants
 Inventions and policies
 Government and health or social service groups’
programs and campaigns to improve health
 Laws requiring immunizations, seat belt use, and child
restraint devices
 Stop smoking, breast feeding campaigns

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Five Categories of Health
Determinants
 Access to Health Care
 Variable across the nation
 Affordability
 Persons who are both able to find and afford
health care are likely to have better health than
those who are not

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Five Categories of Health
Determinants
 Biology
 Produces or contributes to many health conditions
 Includes genetic make up
 Aging process
 Exposure to tobacco, alcohol, or toxic agents can
alter biology

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U.S. Goals for Improving
Health of the Population
 Healthy People 2010
 Document of specific goals and objectives for
health improvement
 Two main, general goals
 Increase both the quality and the length of life
 Eliminate disparities in the health status of different
subgroups of the population

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Top Ten Health Goals of
Healthy People 2010
 Physical activity
 Overweight and obesity
 Tobacco use
 Substance abuse
 Responsible sexual behavior
 Mental health
 Injury and violence
 Environmental quality
 Immunization
 Access to healthcare

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U.S. Goals for Improving
Health of the Population
 The Surgeons General’s Report on Physical Activity
and Health (1996)
 Greatest health benefit-- consistently active five days per
week
 Does not need to be vigorous activity
 Helps to prevent or reduce the risk of:
 Heart disease
 High blood pressure
 High cholesterol
 Cancers
 Type 2 diabetes