WebMD Medical News
Laura J. Martin, MD
May 19, 2011 -- Controlling infectious diseases like AIDS and tuberculosis, doing a better job of fighting tobacco use, improving motor vehicle safety, and reducing heart disease and death have been named by the CDC as being among the 10 top public health achievements of the first decade of the 21st century.
Others include improvements in vaccine-preventable diseases, better maternal and infant health, better cancer prevention, improved occupational safety, and aggressive steps that have led to fewer childhood lead poisonings, the CDC says.
Also, major strides have been made in public safety preparedness since the terrorist attacks of Sept. 11, 2001, the agency says in its Morbidity and Mortality Weekly Report for May 20.
"Americans are living longer, healthier and more productive lives than ever before thanks in part to extraordinary achievements in public health over the past decade," CDC Director Thomas R. Frieden, MD, MPH, says in a news release.
But he says much more can and should be done to protect and promote public health. "Continued investments in prevention will help us and our children live even longer, healthier and more productive lives while bringing down health care costs," Frieden says.
The CDC says the first decade of this century saw a 30% reduction in reported tuberculosis cases in the U.S. and a 58% drop in central line-associated bloodstream infections.
It explains in a news release that a central line is a tube that a doctor usually places in a large vein of a patient's neck or chest to give medical treatment. Occasionally infections related to placement of a central line occur and sometimes cause serious and sometimes deadly bloodstream infections.
Since the first Surgeon General's Report on tobacco in 1964, evidence-based policies and stop-smoking programs have had significant success, the CDC says.
By 2009, the CDC says 20.6% of adults and 19.5% of youths were current smokers, compared with 23.5% of adults and 34.8% of youths a decade earlier.
Also, no state had a comprehensive smoke-free law in 2000 prohibiting smoking in restaurants, bars, and work sites, but now 25 states do, and so does Washington, D.C.
Despite the progress, smoking still results in an economic burden of about $193 billion annually, including medical costs and lost productivity.
In the past decade, there has been a significant reduction in babies born with birth defects such as spina bifida, due largely to folic acid fortification of cereal grain products. Fortifying foods with folic acid has resulted in a savings of more than $4.6 billion in the past decade.
Safer vehicles, safer roadways, and safer road use that came about due to protective messaging and policies, such as laws requiring seat belt and child safety harnesses, have had a major role in reducing motor vehicle crashes, injuries, and deaths, the CDC says.
From 2000 to 2009, while the number of vehicle miles traveled on U.S. roads increased by 8.5%, the death rate declined from 14.9 per 100,000 people to 11, and the injury rate went down from 1,130 to 722 per 100,000 people.
But motor vehicle crashes still are among the top 10 causes of death for U.S. residents of all ages, and the leading cause for people between ages 5 and 34.
Heart disease and stroke have long been among the leading causes of death, but preliminary data for 2009 indicate that stroke, which was the third leading cause of death previously, is now the fourth leading cause of death.
In the past decade, the age-adjusted heart disease and stroke death rates declined significantly. Factors for improvements include medications to reduce cholesterol levels and blood pressure and successful battles against cigarette smoking.
Better cancer prevention measures have led to earlier diagnoses and fewer deaths, especially from colorectal, breast, and cervical cancers. From 1998 to 2007, colorectal cancer death rates decreased from 25.6 to 20 per 100,000 people. Smaller declines were reported for breast and cervical cancer rates in the same time period.
Another improvement has been better efforts and measures to prevent childhood lead poisoning.
In 2000, childhood lead poisoning was a major environmental public health problem in the U.S. Many states have enacted laws designed to prevent lead poisoning, and there has been a steep decline in cases.
The CDC says a major improvement has been the establishment of public health preparedness and response programs since the terrorist attacks of Sept. 11, 2001.
Efforts have been made in many states to battle bioterrorist threats. Many state public health laboratories have improved procedures to better identify bacteria such as E. coli O157:H7.
Also, public health interventions during the H1N1 flu pandemic have prevented up to 10 million flu cases and 1,500 deaths, according to the CDC.
Overall, advances in public health have contributed to a steady downward trend in the death rate. From 1999 to 2009, the death rate in the U.S. declined from 881.9 per 100,000 pop to 741, a record low.
SOURCES:News release, CDC.Morbidity and Mortality Weekly Report, May 20, 2011; vol 60.
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