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33 Cards in this Set

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What are the inputs that "produce" good health?

clean air and water, genetics, health behaviors, good nutrition, exercise, access to high-quality medical care, education, and neighborhood conditions

In the 18th and 19th century, high infant mortality was due largely to...

rampant infectious diseases

Why were children particularly susceptible to infectious disease such as typhoid, small pox, cholera, dysentery, and non-respiratory tuberculosis in the 18th and 19th centuries?

a combination of poor nutrition and the fact that children develop antibodies more slowly

Why did children become more resilient to infectious disease in the 1750-1850 era?

Economic growth and improvements in nutrition

Between 1750-1850, what happened to life expectancy at birth in England and Wales?

Increased about 4 years

What are 3 important pieces of evidence that serve as strong evidence for the importance of nutrition?

-Agricultural yields and caloric intake increased during the 18th century, and average adult height in Europe increased by ten cm


-Mortality is a U-shaped in a person's BMI


-Medical care and public health not likely to explain mortality reductions before 1850, because they simply did not exist

Evidence that medical care and public health not likely to explain mortality reductions before 1850?

They did not exist; Also, mortality from tuberculosis fell 80% BEFORE there was any effective treatment for the disease

What were the major causes of death in Boston in 1811? What do they illustrate?

Infantile flu, typhus, fever: illustrates that few effective medical treatments existed in the 1800s

What happened to US infant mortality rate between 1915 and 1950?

Dropped sharply and steadily (for post post-neonatal and neonatal)

In the 2nd era of health, what was effective against infectious disease?

Public health programs

What are some examples of the Macro-public health programs that combated infectious disease?

Big Works Projects: Filtering and chlorinating water supplies, building sanitation systems, draining swamps, pasteurizing milk, vaccination campaigns

What are some examples of the Micro-public health programs that combated infectious disease?

People's Behaviors: boiling bottles and milk, protecting food from insects, washing hands, ventilating rooms

What did the micro- and macro- public health programs immediately lead to? Example?

Water- and food-borne diseases such typhoid, cholera, dysentery, and non-respiratory tuberculosis essentially eliminated in developed countries by 1970.




England in 1848, 60% deaths due to infectious disease; by 1971, infectious mortality decreased by 95%

What is responsible for changing the common causes of death since 1900?

Public health programs

What were leading causes of death in 1900? in 2010?

1900: flu/pneumonia, tuberculosis, GI infection, heart disease, cerebrovascular conditions




2010: Heart disease, cancer, respiratory, cerebrovascular conditions

Did medical care have an impact on life expectancy in the 2nd era?

Started to contribute in the 2nd era, but wasn't having a large impact yet

Between 1900 and 2013, what happened to life expectancy?

10.6 year increase

When did medical care begin contributing meaningfully to health improvements?

mid-1930s


What important medical discovery in the 1930s contributed to health improvements?

Sulfa drugs


-The first effective antibacterial agents (produced 1932, tested 1936)



In the late 1930s, what medical illnesses did sulfa drugs test successfully for?

Infections associated with childbirth, meningitis, scarlet fever, and pneumonia

In addition to sulfa drugs, what medical technology decreased prevalence of medical affliction after 1924?

introduction of vaccines for 8 contagious diseases

After 1950, what happened to US infant mortality rate?

continued to drop (from % in 1950 to 0.6% today)

The change in US infant mortality rate since 1950 is believed to have been caused by what?

Medical care is believed to be the catalyst behind the more recent improvements in infant survival rates

What has happened to cardiovascular mortality rate since 1965?

Dramatic reduction (first decrease ever)--> from high of 800 deaths per 100,000 in 1950 to 234 in 2013

Why has cardiovascular disease mortality changed since 1965?

Medical care improvements

How has high blood pressure and high cholesterol rates changed from the early 1970s to the early 2000s?

1971-1975: high BP 63%, high cholesterol 46%


1999-2002: high BP 34%, high cholesterol 23%



What are the three eras of health?

Era 1: 1750-1850


Era 2: 1850-1950


Era 3: 1950- today

What was the life expectancy change in each of the three eras of health?

Era 1: 4 years


Era 2: 24 years


Era 3: 11 years

What were the important drivers in reducing mortality in era 1? (in order of importance)

1. Improved nutrition and economic growth


2. Early public health programs


3. Medical care



What were the important drivers in reducing mortality in era 2? (in order of importance)

1. Public health programs


2. Nutrition and economic growth


3. Medical care

What were the important drivers in reducing mortality in era 3? (in order of importance)

1. Medical care: vaccinations and antibiotics then expensive 1 on 1 interventions


2. Public health


3. Nutrition and economic growth

What are the leading determinants of overall health? How much of health does it account for? What are the other determinants and their impact?

BEHAVIORAL (40%), 30% Genetic, 15% socioeconomic, 10% health care, 5% environment

What was per medical spending (and percentage of GDP) in 1950 as compared to 2013?

1950: $500 (4% of GDP)


2013: $9255 (17.4% of GDP)