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33 Cards in this Set
- Front
- Back
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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 |
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In the 18th and 19th century, high infant mortality was due largely to... |
rampant infectious diseases |
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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 |
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Why did children become more resilient to infectious disease in the 1750-1850 era? |
Economic growth and improvements in nutrition
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Between 1750-1850, what happened to life expectancy at birth in England and Wales? |
Increased about 4 years |
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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 |
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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 |
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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 |
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What happened to US infant mortality rate between 1915 and 1950? |
Dropped sharply and steadily (for post post-neonatal and neonatal) |
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In the 2nd era of health, what was effective against infectious disease? |
Public health programs |
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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 |
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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 |
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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% |
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What is responsible for changing the common causes of death since 1900? |
Public health programs |
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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 |
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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 |
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Between 1900 and 2013, what happened to life expectancy? |
10.6 year increase |
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When did medical care begin contributing meaningfully to health improvements? |
mid-1930s
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What important medical discovery in the 1930s contributed to health improvements? |
Sulfa drugs -The first effective antibacterial agents (produced 1932, tested 1936) |
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In the late 1930s, what medical illnesses did sulfa drugs test successfully for? |
Infections associated with childbirth, meningitis, scarlet fever, and pneumonia |
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In addition to sulfa drugs, what medical technology decreased prevalence of medical affliction after 1924? |
introduction of vaccines for 8 contagious diseases |
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After 1950, what happened to US infant mortality rate? |
continued to drop (from % in 1950 to 0.6% today) |
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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 |
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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 |
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Why has cardiovascular disease mortality changed since 1965? |
Medical care improvements |
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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% |
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What are the three eras of health? |
Era 1: 1750-1850 Era 2: 1850-1950 Era 3: 1950- today |
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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 |
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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 |
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What were the important drivers in reducing mortality in era 2? (in order of importance)
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1. Public health programs 2. Nutrition and economic growth 3. Medical care |
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What were the important drivers in reducing mortality in era 3? (in order of importance)
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1. Medical care: vaccinations and antibiotics then expensive 1 on 1 interventions 2. Public health 3. Nutrition and economic growth |
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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 |
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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) |
