Americans Living Healthier, Longer

You may not have read about the most important health story of 1996.

It wasn’t a breakthrough cure or a new plague or another food that some “expert” said you shouldn’t eat.

The big health story of 1996 was that it was a wonderful year, according to leading indicators of public health status.

“Births and Deaths for 1995,” a report on U.S. vital statistics released in October 1996 by the National Center for Health Statistics, revealed that in 1995:

Estimated life expectancy from birth matched the record high attained in 1992 of 75.8 years. Although racial disparities remain, life expectancy is increasing for blacks as well as whites.

The infant death rate reached a record low of 7.5 infant deaths per 1,000 live births with increased survival for both white and black infants.

Age-adjusted homicide rates dropped dramatically - nearly 15 percent.

For the first time on record, the age-adjusted death rate for HIV-related causes showed no increases from the previous year. (AIDS remains the leading cause of death in the United States of males ages 25 to 44.)

There were declines in age-adjusted death rates from 1994 to 1995 for heart disease, cancer, accidents, suicide, chronic liver disease, and deaths from all causes (0.7 percent).

But that’s not all. For example: Citing the United Nations Secretariat, Nicholas Eberstadt of the Harvard Center for Population and Development noted that life expectancy at birth in developing nations rose by an average of nearly 15 years from the early 1960s to the early 1990s. And infant mortality declined by almost 50 percent.

Here at home, the Centers for Disease Control and Prevention (CDC) reported a 4.9 percent decrease in the number of alcohol-related traffic fatalities from 1993 to 1994. CDC noted a 21 percent decline in the rate of involvement by young drivers in fatal crashes from 1988 to 1995 (although the lowest rates were recorded in 1992 and 1993).

The National Cancer Institute, meanwhile, reported that age-adjusted breast cancer death rates declined from 1989 to 1993 by almost 7 percent. And Drs. Philip Cole and Brad Rodu of the University of Alabama at Birmingham noted that the overall age-adjusted cancer death rate in the U.S. decreased by over 3 percent from 1990 to 1995.

The slight but clear progress in the war on cancer is attributable to lifestyle changes, especially reductions in smoking since 1965, and improvements in medical care.

The age-adjusted death rate from heart disease, the leading cause of death in the United States, also has declined dramatically from its peak in the 1950s. Yet, in November The Wall Street Journal, citing researchers at an American Heart Association meeting, put the most negative spin possible on this trend. It noted that “deaths from heart disease, instead of declining, are only being postponed to later ages.” Only? Most people welcome the opportunity to live long enough to die as senior citizens.

Postponing death is no small accomplishment, as some people with AIDS are now appreciating.

In 1996 new combination drug therapies began to offer realistic prospects that AIDS can be a manageable chronic disease rather than a death sentence. Suddenly newspapers were reporting on the difficulties that some people with AIDS were having in coping with their new, realistic chances of looking forward to long lives.

Then again, living a long life can be horrific when all it means is years of unhappiness, pain, suffering, helplessness and hopelessness. However, 1996 also brought good news regarding the quality of lives of America’s growing elderly population.

The federal National Long Term Care Survey reported a continuing decline in the percentage of elderly who are unable to take care of themselves, unable to comb their hair, feed themselves, or take a walk. The Survey, which regularly monitors nearly 20,000 senior citizens, also noted declines in the percentage of the elderly with high blood pressure, arthritis, and emphysema.

An 11-year University of Southern California study of a representative sample of about 12,000 Americans aged 50 to 69 also reported good news. There was a steady decline in the proportion of respondents who said their ability to work is impaired, with similar improvements for blacks as for whites. The trend may be attributable in part to medical advances such as hip replacement and lens replacement for people with cataracts.

To acknowledge that 1996 was a year of progress in public health is not to deny or ignore that we still have a long way to go. About half of all deaths in the United States occur prematurely. Most of these deaths are caused by people and are therefore unnecessary, and also preventable.

By far the leading cause of premature death is cigarette smoking, which is responsible for half of all premature deaths in the United States.

We can expect continued progress in public health as a result of advances in medical care, new cost-effective innovations in sanitation, and reasonable safety reforms. But the greatest progress will come if we make and keep New Year’s resolutions to avoid killing ourselves and others.

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