THE GLOBAL HEALTH CRISIS

W. Thomas London, M.D.

Was there a Golden Age of Human Health?

Life Expectancy 10,000 BC to 1900 AD

• Hunter gatherers 10,000 BC- ~23 yrs

• Early farmers 8,000 BC- 16-20 yrs

• Roman citizens 100 AD ~25 yrs

• Roman slaves 100 AD ~20 yrs

• USA, England 1800 AD ~30 yrs

• USA, Europe 1850 AD ~35 yrs

• USA, Europe 1900 AD 40-50 yrs

Life Expectancy at Birth USA 1900-2000

……….Females ———Males

Life Expectancy by Age USA 1900

Life Expectancy by Age USA 1940

Life Expectancy by Age USA 1990

Survival USA 1900-1991

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Leading Causes of Death USA19001 Tuberculosis

2 Pneumonia & Influenza

3 Heart disease

4 Diarrhea

5 Stroke

6 Kidney disease

7 Accidents

8 Cancer

9 Senility Bronchitis

Leading Causes of Death USA19401 Heart disease

2 Cancer3 Stroke4 Kidney disease5 Pneumonia6 Accidents excluding motor vehicle7 Tuberculosis8 Diabetes9 Motor vehicle accidents Premature birth

Leading Causes of Death USA19601 Heart disease

2 Cancer3 Stroke4 Diseases of early infancy5 Pneumonia & influenza6 Accidents excluding motor vehicle7 Motor vehicle accidents8 Atherosclerosis generalized9 Diabetes0 Congenital anomalies

Leading Causes of Death USA1998

1 Heart disease

2 Cancer

3 Stroke

4 Chronic pulmonary disease

5 Pneumonia & influenza

6 Diabetes

7 Accidents excluding motor vehicle

8 Motor vehicle accidents

9 Suicide

0 Kidney diseases

What happened between 1900 and 1940 to change life expectancy and

the causes of death?

PUBLIC HEATH

Components of Public Health

• Clean water supply

• Sanitary sewage disposal

• Disease surveillance

• Food inspection

• Maternal-child health

• Nutrition- free lunch, free milk

• Housing regulations

• Worker safety

• Worker ages, hours

Indicators of Population Health

1995-2000Infant Mortality Deaths/1000

Live Births

World 59.6

Japan 3.5

France 5.5

USA 7.6

Russia 16.7

China 41.4

Afghanistan 165.0

Sierra Leone 165.4

Life Expectancyat Birth Years

World 65.0

Japan 80.5

France 78.1

USA 76.5

China 69.8

Russia 66.1

Afghanistan 47.0

Sierra Leone 37.3

Leading Causes of Death- World1998

1 Heart disease

2 Infectious diseases

3 Cancer

4 Injuries

5 Respiratory & digestive diseases

6 Maternal

7 Other

Leading Causes of Death Developing Countries

1998

1 Infectious diseases 45%

2 Heart disease 24%

3 Cancer 11%

4 Injuries 11%

5 Perinatal 6%

6 Maternal 2%

7 Nutritional 1%

Infectious Disease Deaths- World1998

1 Pneumonia & influenza 3.5 million2 AIDS 2.3 million3 Diarrhea 2.2 million4 Tuberculosis 1.5 million5 Malaria 1.1 million6 Measles 0.9 million

Total 11.5 million

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