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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
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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 BirthUSA 1900-2000 ……….Females ———Males
Survival USA 1900-1991 Click for larger picture
Leading Causes of Death USA1900 • Tuberculosis • Pneumonia & Influenza • Heart disease • Diarrhea • Stroke • Kidney disease • Accidents • Cancer • Senility • Bronchitis
Leading Causes of Death USA1940 • Heart disease • Cancer • Stroke • Kidney disease • Pneumonia • Accidents excluding motor vehicle • Tuberculosis • Diabetes • Motor vehicle accidents • Premature birth
Leading Causes of Death USA1960 • Heart disease • Cancer • Stroke • Diseases of early infancy • Pneumonia & influenza • Accidents excluding motor vehicle • Motor vehicle accidents • Atherosclerosis generalized • Diabetes • Congenital anomalies
Leading Causes of Death USA1998 • Heart disease • Cancer • Stroke • Chronic pulmonary disease • Pneumonia & influenza • Diabetes • Accidents excluding motor vehicle • Motor vehicle accidents • Suicide • 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
Infant 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 Expectancy at BirthYears 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 Indicators of Population Health1995-2000
Leading Causes of Death- World1998 • Heart disease • Infectious diseases • Cancer • Injuries • Respiratory & digestive diseases • Maternal • Other
Leading Causes of Death Developing Countries1998 • Infectious diseases 45% • Heart disease 24% • Cancer 11% • Injuries 11% • Perinatal 6% • Maternal 2% • Nutritional 1%
Infectious Disease Deaths- World1998 • Pneumonia & influenza 3.5 million • AIDS 2.3 million • Diarrhea 2.2 million • Tuberculosis 1.5 million • Malaria 1.1 million • Measles 0.9 million Total 11.5 million
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