Ten Great Public Health Achievements United States 19001999

• Vaccination

• Motor vehicle safety

• Safer workplaces

• Control of infectious disease

• Decline in deaths from coronary heart disease and stroke

• Safer and healthier foods

• Healthier mothers and babies

• Family planning

• Fluoridation of drinking water

• Recognition of tobacco use as a health hazard

SOURCE: CDC, 1999.

way improvements have enabled us to make great progress in reducing motor vehicle deaths from this peak (Bolen et al., 1997; NSC, 1997). As the number of miles driven in the United States rose from 206 billion in 1930 to 2,467 billion in 1996, the death rate per 100 million miles declined dramatically from 15.97 in 1930 to 1.76 in 1996 (NSC, 1997; IOM, 1999). Even with this progress, however, we continue to record over 42,000 deaths a year from motor vehicle collisions (U.S. Department of Transportation, 2004).

Early in the 20th century, when cigarettes were hand-rolled, few would have predicted that cigarette smoking would become the major preventable cause of death in the United States a century later. Tobacco reform efforts can be traced back to the late 19th and early 20th century and were strengthened in the 1940s and 1950s as epidemiological studies began to convince the medical community and public about the health hazards of tobacco (Fee et al., 2002). In 1964, nearly 70 million people in the U.S. consumed tobacco on a regular basis; and according to the 1955 Current Population Survey, two-thirds of men (68 percent) and one-third of women (32.4 percent) 18 years and older were regular smokers of cigarettes. As revealed by these data, cigarette smoking was the social norm, its link with heart and lung diseases was not widely accepted, and the desire or ability to quit smoking in that era was very low (DHHS, 1964). The reduction in national prevalence of cigarette smoking from 41.9 percent in 1965 to 23 percent in 2001 (Kochanek and Smith, 2004) reflects changes in the social norms and the positive influence of public health and policy interventions (Public Health Service, 1994; Economos et al., 2001).

Recently, intensive effort has been devoted to reviewing the evidence of the effectiveness of community preventive services. The Guide to Community Preventive Services (Task Force on Community Preventive Services, 2004) has completed an analysis of the evidence in nine major areas (two health behaviors, six specific health conditions, and one addressing the social environment). Additional reports, including those central to preventing childhood obesity (e.g., school-based programs, community fruit and vegetable consumption, consumer literacy, and food and nutrition policy) are forthcoming. In the nine health areas examined to date, the Task Force found that certain categories of interventions appear to have strong evidence of effectiveness for multiple health behaviors and problems (Table 1-3). Further, based on the experience to date from the Guide

TABLE 1-3 Recommended Public Health Interventions Common to Multiple Health Behaviors and Conditions

Type of Intervention

Health Behavior or Condition

Community-wide campaigns

Physical activity**

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