Notes for Three Eras of Health Care

215. “Ten Great Public Health Achievements—United States, 1900-1999,” Morbidity and Mortality Weekly Report, Centers for Disease Control, 02 April 1999. “During the 20th century, the health and life expectancy of persons residing in the United States improved dramatically. Since 1900, the average lifespan of persons in the United States has lengthened by greater than 30 years; 25 years of this gain are attributable to advances in public health.”

See also James W. Henderson, Health Economics and Policy, Cincinnati: South-Western, 1999, p. 142. “Research on the relationship between health status and medical care frequently has found that the marginal contribution of medical care to health status is rather small.”

See also Sherman Folland, Allen Goodman, and Miron Stano, The Economics of Health and Health Care, 3rd ed., Upper Saddle River: Prentice Hall, 2001, p. 118. “The historical declines in population mortality rates were not due to medical interventions because effective medical interventions became available to populations largely after the mortality had declined. Instead, public health, improved environment, and improved nutrition probably played substantial roles.”

216. Health, United States, 2008, U.S. Department of Health & Human Services, National Center for Health Statistics, 2008. Table 26.

217. Mitchell L. Cohen, “Changing Patterns of Infectious Disease,” Nature, 17 August 2000. “For most of the twentieth century, the predominant feeling about the treatment, control and prevention of infectious diseases was optimism. In 1931, Henry Sigerist wrote(1), ‘Most of the infectious diseases . . . have now yielded up their secrets. . . . Many illnesses . . . had been completely exterminated; others had [been brought] largely under control.’ Between 1940 and 1960, the development and successes of antibiotics and immunizations added to this optimism, and in 1969, Surgeon General William H. Stewart(2) told the United States Congress that it was time to ‘close the book on infectious diseases.’”

[Footnotes within this note can be found in the citation itself.]

218. Health, United States, 2008, U.S. Department of Health & Human Services, National Center for Health Statistics, 2008. Table 26.

219. “Chronic Diseases and Health Promotion,” Centers for Disease Control and Prevention,, accessed 29 March 2014.

220. Ibid.

See also Kathleen Fackelmann, “Stress Can Ravage The Body, Unless The Mind Says No,” USA Today, 22 March 2005. “Up to 90 percent of the doctor visits in the USA may be triggered by a stress-related illness, says the Centers for Disease Control and Prevention.”

See also David H. Freedman, “The Triumph of New-Age Medicine,” Atlantic, July 2011.  The article quotes Elizabeth Blackburn, a Nobel laureate and researcher at the University of California at San Francisco: “Relieving patient stress, in particular, is looking more and more important.”

221. Health, United States, 2012: With Special Feature on Emergency Care, U.S. Department of Health & Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics. Table 88 (p. 1 of 3). In 2010, 1,008,802,000 office visits are noted.

The U.S. Census Bureau reports at, accessed 26 March 2014, a U.S. population in 2010 of about 309,000,000 people, thus an average of about 3.3 visits per person in a year.

(Extracted from When Health Care Hurts by Elizabeth L. Bewley)