Healthy Futures

Almost daily we receive reports that suggest if we eat less salt or exercise more we are more likely to be healthy in the future. Today let’s look at some past efforts to improve health and the evidence that these efforts worked and why.

The Centers for Disease Control (CDC), the Federal agency responsible for collecting and providing information to help Americans improve health, recently reported that the rate of death from unintentional injuries in this country fell by about 30% between 2000 and 2009 in youths less than 19 years of age. This is particularly important as in this age group unintentional injuries are the leading cause of death.The principle unintentional injuries are motor vehicle accidents, falls, drowning, suffocation, poisonings and fires and burns.

Let’s just look a bit at why this improvement occurred.  First it is hard to improve something without first recognizing there is a problem. One way to recognize problems is to collect data, for example numbers about the kinds of problems that exist and whether they are increasing or decreasing. Years ago the government, through organizations like the CDC, began to track data on lots of health issues such as causes of death, the differences in causes of death in different age groups and races, the reasons for ER visits, doctor visits, hospitalizations and so forth. By consistently obtaining and analyzing this information trends become apparent. For example we learned that serious infectious diseases like meningitis, measles and polio were surpassed by accidents and injuries as causes of death in children and adolescents over the last 50 years. Information like this is used to determine where to allocate resources to improve health.

As it became apparent that unintentional injuries were overtaking illnesses, especially infectious diseases, as a cause of death in this age group then more effort went into national campaigns to educate parents, legislators, and industry. One important result was legislation requiring the use of seat belts, car seats and automobile safety features, improvements in toy safety,  the use of fire alarms and safety caps for medicines to name but a few of the reasons for the improvement. Change is rarely easy and many were concerned about the cost of these changes or infringement of personal liberty.  The results of these efforts to improve health are now in. In the age group 0-19 years death rates from motor vehicle accidents are down 41%, falls down 15 %,  fires and burns deaths down 45%, and drowning deaths down 28%.  The news is not all good. Poisonings deaths are up 80% and suffocations up 30%.

Further review of the data provides more information. The suffocation problem is mostly in infants and the reason appears to be insufficient adherence to guidelines suggesting that infants sleep on their back on a firm surface in their own bed and avoiding loose bedding. Poisonings are up primarily in the 15-19 year old age group due to an increase in the misuse of prescription medications, especially narcotic pain relievers, by these teens.

There will always be something needing to be done to improve health. Despite these improvement unintentional injuries remain the leading cause of death in children and adolescents, and we trail most of the wealthier nations in the death rates in this age group.

This is Dr Woodard.  Have a good day.

Dr Woodard is physician and owner of Alaska Center for Pediatrics