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1968-03
AUTHORS ABSTRACTThis report presents a brief review of health services in the United States during the years 1850–1968, analyzes trends in mortality on the basis of eleven reports that have been published by the National Center for Health Statistics during 1964–68, and compares the results with recent trends in England and Wales, Chile, and Japan. An overview of the analysis and of the current health situation permits three major observations. First, reductions in infant mortality since 1965 are encouraging, but only further research can confirm that they are the result of control of morbidity conditions and thus indicative of still lower infant mortality rates to come. Second, chronic diseases have come to replace infectious diseases as the principal causes of natural death. Further reductions in infectious diseases can have only a very small effect on total mortality. Now, since improved mortality from a chronic condition often means that death from that condition has been postponed to a later age, the older age groups appear to be accumulating increasing proportions of physically impaired lives, and this means an adverse effect on mortality trends. There is no reason, then, to expect improvement in these trends at the very high ages. Third, violent deaths out-rank natural deaths as causes of death before mid-life. While safety measures have reduced accident death rates at home, at work, and in public places, automobile accidents and suicide and homicide will not show decline soon. This is because control of the automobile hazard, which involves motor vehicle design, road construction, and driver education will come slowly. Public health measures for the control of suicide are also slow in development; both suicide and homicide are essentially social problems. Finally, rates of improvement remain greater for females than for males; differentials in mortality by residence, color, and social class will become even smaller; and mortality trends will be influenced increasingly by individual efforts in the future. More... »
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