Our collective health is getting better. In the last century, life expectancy in the US rose from 47 years to about 79 years. Notwithstanding recent, troubling declines in our national life expectancy, this overall trend is encouraging, and is due largely to improvements to the social, economic, and environmental context in which we live. Yet not everyone has shared in these gains. As we in public health well know, deep gaps exist between the overall health of populations and the health of vulnerable, marginalized groups.
The Public's Health: The Smoking Gap | The Public Health Post
Four in ten American adults smoked cigarettes in 1965; only 15% smoke today. That’s an impressive public health success, but it should not be the end of the story. There remain 40 million smokers in the United States who will suffer cancer and cardiovascular consequences from the dozens of harmful chemicals in tobacco products for decades to come, at a cost of $300 billion per year.
Fifty years ago, smoking prevalence for all education groups was clustered at that 40-45% mark. Five decades later, 6.5% of college-educated individuals continue to smoke, while the prevalence is more than triple that among those with a high school education or less (23.1%). These smokers tend to be disadvantaged socially and economically, and bear the majority of morbidity and premature mortality. Education seems to matter.
Homelessness and Health | Dean's Note
A core aim of public health is to care for the most vulnerable members of our society—the marginalized and the dispossessed. At this festive season, when friends and family gather together, and “abundance rejoices,” it seems to me especially important that we focus on these vulnerable groups—people who find themselves excluded from the resources and community ties that generate health. For this reason, we will run a “trilogy” of Dean’s Notes on the conditions that create this marginalization, starting this week with homelessness. The goal is to inspire reflection this holiday season on the vulnerable populations whose challenges are a central concern of public health.
The Real Reason Why American Lives Are Getting Shorter | HuffPost
A Spanish flu pandemic infected approximately one-third of the global population in 1918. In the United States alone, about 675,000 people died, enough to contribute to a decline in the country’s life expectancy. For a century, this decline remained singular in the annals of American health ― until last month, when the National Center for Health Statistics reported that, between 2016 and 2017, U.S. life expectancy dropped from 78.7 to 78.6 years.
This marks the third consecutive year that life expectancy in the U.S. has decreased, a multiyear drop not seen since that 1918 flu pandemic. And it reflects a longer-term trend in which U.S. life expectancy has lagged relative to other economically comparable countries. Overall, our lives have gotten longer, but at a slower rate than our peers.
Why has U.S. life expectancy slowed to its present reversal? The reasons cited by the National Center for Health Statistics are largely twofold: suicide and opioid deaths. But the real explanation as to why those issues continue to worsen is because America has failed to invest in our nation’s health.
Read the full piece at HuffPost.
The Public's Health: Making Aging Healthier | Public Health Post
When Jeanne Calment was 90 years old she sold her apartment to a lawyer named Andre-Francois Raffray on a contingency contract. The deal was that he would pay her 2,500 francs a month (about $400) until her death, whereupon the apartment would become his. This would have been a nice arrangement for Raffray, were it not for the fact that Calment lived for another 32 years, to the age of 122—the longest human life on record.
What Amazon's Move Teaches Us About Health | Fortune
At last, Amazon made its decision. After a yearlong search, in which dozens of US cities competed to host Amazon’s second headquarters, the company announced it will build new locations in New York City and Arlington, Virginia. In a statement about the move, Amazon founder and CEO Jeff Bezos said, “These two locations will allow us to attract world-class talent that will help us to continue inventing for customers for years to come…we look forward to becoming an even bigger part of these communities.”
The search took as long as it did, in part, because of the complex political and economic maneuvering necessary to close a deal of this size, and there have been plenty of cynical motives attributed to Amazon’s search for new homes. But there is something more fundamental at play here than just tax breaks and land values.
On Urban Health, and the State of the Science | Dean's Note
Urbanization is one of the two most important global demographic shifts over the past 200 years, with the other being the aging of populations. The demographic evidence for urbanization is unquestionable, and well described in an accompanying Viewpoint that appears in this SPH This Week. As urbanization accelerated, the field of urban health emerged around the turn of the 21st century, concerned with understanding how, and why, cities influence health. An appreciation of the role that cities can play in shaping the health of populations is an extension of a growing scholarship around the role of context as an inextricable determinant of the health of populations, the subject of one of my previous Dean’s Notes. In many respects, that cities influence health is intuitive. Cities influence the food we eat, the water we drink, and the air we breathe. Urban living can affect everything from available food to walkability to the spread of infectious diseases. Early writing in the field was focused on challenges to the health of populations in cities, including the coining of the term “urban health penalty.” However, as the field has matured, it has become readily apparent that the relationship between urban environments and health is complex, and that a range of determinants of health, both positive and negative, characterizes the urban experience. In the past decades, an equally apparent “urban health advantage” has emerged where, particularly in high-income countries, overall health in urban areas surpasses that of non-urban areas.
The Public's Health: Should Black Boxes Be Welcome in Medicine? | Public Health Post
It has become an article of faith that technology will improve the practice of medicine in coming decades. Medicine enthusiastically embraces novel technical approaches that may improve patient care. But what if those technical approaches bring greater scrutiny to clinical work? What if they may cast a harsh light on work that medicine typically does behind closed doors?
Such questions emerge as efforts grow to introduce “black boxes” to surgery.
When an airplane goes down, there is an urgent search for the plane’s black box. The black box contains both the audio recording of all cockpit discussion as well as a recording of flight instrument readings. These two flight recorders are required by international regulation and together offer the best possibility of learning what happened in the minutes preceding any aviation accident or incident.