Institute:Office of National Coordinator (ONC) Workforce Training Curriculum
Component:The Culture of Health Care
Unit:An Overview of the Culture of Health Care
Lecture:What is meant by "the culture of health care"
Slide content:Infectious Disease Deaths Controlled With Broad Social Improvements: Food, Housing, Sanitation 1.1 Chart: Health Sentinel, n.d. Used with Permission. 9
Slide notes:This slide illustrates what we've been talking about. The chart shows the United States mortality data for the period between 1900 and 1963 for diseases including measles, scarlet fever, typhoid, whooping cough, and diphtheria. In modern times, all of these are illnesses for which we have specific vaccines or medications to prevent or treat them. However, if you look at the graph, most of the improvement in mortality for these diseases happened before our modern treatments were available. Consider typhoid fever. It appears as a very dark blue line in the chart. Today we treat this disease with antibiotics and can prevent it with an oral vaccine, but antibiotics only became available in the mid-20th century and as you can see from the chart, typhoid fever mortality declined about tenfold before antibiotics were ever available. The improvements were mainly due to improvements in sanitation, water supply, and housing. Even today, most of the deaths in persons who get treated are in those who are malnourished or otherwise in a weakened state. Similarly, mortality from measles fell substantially before the measles vaccine became available in the 1960s; mortality from scarlet fever also fell dramatically before antibiotics became available in midcentury. The point here is that broad social and cultural factors, such as improved sanitation, improved nutrition, and reduced overcrowding, were the major contributors to reducing mortality due to these serious infectious diseases. Modern treatments delivered through the health care system have continued to improve things. Most of what we call health, in terms of longer life expectancy and better quality of life, is the result of other factors. 9