![]() 16 Of note, except for diabetes in Hispanics and unintentional injury in American Indians, both groups have lower rates than whites for the leading causes of death Asians have the lowest rates for all major causes of death except cerebrovascular disease. For example, blacks suffer higher rates of death for almost all leading causes ( Table 2). Similarly, stratification of mortality data by race and ethnicity helps to quantify health disparities. For example, infant deaths are dominated by congenital anomalies, short gestation, and sudden infant death syndrome (SIDS) young adults are killed primarily by intentional and unintentional injuries ( Table 1). 15 Age-specific mortality rates provide additional insights that might influence policy decisions. For example, in the United States, chronic diseases-cardiovascular disease, cancer, chronic lung disease, and diabetes-are leading causes of death, followed closely by unintentional injuries and influenza. Numbers and rates of deaths have been used for centuries to measure burden and to compare the impact of diseases. Finally, we describe new measures needed to assess the public’s health and monitor the effectiveness of public health programs and practice. In this article, we discuss general characteristics of useful measures of the public’s health as well as activities that are essential to protect the public’s health even though their impact might be difficult to measure. We analyzed selected traditional measures of public health, including morbidity, mortality, and disability, and their related costs, as well as summary measures of burden and quality of life, which can be used to prioritize conditions for attention ( Figure). In 1946, the World Health Organization (WHO) defined health as “… a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” 14 Today, despite extensive analytic efforts to assess health more accurately, measures available to evaluate the health of populations continue to be morbidity, mortality, and disability. 13 However, successful efforts require developing and validating better measures of the public’s health and associated costs to guide rational decisions about the allocation of limited resources. Rebalancing the investment portfolio to emphasize health protection and prevention of those conditions with high burden and cost is a logical strategy. The anticipated increase in health care costs and inequities 12 in access to the benefits of our health system should stimulate vigorous dialogue regarding solutions. The increasingly older age distribution in the United States is an indication that these costs will continue to increase in future years. Although national health expenditures took 10 years to grow from 12% of GDP in 1990 to 13.3 % in 2000, these expenditures took only one year to grow to 14.1% in 2001. 11 Medicaid and Medicare alone accounted for one-third of these costs. ![]() 10 In 2002, spending for health care in the United States was $1.6 trillion when adjusted for inflation, this is a fivefold increase from 1970. 8, 9 Medicare spending has been projected to increase from 2% to 6% of the gross domestic product (GDP) from 2004 to 2050. Whereas longer life, if accompanied by improved health in advanced years, will have only a slight impact on health costs, 7 longer life with no improvements in health will cause increased use of new health care technologies and escalate spending, not only for direct medical care, but also for long-term care of older persons and those living with disabilities. In addition, age-adjusted quality of life as measured by healthy days has decreased over time. 2 Similar projections have been made for obesity, 3 diabetes mellitus, 4 chronic lung disease, 5 and other chronic conditions. The projections for prevalent cases of Alzheimer’s disease, for example, will more than double by 2030. An older population will suffer from more chronic disease, even if age-specific prevalence of conditions remains stable. 1 Because of persisting inequities in health status, these demographic changes will have a dramatic impact on health. population in 2050 will be white the largest increases will be seen in Hispanic and Asian populations. 1 More than 20% of the population will be over 65 years, an increase from 12.5% in 2003. population is projected to increase by approximately 40% to more than 400 millions persons. ![]() By the middle of the 21st century, the U.S. ![]()
0 Comments
Leave a Reply. |
Details
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |