SYMPOSIUM ON PUBLIC HEALTH

Abstract

Public Health and the Pediatrician, Knox E. Miller, M.D., District Director, U. S. Public Health Service, Federal Security Agency, Dallas, Tex. The era in which we live is one characterized by superlatives. Within less than an average life span have been crowded into human experience more epoch making developments wrought by human instrumentalities than in any dozen life spans in previous history. Though too familiar to you all to require recounting, they may be classified in general as measures and devices for labor saving and mechanical perfection, speedy communication and transportation, life conservation and life destruction. The recent war brought forth unparalleled refinement in methods for destroying human life, while medical science has been equally industrious in devising ways and means for health protection and life saving. The former enterprise we hope to see held in abeyance but the latter can and must continue on in its triumphs over the yet unresolved mysteries and obstacles. Of all the colossal human achievements within our era there is none so impressive as the downward trend of morbidity and mortality. From a general death rate in the registration area of 17.2 per 1,000 people in 1900 it has sunk to approximately 10 at the present time. Coincident with this there has been an increase in the life span from 49.25 years to about 65. Translated into more familiar terms, these figures mean that, if the death rate of 1900 had prevailed in 1946, in a population of 143,000,000, there would have been 1,029,600 more deaths than actually occurred during the latter year, or an annual saving of more than 1,000,000. Also the lengthened life span means that every group of 100,000 persons can look forward to 1,575,000 more years of life than a similar group in 1900. Of the many other thought provoking achievements, a few more will be mentioned. Since 1900 tuberculosis has dropped from second to seventh in the causes of death in the United States. As late as 1935 its mortality rate was 55.1 per 100,000 population. In 1945 it was 40.1. Up to 1940 only 10% to 15% of admissions to tuberculosis hospitals were minimal cases. Today, with modern case finding techniques, 65% to 70% of all cases found are minimal. Typhoid fever, diphtheria and smallpox are approaching the vanishing point.