By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
In the last century, major changes in health care and technology, as well as simple progress in such innocuous conveniences such as public water fountains, have dramatically improved the quality of life. These have increased the average life expectancy in the United States from 47 years in 1900 to 78 years in 2011 almost doubling life expectancies. Health advances achieved throughout the 20th century and into the 21st are a result of investments and improvements in scientific, technical, legal, and political resources for the purpose of improving living conditions.
This blog is the third in a series of four in which I will discuss these. The first part of the series can be found here. The second part of the series can be found here.
Following are the next four of a list of seventeen of the most important achievements in health care and quality of life. It should serve as a reminder of how health innovations and common science have improved the comfort and longevity of our lives.
11. Motor-Vehicle Safety.
Although six times as many people drive today as in 1925, the annual death rate has declined by 90%, according to the Centers for Disease Control (CDC).
Improvements in motor-vehicle safety have contributed to this large reduction in motor-vehicle-related deaths. Engineering efforts have made both vehicles and highways safer. Vehicles were built with new safety features, including head rests, energy-absorbing steering wheels, shatter-resistant windshields, and safety belts. Roads were improved with edge and center line stripes and reflectors, use of breakaway signs and utility poles, improved illumination, addition of barriers separating oncoming traffic lanes, and guardrails.
Changes in driver and passenger behaviors have also reduced motor-vehicle crashes and injuries. Enforcement of laws against driving while intoxicated (DWI) and enforcement of safety-belt usage, child-safety seats, and motorcycle helmets have contributed to creating drivers and passengers that are more aware of motor-vehicle safety.
When I was still in college, most states did not have any "open container" laws that prohibited drinking and driving. In fact, many liquor stores, lounges and bars had drive-up windows where motorists could drive-up and be served a cocktail or beer in their car. This is a thing of the past.
The biggest lifesavers are probably vehicle safety restraints (seat belts together with air bags) as well as the nationwide crackdown in the form of DUI laws.
12. Workplace Safety.
Throughout the early years of the 20th century, work-related health problems, injuries and deaths were a significant concern. Efforts by labor and management, state labor and health authorities, and government agencies to improve worker safety resulted in a major decline in deaths from work-related injuries.
Through research, education, and regulatory activities these groups created physical changes in the workplace. Such changes include improved ventilation and dust suppression in mines; safer equipment; development and introduction of safer work practices; and improved training of health and safety professionals and of workers.
Because of these changes, deaths from unintentional work-related injuries declined 90% from 1933 through 1997, while the workforce more than tripled, according to the CDC.
13. Food Safety.
During the early 20th century, food was to be eaten with caution. Contaminated food, milk, and water caused many infections, including typhoid fever, tuberculosis, botulism, and scarlet fever. Public awareness of unsafe foods dramatically increased after the publication of Upton Sinclair's The Jungle in 1906. The Jungle graphically details the unsanitary food production methods of the Chicago meat-packing industry.
The passage of the Pure Food and Drug Act soon followed. The sources and characteristics of foodborne diseases were then identified and could be controlled by handwashing, sanitation, refrigeration, pasteurization, and pesticide application.
Since the early 1900s, safer and healthier foods have resulted from decreases in microbial contamination and increases in nutritional content. Everything from public health inspections of restaurants to mandatory pasteurization of milk has helped to eliminate food-borne bacteria and illnesses.
Requiring manufacturers to sterilize bottles and cans for commercially prepared foods has also worked to reduce botulism and other food-borne illnesses.
Even techniques which are often unfairly criticized, e.g., adding chemical preservatives to commercially prepared foodstuff, have helped to greatly reduce bacterial and microbial illnesses spread through food products.
14. Tobacco Health Hazard Education.
During the first decades of the 20th century, smoking was a popular and socially acceptable behavior. At that time, lung cancer was rare. However, as cigarettes became more popular, the rate of occurrence of lung cancer reached epidemic proportions, according to the CDC. In 1930, the lung cancer death rate for men was 4.9 per 100,000; in 1990, the rate had increased to 75.6 per 100,000. Other diseases and conditions now known to be caused by tobacco use include heart disease, atherosclerotic peripheral vascular disease, laryngeal cancer, oral cancer, esophageal cancer, chronic obstructive pulmonary disease, intrauterine growth retardation, and low birthweight. Since the initial Surgeon General's report on the health risks of smoking in 1964, the prevalence of smoking among adults has decreased, and millions of smoking-related deaths have been prevented. This decrease can be attributed to:
- Public dissemination of scientific evidence of the relation among disease, tobacco use, and environmental exposure to tobacco;
- Restrictions on cigarette advertising;
- Counteradvertising by coalition groups; and
- Policy changes (e.g., enforcement of minors' access laws, legislation restricting smoking in public places, and increased taxation).
Brayer, Toni. "Top 10 Greatest Public Health Achievements of this Century." MyLifeStages. (May 26, 2011). From
Centers for Disease Control and Prevention. "Ten Great Public Health Achievements in the 20th Century." Centers for Disease Control and Prevention. (Aug. 20, 2008). From http://www.cdc.gov/about/history/tengpha.htm.
Childs, Dan and Susan Kansagra. "10 Health Advances That Changed the World." ABC News. (Sept. 20, 2007). From
Elliot, Jason. "What You Should Know About Drinking from a Public Water Fountain." Yahoo! Voices. (March 21, 2007). From
Stibich, Mark. "Top Life Expectancy Achievements." About.com. (Sept. 29, 2009). From http://longevity.about.com/od/wholiveslongest/tp/life-expectancy-successes.htm?p=1
Wight, David. "A Pound of Cure." The Costco Connection. (April 2012).
About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.
Tag words: public health, health innovations, health achievements, health care advances, centers for disease control and prevention, vaccines, health improvements, workplace safety, motor vehicle safety, heart disease prevention, tobacco education, radiology, radiologic imaging, organ transplants, antibiotics, anesthetic, antiseptic, motor-vehicle safety