The Greatest Health Advances that Changed our Lives in the Past Century: Part 4

Thursday, May 3, 2012

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 final part of 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. The third part of the series can be found here.

Following are the last three 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.

15. Water Fountain Design.
Changes in the way we drink water have also assisted in improving public health. One such change involves the improved structure of drinking water fountains. The government changed drinking water fountains in the early 20th century due to an outbreak of illnesses. During that time, drinking water fountains had a vertical spout. Research supported that the vertical spouts were contributing to the illnesses because water would touch the mouth of the consumer and fall right back down into the spout. Arched water spouts now decrease instances of contaminated water coming in contact with the water spout.

16. Fluoridation of Water Supplies.
The fluoridation of drinking water, which began in 1945, has also had an impact on public health. According to the Centers for Disease Control (CDC), this process safely and inexpensively benefits both children and adults by preventing dental caries (tooth decay).

Dental caries is attributed to causing loss of tooth structure and dental function, as well as more serious ailments. For example, researchers have found that people with poor dental hygiene are more likely to suffer from heart disease and stroke. Drinking fluoridated water reduces the chances of developing dental caries, as well as other health problems associated with poor dental health.

Water fluoridation is especially beneficial for communities of low socioeconomic status, which have more occurrences of dental caries. These communities have less access than higher income communities to dental-care. Water fluoridation assists in reducing dental health problems, and other health problems that are caused by poor dental hygiene.

Although other fluoride-containing products are available, water fluoridation remains the most equitable and cost-effective method of delivering fluoride, regardless of socioeconomic status.

17. Food Additives and Supplements.
Rickets, goiter and other diseases caused by a lack of required nutrients were common one hundred years ago. The simple addition of minor, unnoticeable quantities of vitamins, minerals and elements to certain every day foods has almost eliminated these diseases from American life.

Food restrictions and shortages during the first world war led to scientific discoveries in nutrition that quickly led to new public health policies. In 1924, iodine was added to salt to prevent goiter. Milk became fortified with vitamin D in 1933 to help prevent rickets. In the 1940s, the enrichment of flour with niacin helped to eliminate pellagra.

In 1941, President Franklin D. Roosevelt convened the National Nutrition Conference for Defense. This led to the first recommended dietary allowances of nutrients, and resulted in a program to enrich wheat flour with vitamins and iron. The most recent food fortification program was initiated in 1998 when folic acid was added to cereal and grain products to prevent neural tube defects.

Sources Include:

American Academy of Periodontology. "Gum Disease Links to Heart Disease and Stroke." American Academy of Periodontology. From

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

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." (Sept. 29, 2009). From

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.  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, food fortification


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