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Closing the Gap: The Burden of Unnecessary Illness

Jimmy Carter
JAMA. 1985;254(10):1359-1360. doi:10.1001/jama.1985.03360100109024.
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Improvements in medical technology and health care have led most Americans to expect long and healthful lives. In part, these expectations have been realized. Nevertheless, despite remarkable accomplishments by the American medical community, there exists a gap between what is and what could be the health of the American people. Hundreds of thousands of illnesses and deaths occurring each year are unnecessary in light of currently available medical knowledge. Such occurrences pose a double burden for our nation: the impact on the victims themselves, and the diversion of medical resources from unavoidable health problems. Recognizing this condition, I directed The Carter Center (established at Emory University shortly after I left the White House) to determine the factors most responsible for unnecessary morbidity and mortality in the United States, and to recommend intervention strategies to reduce or eliminate those factors.

The Carter Center consultants analyzed the burden imposed by cancer, heart


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