Health care and public health professionals in the United States can look at their achievements over the last century with pride. Increasing the life span of Americans by almost one-third of a year each year over an entire century is an enormous and unprecedented accomplishment. The virtual elimination of many childhood illnesses, control of cardiovascular disease and stroke, effective treatment of pneumonia, and reductions in infant mortality exemplify the remarkable progress made. Along with changes in the social and physical determinants of health, these improvements are often attributed either to application of better medical knowledge or to public health actions, but have really required both.
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