Why America's Public Health Has Always Been Fragmented

Governing: When the 20th century began, the leading causes of death in the United States were all infectious diseases — pneumonia, influenza, tuberculosis, gastrointestinal infections and diphtheria. No one worries much about diphtheria anymore. Or cholera or yellow fever or other infectious diseases that triggered terror and caused death throughout the 19th century.

Improvements in sanitation, antibiotics and vaccinations have all limited the spread of infectious diseases. As a result, life expectancy at birth has increased in the U.S. by more than three full decades of life — from 47.3 years in 1900 to more than 78 today.

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