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Work-related health problems, such as coal workers' pneumoconiosis (black lung), and silicosis—common at the beginning of the century— have come under better control. Severe injuries and deaths related to mining, manufacturing, construction, and transportation also have decreased; since 1980, safer workplaces have resulted in a reduction of approximately 20% in the rate of fatal occupational injuries.
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Decline in deaths from coronary heart disease and stroke have resulted from risk-factor modification, such as smoking cessation and blood pressure control coupled with improved access to early detection and better treatment. Since 1972, death rates for coronary heart disease have decreased 21%.
Access to family planning and contraceptive services has altered social and economic roles of women. Family planning has provided health benefits such as smaller family size and longer interval between the birth of children; increased opportunities for preconceptional counseling and screening; fewer infant, child, and maternal deaths; and the use of barrier contraceptives to prevent pregnancy and transmission of HIV & other STDs.
Fluoridation of drinking water began in 1945 and in 1999 reaches an estimated 144 million persons in the US. Fluoridation safely and inexpensively benefits both children and adults by effectively preventing tooth decay, regardless of socioeconomic status or access to care. Fluoridation has played a minor role in the reductions in tooth decay (40-70% in children) and of tooth loss in adults (40-60%).
Recognition of tobacco use as a health hazard and subsequent public health anti-smoking campaigns have resulted in changes in social norms to prevent initiation of tobacco use, promote cessation of use, and increase exposure to environmental tobacco smoke.
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