Year: 2005
Type: article
Abstract: I n this century we are progressing through three separate eras with dramatically different characteristics of health and illness.We entered the century in an era of infectious disease, with tuberculosis the number one killer of our population, and smallpox, diphtheria, tetanus, and other infectious illnesses extremely prevalent.A reduction in mortality from these diseases of over 99 percent (Fries and Crapo 1981;Cooper 1982) has led to the present era, where the major burdens of illness of the United States are the chronic diseases.Atherosclerosis and its complications, neoplasia, emphysema, diabetes, cirrhosis, and osteoarthritis have increased in prevalence even as the infectious illnesses which preceded them declined.It is one thesis of this discussion that this chronic disease era in its turn will slowly decline in significance, leaving a third era in which the major health problems of the United States will be directly related to the process of senescence, and where the aging process itself, independent of specific disease, will constitute a major burden of illness for the United States.The ultimate constraint within which we must develop health policy for the future is, of course, the limit of life itself.Man is mortal, and the limits to what presently may be accomplished in decreasing mortality are set by the life span of our species.In the following discussion, we will This paper was first delivered as a keynote address to the Institute of Medicine, National Academy of Sciences, Washington, October 20, 1982.
Source: Milbank Quarterly
Author: JAMES F. FRIES
Institutions: Stanford Medicine, Stanford University
Language: English
Subfield: Demography
Field: Social Sciences
Domain: Social Sciences
Open Access status: bronze
OpenAlex ID: W2110353535