Mortality and morbidity considerations

An understanding of the mortality and morbidity patterns in the modern human being is essential to the planning of preventive programs. The great infectious diseases of the past, such as tuberculosis, syphilis, smallpox, influenza, diphtheria and streptococcal infections, have been largely contained but other diseases have become prominent as life expectancy increases. The great modern diseases are atherosclerosis (hardening of the arteries), malignant disease (cancer), HIV infection and iatrogenesis (doctor-induced illness).

These diseases and the common causes of mortality (Table 9.1) act as a focus for our energies in addressing preventive programs.

It is worth focusing on the changes in disease indices during the past generation in order to evaluate the effect of preventive and health promotion programs during this period (Table 9.2). 3 The messages are to harness and promote with renewed vigour those strategies that are working, such as prevention of death from coronary artery disease and motor vehicle accidents, and to reevaluate those important areas such as Aboriginal mortality, HIV infection, cancer, suicide and asthma which are bad news!

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