Triangulating on success: innovation, public health, medical care, and cause-specific US mortality rates over a half century (1950-2000)

Abstract

To identify successes in improving America's health, we identified disease categories that appeared on vital statistics lists of leading causes of death in the US adult population in either 1950 or 2000, and that experienced at least a 50% reduction in age-adjusted death rates from their peak level to their lowest point between 1950 and 2000. Of the 9 cause-of-death categories that achieved this 50% reduction, literature review suggests that 7 clearly required diffusion of new innovations through both public health and medical care channels. Our nation's health success stories are consistent with a triangulation model of innovation plus public health plus medical care, even when the 3 sectors have worked more in parallel than in partnership.

FIGURE 1

Conceptual framework of interdependence of research innovation, clinical practice implementation, and public health advances in achieving America's health success stories: 1950–2000.