Healthier People: 20 Years of Public Health Achievements

Ingrid G. Hein

November 20, 2015

In This Article

Unintentional Injuries

Motor Vehicle Accidents

Motor vehicle fatalities per 100,000 population from 1995 to 2013 declined from approximately 16% to 10%. Seat belt laws, safer vehicles, and improved safety of roadways and regulations all played a part.[25]

"The car used to be a death trap," says Benjamin. "Now we have better designs with side air bags and wheels that don't lock up." He also points to new telescopic steering wheels that retract in the case of a crash, minimizing potential injury to the driver.

Blumenthal agrees that we have made progress but notes that new problems are always arising. "When I first heard 'Don't text and drive,' I thought, are you kidding me? I can't even walk and text at the same time. I keep bumping into stuff!"

But a downward trend on motor vehicle safety has not been secured. According to the National Highway Traffic Safety Administration, in 2012, a total of 33,561 people died in motor vehicle crashes in the United States—a 3.3% increase, the first increase in fatalities since 2005, when there were 43,510 fatalities.[25]

US Transportation Secretary Anthony Foxx responded to the increase, saying, "As we look to the future, we must focus our efforts to tackle persistent and emerging issues that threaten the safety of motorists, cyclists, and pedestrians across the nation."[26]


"In the past 20 years, we have come to be aware of violence as a public health issue. It used to be seen as only a police issue," says Blumenthal.

"We have seen that we can help some of those people engaged in violence. Educational programs keep young people busy after school and during the summers. The thing we haven't achieved is gun control. I'm not optimistic about that, but it's an important challenge," he adds.

Khan agrees. "There has been no effective conversation about deaths from firearms. The Brady bill[27] is more than 20 years old. We need stricter background checks. Children still die daily, and we have done little about it."

Gun deaths since 1999 are on the rise. Firearm fatalities outpaced motor vehicle deaths in 14 states and the District of Columbia in 2011, according to the Violence Policy Center (VPC). "Gun violence is a public health crisis with an unacceptable toll on human life," says VPC Legislative Director Kristen Rand. "To reduce gun death and injury, firearms must be regulated for health and safety just as we regulate motor vehicles and all other consumer products."[28]

Substance Use and Addiction

In 2013, an estimated 24.6 million Americans aged 12 years or older—9.4% of the population—had used an illicit drug in the past month. This number is up from 8.3% in 2002.[29] The increase mostly reflects the recent rise in the use of marijuana, the most commonly used illicit drug.

"Drugs and alcohol continue to be a challenge," Benjamin laments, "And the problem is increasing, with inadequate resources to address it."

Rates of heroin use have more than doubled since 2002 in the United States. In 2013, an estimated 517,000 persons reported past-year heroin use or dependence.[30,31] The substances reported to be used prior to heroin included alcohol, marijuana, cocaine, or opioid pain relievers.

Benjamin says, "We are seeing a lot of overdoses. We have an epidemic of opiate use and are seeing that opiates lead to people using heroin and other drugs." He said that people end up with a lot of prescription drugs in their medicine cabinets. "There are programs now in which people can give unused prescription drugs back. We need to do a better job at educating the public about the risks associated with drugs and perhaps prescribe less medication."


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