社区医学与健康教育

抽象的

The Contribution of Public Health and Improved Social Conditions to Increased Life Expectancy: An Analysis of Public Awareness

Gordon B Lindsay, Ray M Merrill, Riley J Hedin

Background: Historical analysis of health data suggests the majority of the life expectancy increase that occurred during recent centuries was caused by improvements in public health and social determinants of health. The purpose of this study was to assess lay public perceptions regarding why life expectancy has increased. Methods: A nationally representative sample of 705 adults were surveyed to determine which factors people credit for the 40 plus year increase in life expectancy that occurred since the mid-1800s. Survey items included open-ended questions, rank ordering of possible explanations, and numeric estimates of attribution. Results: Participants in the study rarely attributed increased life expectancy to public health measures or improvements in social health determinants. In contrast, subjects believed that medical care, by far, played the predominant role and attributed medical care for causing 80% of the life expectancy increase. Conclusion: The public grossly overestimates how much of our increased life expectancy should be attributed to medical care and is largely unaware of the critical role played by public health and improved social conditions determinants. These misperceptions may hinder adequate public health funding and efforts to address important health-related social issues. Misattribution of credit may also contribute to overfunding the medical sector of the economy and impede efforts to contain health care costs.