IMPROVING HEALTH OF UNITED-STATES, 1850-1915
IMPROVING HEALTH OF UNITED-STATES, 1850-1915
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DOI：
10.1016/0014-4983(71)90066-0
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发表时间：
1972-01-01
影响因子：
2.3
通讯作者：
MEEKER, E
中科院分区：
文献类型：
--
作者：
MEEKER, E
从1850年到1915年，美国人的健康状况得到了前所未有的改善。男性出生时的预期寿命从19世纪50年代的大约41岁上升到1915年的53岁以上。粗死亡率从五十年代每1 000人死亡22人左右下降到这一时期末期的15人左右。与此同时，人们死于的疾病类型也发生了重大变化。1850-1860年间最重要的致命疾病是传染病。心脏病和其他老年疾病相对来说不重要。到1915年，情况发生了逆转。关于19世纪后半叶美国人健康状况的可靠数据很少，这使得人口统计学家很难确定整个美国健康状况改善的趋势。正如人们所预料的那样，在这种情况下，学者们对健康改善的时间路径远非一致。在本文中，我试图证明这种趋势是可以导出的。更具体地说，我试图证明健康状况的根本转变发生在八十年代的十年，平均死亡率和预期寿命几乎没有改善，很可能在1880年之前恶化，但此后迅速改善。为了证明这个时间路径是正确的，我将给出这一时期前半段的死亡率的新估计。此外，我将提出关于决定健康状况的变量的新证据，并证明在19世纪后半叶，这些变量变化的时间如何与健康状况直到1880年左右才开始迅速改善的假设相当吻合。
The period from 1850 to 1915 witnessed unprecedented improvements in the health of Americans. Male expectation of life at birth rose from approximately forty-one years in the 1850s to over fifty-three years by 1915. The crude death rate fell from approximately twenty-two deaths per 1,000 living during the fifties to about fifteen at the end of the period. At the same time an important change occurred in the types of diseases from which people died. The most important fatal diseases during the decade 1850-1860 were infectious ones. Heart disease and other diseases of old age were relatively unimportant. By 1915 the pattern was reversed. There is a paucity of sound data on the American health experience during the last half of the nineteenth century, making it very difficult for demographers to specify the trend of health improvement for the United States as a whole. As one might expect under these circumstances, scholars are far from agreement as to the time path of health improvement. In this paper I attempt to show that the trend can be derived. More specifically, I attempt to demonstrate that a fundamental transition in the state of health occurred in the decade of the eighties, that average mortality and life expectancy improved little, and very likely worsened, prior to 1880, but improved rapidly thereafter. To show that this time path is the correct one, I shall present new estimates of mortality for the first part of the period. In addition I shall present new evidence on the variables that determine the state of health and demonstrate how the timing of changes in these variables during the last half of the nineteenth century conforms rather well with the hypothesis that health improved very little until about 1880, and then began to improve rapidly.