Today is my mother's 90th birthday. She has the dubious distinction of being born the very day World War I began -- July 28, 1914, when Austria-Hungary declared war on Serbia after it failed to meet the conditions of an ultimatum it sent on July 23 following the Sarajevo assassination. Wife, mother, "career woman" (she served as pioneer self-help book author Dale Carnegie's personal secretary in the early 1940s) , she has seen a lot of life and a substantial amount of societal change -- almost all for the better.
When she was born, influenza and pneumonia, tuberculosis, dysentery, diphtheria, and measles were among the leading causes of death. At the time of her entrance into the world, life expectancy at birth in America was around forty-seven years.
Dramatic changes in public health policy and practice occurred in her lifetime: widespread vaccinations, control of infectious disease, fluoridation and chlorination of drinking water, safer sewage disposal and water treatment, a dramatic decline in food-borne diseases (mainly controlled by refrigeration), handwashing, sanitation, and pasteurization. Back then, lack of essential nutrients caused nutritional deficiency diseases such as goiter, rickets, beriberi, and pellagra -- diseases which have since essentially disappeared in the West.
About the time of her birth, 100 infants per l,000 died before reaching their first birthday. Since that time the infant mortality rate has plummeted to under seven per 1,000 births. Life expectancy has nearly doubled; today, the average life expectancy at birth is more than seventy-seven years.
Life expectancy would be even greater today -- had it not been for an event that occurred just months before my mom was born. In 1913, R.J. Reynolds introduced the first commercially successful "modern" cigarette -- Camels. Before that, cigarettes were primarily hand-rolled (safe matches were hard to come by then) -- and thus pipes, cigarettes, and "spit" tobacco were much more popular -- and much, much less hazardous. No one knew the exquisite dangers of tobacco in the form of a cigarette -- which could be deeply inhaled and used during all waking hours (as opposed to cigars and pipes, which were lit by the fire or candles in limited, ritualistic style).
Thomas A. Edison, with not a shred of medical data, did, however, issue an open letter about cigarettes a few weeks before my mother was born. On April 26th he declared that the dangerous element of the cigarette was the paper wrapper which caused "degeneration of the cells of the brain, which is quite rapid in boys...is permanent and uncontrollable...I employ no person who smokes cigarettes". Edison was off in his facts, but, in his own way, ahead of his time in his concern about the health impact of smoking cigarettes. His words of warning did nothing to stop the spectacular popularity of cigarettes as "dough boys" entered World War I -- and the blitz of advertising that followed in the 1920s and 1930s left America hooked on cigarettes -- with the myriad chronic diseases associated with that habit.
We have come a long way in public health since 1914 -- but with particular regard to that "new fangled" use of tobacco back then -- we still have a very long way to go.
Happy Birthday, Mom!
Elizabeth Whelan, Sc.D., M.P.H., is president and founder of the American Council on Science and Health.
