From the Centers for Disease Control and Prevention. Achievements in public health, 1900-1999: changes in the public health system.

Public Health System — Continued The 10 public health achievements highlighted in this MMWR series (see box) reflect the successful response of public health to the major causes of morbidity and mortality of the 20th century (1–11 ). In addition, these achievements demonstrate the ability of public health to meet an increasingly diverse array of public health challenges. This report highlights critical changes in the U.S. public health system this century. In the early 1900s in the United States, many major health threats were infectious diseases associated with poor hygiene and poor sanitation (e.g., typhoid), diseases associated with poor nutrition (e.g., pellagra and goiter), poor maternal and infant health, and diseases or injuries associated with unsafe workplaces or hazardous occupations (4,5,7,8 ). The success of the early public health system to incorporate biomedical advances (e.g., vaccinations and antibiotics) and to develop interventions such as health education programs resulted in decreases in the impact in these diseases. However, as the incidence of these diseases decreased, chronic diseases (e.g., cardiovascular disease and cancer) increased (6,10 ). In the last half of the century,