IsisCB Explore

Thesis ID: CBB114540913

Explaining the Decline of Coronary Heart Disease Mortality in the United States in the 1960s: an Historical Analysis (2015)

Leslie Steven Leighton (Author)
Kushner, Howard I. (Advisor)

Emory University
Kushner, Howard I.
Publication date: 2015
Language: English

URI: http://search.proquest.com/docview/1692526093?accountid=12964

Outside Links

PubMed

Health Medicine Mortality Cardiology Heart Disease and diseases 20th century

Coronary heart disease (CHD) as a chronic disease came to attention in the United States and other countries in the early 20 th century. Over the course of the 20th century its incidence rose to epidemic proportions and it became the leading cause of death in this country as well as most industrialized nations. Prevention and treatment of the disease evolved over the century and mortality plateaued in the U.S. in the 1960s and by all accounts began to decline by the end of the decade. The reason for the decline has been speculated and investigated since the 1970s, when it was first fully recognized, but has never been adequately explained. This dissertation takes a critical look at CHD and its evolution as a disease and major cause of death over the course of the twentieth century. More pointedly it attempts to explain the reason or reasons for the abrupt initial decline in its mortality which began in 1968 and has continued to date. As a result of archival research and oral histories, as well as statistical analysis, it is clear that there is no one single explanation for the initial decline in disease mortality. After 1974 it appears that both prevention and treatment played important roles in reducing the mortality of CHD but the initial decline in 1968 appears to have been the result of a number of factors, the least of which seems to be prevention. By the data amassed in this dissertation it is unlikely that mitigation of what are considered the major risk factors for CHD, including elevated serum cholesterol, hypertension and smoking, resulted in an initial reduction in mortality. Much more likely it was a number of incremental changes that occurred in the treatment of the disease, including the cardiac chair (an end to prolonged bed rest as treatment), the advent of the coronary care unit, the professionalization of the specialty of cardiology, Medicare and Medicaid that together led to a reduction in CHD mortality.

...More

Citation URI

data.isiscb.org/p/isis/citation/CBB114540913

This citation is part of the Isis database.

Citations Indexes

Similar Citations

Article Nicholas Binney; (2018)
The function of the heart is historically contingent (/p/isis/citation/CBB696611235/)

Book Pollock, Anne; (2012)
Medicating Race: Heart Disease and Durable Preoccupations with Difference (/p/isis/citation/CBB001420205/)

Book Hurst, J. Willis; Conti, C. Richard; Fye, W. Bruce; (2003)
Profiles in Cardiology: A Collection of Profiles Featuring Individuals Who Have Made Significant Contributions to the Study of Cardiovascular Disease (/p/isis/citation/CBB000471201/)

Article Harris, Bernard; Gorsky, Martin; Guntupalli, Aravinda; Hinde, Andrew; (2011)
Ageing, Sickness and Health in England and Wales during the Mortality Transition (/p/isis/citation/CBB001210679/)

Book Levy, Daniel; Brink, Susan; (2005)
A Change of Heart: How the Framingham Heart Study Helped Unravel the Mysteries of Cardiovascular Disease (/p/isis/citation/CBB000641628/)

Article Jones, David S.; (2000)
Visions of a Cure: Visualization, Clinical Trials, and Controversies in Cardiac Therapeutics, 1968-1998 (/p/isis/citation/CBB000111163/)

Book Fabio Zampieri; Sabino Illecito; (2022)
The Heart in Antiquity: A Journey through Egypt, Mesopotamia, India, China, Pre-Hispanic America, and Greece (/p/isis/citation/CBB258088710/)

Book Jones, David S.; (2013)
Broken Hearts: The Tangled History of Cardiac Care (/p/isis/citation/CBB001214282/)

Article Ziskind, Bernard; (2006)
L'examen cardiovasculaire à la lumière des papyrus médicaux de l'Egypte ancienne (/p/isis/citation/CBB000931796/)

Book Hamraoui, Eric; (2002)
Philosophie du progrès en cardiologie (/p/isis/citation/CBB000771385/)

Article Danesh-Pajouh, Mohammad; (2006)
The History of Cardiology: The Era from Galen to William Harvey (/p/isis/citation/CBB001510462/)

Chapter Singh, Abhay Kumar; (2010)
Disease, Morbidity and Mortality in the Indian Ocean World, 1500--1800 (/p/isis/citation/CBB001500560/)

Article Aronowitz, Robert A.; (2011)
The Framingham Heart Study and the Emergence of the Risk Factor Approach to Coronary Heart Disease, 1947--1970 (/p/isis/citation/CBB001036212/)

Article Howell, Joel D.; (2011)
Coronary Heart Disease and Heart Attacks, 1912--2010 (/p/isis/citation/CBB001230162/)

Article Murray, John E.; (2003)
Social Insurance Claims as Morbidity Estimates: Sickness or Absence? (/p/isis/citation/CBB000770495/)

Book Fuchs, Thomas; (2001)
The Mechanization of the Heart: Harvey and Descartes (/p/isis/citation/CBB000320365/)

Article Vilarinho, Yuri C.; (2014)
Irritable Heart Syndrome in Anglo-American Medical Thought at the End of the Nineteenth Century (/p/isis/citation/CBB001552700/)

Book Michaels, Leon; (2001)
The Eighteenth-Century Origins of Angina Pectoris: Predisposing Causes, Recognition and Aftermath (/p/isis/citation/CBB000101567/)

Article Padiak, Janet; (2005)
The Role of Morbidity in the Mortality Decline of the Nineteenth Century: Evidence from the Military Population at Gibraltar 1818--1899 (/p/isis/citation/CBB000671035/)

Article Beemer, Jeffrey K.; (2009)
Diagnostic Prescriptions: Shifting Boundaries in Nineteenth-Century Disease and Cause-of-Death Classification (/p/isis/citation/CBB001231860/)