The gradual increase in life expectancy tends to convince the medical profession that they are doing an outstanding job in providing superb medical care. We have accepted all types of heroic measures to add a year or even a month to individual longevity. It is always best to review where we have been and what was actually accomplished. Several things are interesting to note. There was no more rapid change in longevity when antibiotics were introduced. Dramatic cardiovascular surgery has not created any kind of sudden change in life expectancy. In spite of the highest cost for medical care, the United States does not lead the world except in cost (actually we are 49th in our world standing).
The major changes in the increased life expectancy have been accomplished by public health measures. The control of infectious diseases has played a much greater role than organ transplants and open heart surgeries. Smallpox, chickenpox, whooping cough, malaria and enteric infections as well as polio, meningitis and tuberculosis have all been made tractable. While physicians argue about who has done the most to influence longevity the slow and steady advances the result of public health measures have stolen the show.