In 2011, thanks to the triumph of public health and medical interventions, Americans will live 30 years longer, on average, than they did a century ago. In fact, there are more than 100,000 people in the United States who have lived to be more than 100. These dramatic advances have resulted in a shift in the threats to American's health. In the early 1900s, when average life expectancy was 48, the leading killers were infectious diseases like smallpox, tuberculosis and diphtheria, but today the major causes of death are chronic illnesses including heart and lung disease, cancer and stroke.
Many of these illnesses are preventable. Smoking, a health damaging behavior in which about 20 percent of the U.S. population engages, is the largest preventable cause of death in the U.S.  Furthermore, for every person who dies from a smoking-related illness, 20 more live with at least one smoking-related chronic disease such as lung disease, heart disease and cancer.  The two-thirds of Americans who are overweight or obese are at greater risk for cardiovascular disease, cancer, diabetes and stroke. If this trajectory is not changed, one in three children born today will develop type 2 diabetes as well as other obesity related illnesses, and as a result, this generation of children may become the first that does not live as long and is less healthy than their parents.  Alcohol abuse accounts for 79,000 premature and preventable deaths every year, and is linked to liver disease, cancer, cardiovascular illness, stroke and dementia.  Furthermore, 75 percent of the $2.6 trillion health care budget in America is associated with these preventable lifestyle factors.
There are also significant health disparities in our country. A recent report revealed significant differences in life expectancy among population groups in the United States. It described "Eight Americas" -- categories based on a combination of race and county of residence -- in which there is a 30 year life expectancy gap in the U.S. between a Native American man living in South Dakota whose lifespan is 58 years and an Asian American woman living in Bergen County, New Jersey whose life expectancy is 91. 
Developing and implementing strategies to reduce health damaging behaviors and injuries as well as to rectify health disparities -- perhaps more than any miracle medication that could be discovered--has the potential to reduce annual deaths in the U.S. by half as well as dramatically cut health care costs and disability.
The good news is that the recent health care reform legislation, The Patient Protection and Affordable Care Act of 2010, is fueling a prevention revolution by making many preventive and early detection services free at the doctor's office. It also establishes a $15 billion Prevention and Public Health Fund to invest in programs -- from smoking cessation to combating obesity -- that will help to keep Americans healthy. The legislation invests in both individual and community based programs to build environments that will foster healthier behaviors.
But there is also much that individuals and families can do to lead healthier lives. This New Year, make and keep resolutions to improve your health -- you will feel better and live longer. Listed below are some key ingredients of a prescription for a healthier future in 2011:
Find a doctor with whom you feel comfortable and get routine check ups. Enter into a partnership with your doctor for your health. If you ever have doubts about a physician's recommendations, get a second opinion. Make sure you obtain regular screening exams (cholesterol, blood pressure, pap smears, mammograms, prostate checks and colonoscopies depending on your age and sex). Keep your immunizations current, including pneumonia and seasonal flu vaccinations. Early detection and regular preventive care reduces the risk of disease and disability and saves lives and billions of dollars in health care costs for our nation.
Know and keep a record of your family health history. Some diseases run in families. Talk with your relatives to get information. Share this knowledge with your doctor. Learn about the signs and symptoms of these illnesses so that you can detect them early.
Quit smoking. If you don't smoke, please never start. If you do smoke, make a plan to stop and see it through. Smoking is the leading cause of preventable death in America and is linked to heart disease, cancer, stroke, emphysema and other chronic illnesses. Second hand smoke also significantly impairs the health of those who are in contact with smokers.
Eat smart. Eating a balanced diet rich in fruits, vegetables, fiber, whole grains, vitamins, folate and calcium that is low is saturated fats and salt is a critical ingredient in the recipe for a healthier future. Limit your fat intake to 30 percent of daily calories. Also try to incorporate lean meats and other sources of protein that are low in fat like tofu and legumes. Portion control is a key element! Visit nutrition.gov and mypyramid.gov for more information.  Eating smart will help you to maintain a healthy weight and reduce the risk of stroke, type 2 diabetes, coronary heart disease and certain cancers. 
Exercise regularly. Physical activity is one of the most important steps you can take towards a healthier future. If you are not currently exercising, start slowly and build up. Aim for at least 30 minutes at least five days a week of moderate-intensity aerobic exercise, or 1 hour and 15 minutes per week of high-intensity aerobic exercise. Cross train to avoid injury. Also remember to strength train all of your major muscle groups at least twice a week, and don't forget to stretch! Pick activities you like -- take stairs instead of elevators, dance, take a power walk instead of a power lunch. Try a pedometer and aim for 10,000 steps a day! Walking with others or going to the gym with friends can make exercise more enjoyable. Visit fitness.gov to learn more.
Exercise your mind as well. Turn off the TV! Playing Sudoku, doing crossword puzzles, joining a book club, or learning a new language or skill are great ways to keep your mind sharp and engaged. Choosing fun and meaningful activities also makes life more enjoyable.
Get enough sleep. Most adults need 7 to 8 hours of sleep per night. Getting a good night's rest leaves you refreshed, alert and ready to tackle the day's challenges. Adequate sleep can also help to reduce stress and give your body a chance to heal from illness and injury. To take advantage of these benefits, the National Sleep Foundation recommends establishing a regular bedtime routine, avoiding caffeine, alcohol, heavy meals, and exercise right before bedtime, as well as creating a dark, quiet, and comfortable environment to fall asleep in.
Limit alcohol intake -- if you drink, do so responsibly and only in moderation. While one glass a day of red wine might help prevent heart disease, remember that serious health issues are associated with its use including car crashes, alcohol abuse, increased risk of liver disease and some cancers. For women, more than 1 drink a day is associated with an increased risk of breast cancer.  Avoid alcohol totally if you are pregnant. Never drink and drive. And drugs? Don't, unless they are prescribed for you and then be sure to take them for the recommended period of time.
Schedule regular skin exams. Skin cancer is on the rise. Perform self-exams looking for growths with irregular shapes and colors. Have your skin checked annually. Above all, practice preventive medicine. Use sunscreens and be a shade worshiper. While adequate vitamin D from the sun has been shown to have important health benefits, taking a supplement to get sufficient amounts may be necessary for some people.
Be safe. Be safe in your home, in your workplace, on your bike, in your car, outdoors and in your sexual practices. Wear a helmet, use your seat belt, wear sun screen, check your smoke alarms and install a carbon monoxide detector in your home.
Be ready in case of an emergency. Be prepared in the event of a disaster such as a tornado, hurricane, terrorist attack or flu pandemic. Develop a family plan and communication strategy. For more information, call 1-800-Be-Ready or visit www.ready.gov and www.fema.gov. Know what you can do to keep safe from the flu: practice good hygiene, wash hands, cover coughs, get vaccinated for seasonal flu (this year's vaccine provides protection against H1N1, which was pandemic in 2009), and avoid settings with people who are ill. Check out www.pandemicflu.gov to learn more.
Find your own stress buster. Find time in the day that's just for you. Take a walk, read a book, practice yoga. Make sure you have time to engage in the activities in life that bring you joy and satisfaction.
Stay connected with your social network. Having strong connections to others can improve your health and longevity. It's also more fun and easier to engage in healthy behaviors if others join you. Many studies have shown that relationships influence our long term health in ways that are as powerful as a healthy diet and getting enough sleep. These benefits extend to givers and receivers of support. A lack of connections, on the other hand, is associated with increased mortality by as much as 50 percent, depression, and a decline in cognitive function later in life. It's the quality of relationships that makes the difference, so visit with your friends and family regularly, reach out to new contacts, and enjoy developing meaningful connections.
Know your health care plan. The recently passed health care reform legislation, The Patient Protection and Affordable Care Act, ensures that all Americans have access to quality health care by 2014. It also ends discriminatory health insurance practices such as denying health insurance due to a pre-existing condition, removes the lifetime cap on insurance benefits, and requires insurance companies to spend 85 percent of every health insurance dollar on benefits rather than administrative costs or profits. 44,000 Americans lose their lives because they don't have access to health care.  The new law will expand access to health services, helping to enroll as many as 32 million Americans who currently lack insurance coverage. In 2014, the new state health insurance exchanges will regulate the quality of participating insurance plans and will provide consumers with standardized information about the various plans that is easy to compare. But you don't have to wait until 2014 to benefit from the law. Starting now, certain health plans are required to cover preventive services, and for seniors the Medicare "donut hole" -- the gap in prescription drug coverage -- will begin to close. Choose a health care plan that is right for you and your family. For more information, visit healthcare.gov.
Be a savvy health consumer. Read as much as you can and use trustworthy Internet sites (see list below) for reliable health information. Know your health plan. Be informed. Knowledge is power when it comes to your health and the health of your family, business and community.
By following the steps in this prevention prescription, we can move towards a healthier future for ourselves, our families, and our country in the New Year and beyond.
1. Centers for Disease Control and Prevention. Inhaling Tobacco Smoke Causes Immediate Harm. December 9, 2010. Electronic document, retrieved December 14, 2010,
2. Centers for Disease Control and Prevention. Inhaling Tobacco Smoke Causes Immediate Harm. December 9, 2010. Electronic document, retrieved December 14, 2010,
3. Centers for Disease Control and Prevention. Overweight and Obesity: Health Consequences. August 19, 2009. Electronic document, retrieved December 14, 2010.
4. Centers for Disease Control and Prevention. Fact Sheets: Alcohol Use and Health. July 20, 2010. Electronic document, retrieved December 14, 2010.
5. Murray CJL, Kulkarni SC, Michaud C, Tomijima N, Bulzacchelli MT, et al. (2006) Eight Americas: Investigating mortality disparities across races, counties, and race--counties in the United States. PLoS Med 3: e260. doi:10.1371/journal.pmed.0030260.
7. FDA. Dietary Guidelines for Americans, 2005.
8. Allen NE, Beral V, Casabonne D, Kan SW, Reeves AB, and Green J. (2009) Moderate Alcohol Intake and Cancer Incidence in Women. JNCI Natl Cancer Inst 101(5): 296-305. First published online February 24, 2009, accessed at
9. Wilper AP, Woolhandler S, Lasser KE, McCormick D, Bor DH, Himmelstein DU. Health Insurance and Mortality in U.S. Adults. American Journal of Public Health, Sept. 17, 2009 (online); print edition Vol. 99, Issue 12, December 2009.
Recommended Websites for More Information:
Rear Admiral Susan Blumenthal, M.D., M.P.A. (ret.) is the Public Health Editor of the Huffington Post. She is the Director of the Health and Medicine Program at the Center for the Study of the Presidency and Congress in Washington, D.C., a Clinical Professor at Georgetown and Tufts University Schools of Medicine, Chair of the Global Health Program at the Meridian International Center, and Senior Policy and Medical Advisor at amfAR, The Foundation for AIDS Research. Dr. Blumenthal served for more than 20 years in senior health leadership positions in the Federal government in the Administrations of four Presidents, including as Assistant Surgeon General of the United States, the first Deputy Assistant Secretary of Women's Health, as a White House Advisor on Health, and as Chief of the Behavioral Medicine and Basic Prevention Research Branch at the National Institutes of Health. Admiral Blumenthal has received numerous awards including honorary doctorates and has been decorated with the highest medals of the US Public Health Service for her pioneering leadership and significant contributions to advancing health in the United States and worldwide. She is the recipient of the 2009 Health Leader of the Year Award from the Commissioned Officers Association and was recently named a 2010 Rock Star of Science.
Research assistance for this article was provided by:
Brigitte Hurtubise, a recent graduate of the University of Pennsylvania, is a Health Policy Fellow at the Center for the Study of the Presidency and Congress in Washington D.C.
Deirdre Horvath, a recent graduate of Wesleyan University, is as Health Policy Fellows at the Center for the Study of the Presidency and Congress in Washington D.C,
Sophie Turrell, a recent graduate of Yale University, is the Health Policy Research Associate at the Center for the Study of the Presidency and Congress.
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