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  Chapter Eight:

  Health of Children
  Health of Adults
  STDs and AIDS
  Illegal Drugs
  Accidental Deaths
  Hospital Patients
  Health Care Costs
  Mental Patients
  Disabled Persons



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The incidence of sexually transmitted infections did not decline as much as that of other infectious diseases. In the last two decades of the century, the AIDS epidemic took a heavy toll of lives.
As the upper chart shows, the incidence of syphilis increased sharply from 1920 to 1943, when the number of reported cases per hundred thousand people reached an all-time high, presumably because of the proliferation of commercial sexual activity around military bases. Penicillin and other antibiotics brought a steady decline in the incidence of syphilis per hundred thousand people from its peak of 447 cases in 1943 to 18 cases in 1997. The 1997 rate, the latest available at this writing, was the lowest on record for this country. 

The incidence of gonorrhea followed a different trend. Its incidence, like that of syphilis, reached a peak during World War II and then declined. In the 1960s, the rate began to climb again, apparently because of the increase in premarital sexual activity. The incidence of gonorrhea per hundred thousand people peaked at 441 cases in 1980 and declined steadily to 121 cases in 1997. 

The most severe of the sexually transmitted diseases—indeed one of the most severe diseases known to history—is AIDS. It was first recognized in 1981, although it is believed that the first victims were infected around 1950. Homosexual intercourse was the mode of transmission for about half of the cases. Needle-sharing by drug addicts accounted for another fourth. The remaining patients were infected by contaminated blood, in utero, by heterosexual contact, or by other routes. Eighteen percent of the patients diagnosed from 1981 through 1997 were women. 

Until the last few years of the century, as the lower chart shows, a diagnosis of AIDS had been a death sentence without much hope of reprieve. Of the 641,000 Americans diagnosed with AIDS through December 1997, only 256,000 were still alive at the end of that year. Perhaps a million other Americans were infected with HIV. The number of new AIDS cases began to fall in 1994 and then declined quite sharply in 1996, presumably because more of the people at risk took preventive measures. At about the same time, new medications helped in the treatment of HIV and AIDS, and the number of deaths began to decline.

Chapter 8 chart 3

Source Notes
Source Abbreviations

HS series B 292 and B 293; SA 1997, tables 133 and 213; SA 1999, tables 2 and 226; WA 1998, page 391; and WA 1999, page 887. For AIDS information, see WA 1999, page 887, and SA 1998, tables 144 and 224; see also National Center for Health Statistics at (accessed August 31, 2000). See also American Medical Association, Home Medical Encyclopedia (New York: Random House, 1989), pages 898 and 900. For the downturn in AIDS after 1996, see Centers for Disease Control and Prevention, “Trends in the HIV and AIDS Epidemic 1998” at (accessed September 29, 2000).


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