Department of Social Studies of Medicine, McGill University, Montreal, Quebec, Canada.
Am J Public Health. 2011 Mar;101(3):438-47. doi: 10.2105/AJPH.2010.196519. Epub 2011 Jan 13.
The National Health Survey undertaken in 1935 and 1936 was the largest morbidity survey until that time. It was also the first national survey to focus on chronic disease and disability. The decision to conduct a survey of this magnitude was part of the larger strategy to reform health care in the United States. The focus on morbidity allowed reformers to argue that the health status of Americans was poor, despite falling mortality rates that suggested the opposite. The focus on chronic disease morbidity proved to be an especially effective way of demonstrating the poor health of the population and the strong links between poverty and illness. The survey, undertaken by a small group of reform-minded epidemiologists led by Edgar Sydenstricker, was made possible by the close interaction during the Depression of agencies and actors in the public health and social welfare sectors, a collaboration which produced new ways of thinking about disease burdens.
1935 年和 1936 年进行的全国健康调查是当时规模最大的发病率调查。这也是第一次全国性的关注慢性病和残疾的调查。进行如此大规模调查的决定是美国医疗改革的更大战略的一部分。对发病率的关注使改革者能够争辩说，尽管死亡率下降表明情况相反，但美国人的健康状况很差。对慢性病发病率的关注被证明是一种特别有效的方式，可以证明人口的健康状况不佳，以及贫困与疾病之间的紧密联系。这项由一小群以改革为导向的流行病学家在埃德加·西登斯特里克(Edgar Sydenstricker)的领导下进行的调查，得益于大萧条期间公共卫生和社会福利部门的机构和行为者之间的密切互动，这种合作产生了关于疾病负担的新思维方式。
