Additionally, some middle-tier countries are concerned 

 that the rapid deployment of communications satellites 

 into geosynchronous orbits will preempt them from im- 

 plementing their own research systems. Technologies 

 now being developed for handling increasingly higher 

 data transmission rates to and from communications satel- 

 lites and for broadening the communications frequency 

 band should partially allay such concerns (pp. 42-43). 



HEALTH 



There are many indications that advances in, and applica- 

 tions of, biomedical science will continue to contribute 

 substantially to improvements in the overall health of 

 Americans. Genetic recombinant techniques are facilitat- 

 ing the development of a variety of pharmaceutical sub- 

 stances, including new and more effective vaccines and 

 drugs. In the future, the use of these technologies could 

 help control genetic disorders. Advances in the neuro- 

 sciences, leading to a deeper understanding of the func- 

 tioning of the brain, could result in substantial progress in 

 the field of mental health. Increased attention to the pre- 

 vention and cure of tropical diseases will benefit millions 

 of people in developing countries as well as American 

 military personnel stationed abroad (pp. 43^14). 



PREVENTION OF MAJOR DISEASES 



Death rates from cardiovascular diseases have fallen by 

 more than 30 percent since 1950, due, in part, to the use of 

 more effective drugs and procedures for repairing the 

 heart and blood vessels. The rate of successful treatment 

 of certain cancers also continues to improve. Scientific 

 knowledge of behavioral and environmental risk factors 

 and broadened public awareness of the links between 

 those factors and disease promise substantially reduced 

 incidence of both disorders. However, improvements in 

 the prevention of cardiovascular diseases, cancer, and 

 several other major illnesses will depend upon the collec- 

 tion and analysis of detailed data about specific causal 

 relationships between most major risk factors and major 

 illnesses. Accordingly, there is a high priority need to 

 integrate information about the interplay between be- 

 havior, pathological processes, and bodily dysfunction to 

 provide a basis for developing more effective treatment 

 and prevention techniques. In the interim, a variety of 

 approaches are possible to motivate individuals to take 

 more responsibility for their own health by altering their 

 behavior patterns (pp. 44-45). 



PROBLEMS OF THE AGED 



By the year 2000, the number of Americans over age 65 is 

 projected to increase by nearly 50 percent. Thus, there is 

 an increasing focus on the problem of how to deal with 



and take greater advantage of the potential of the aged 

 U.S. population. The number of women over 65 is in- 

 creasing more rapidly than the number of men. Under 

 present conditions, for example, a newborn American 

 female can expect to live 9 years longer than a newborn 

 male. Although some progress has been made — and more 

 is anticipated — in treating such disorders as arthritis, se- 

 nile dementias, diabetes, and cardiovascular diseases, 

 there is still a relative lack of knowledge about the true 

 functional capacity of the aged and their health care 

 needs. Thus, the potential exists for a considerable im- 

 provement in the quality and productiveness of the lives of 

 that population. Two health-related areas requiring par- 

 ticular research attention are the effects of drug metabo- 

 lism and drug interactions in the elderly, and the debilitat- 

 ing effects of social stresses to which the elderly are 

 subjected, including nursing practices and changes in 

 family and economic circumstances. Additionally, health 

 care and social service strategies need to be devised to 

 maximize the functional and social independence of the 

 aged (pp. 45-46). 



ADDICTIVE BEHAVIOR 



Alcoholism, drug abuse, and cigarette smoking continue 

 to be major individual, societal, and economic problems. 

 Ongoing research has provided considerable information 

 about the physiological and psychological causes of ad- 

 diction to cigarettes and marijuana. Research on genetic 

 predispositions and other biomedical factors may offer the 

 first real prospects for advancing knowledge about the 

 causes of alcoholism. Ultimately, the results of those 

 research efforts should lead to improved prevention and 

 treatment strategies, although the effective incorporation 

 of innovative behavioral approaches into such strategies 

 may well require more systematic cooperation between 

 biomedical and behavioral scientists (pp. 46-47). 



ASSESSMENT AND DISSEMINATION OF BIOMEDICAL 

 SCIENCE AND TECHNOLOGY 



Rapidly escalating health care costs increasingly threaten 

 to constrain the application of advances in biomedical 

 science and, more particulariy, biomedical technology. 

 Many new technologies are simply not cost-effective. 

 Hence, we can expect more widespread use of risk-cost- 

 benefit analyses and technology assessments, involving 

 the participation of a broad range of health care special- 

 ists, to evaluate the efficacy and possible hazards of medi- 

 cal technologies. Such evaluations will inevitably involve 

 difficult equity questions about the appropriate distribu- 

 tion of health care and the ethical dilemmas associated 

 with the value of human life (pp. 47-48). 



The effectiveness of programs to disseminate both bio- 

 medical research results and assessments of the efficacy of 



XVI 



