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  • Print publication year: 2013
  • Online publication date: June 2014

Chapter 7 - Human Health: The Twentieth-Century Transformation of Human Health – Its Magnitude and Value


I have tried always to remember a simple truth about the past that the historically inexperienced are prone to forget. Most people in the past either died young or expected to die young, and those who did not were repeatedly bereft of those they loved . . . the power of death cut people off in their prime and made life seem precarious and filled with grief. It also meant that most of the people who built civilizations of the past were young when they made their contributions.

– Niall Ferguson, Civilization: The West and the Rest (2011, pp. xxii–xxiii)

Ferguson refers to a past with mortality far higher than today, a past in which people not only died young but lived with frequent illness, undernutrition and (for women) the often debilitating consequences of high fertility. This past was not so very long ago. Section 1 will present long trends in life expectancy in the country where it is highest. From a period of virtually no change in mortality prior to 1790, improvements became rapid in the nineteenth century and extremely rapid in the period 1880–1960. During this latter period life expectancy in the leading country increased by 3.2 years per decade. And, as this chapter will document, not only did the leading country rapidly improve but much of the rest of the world converged toward the leader.

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