When you think about why the life expectancy of humans has increased dramatically over the past century, what comes to mind? Better treatment for cancer and heart attacks? Overall better medical care of the diseases of old age?
Sure, these things save a lot of people and give them a few additional years of lifespan – sometimes more than a few additional years. However, the advances in medicine that have made the most difference in lifespan may surprise you.
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Sanitation, Hygeine and Clean Water
According to the CDC, population shifts to cities in the 19th century led to overcrowding and poor housing practices. Many city residents lived in despicable conditions without public water supplies or waste disposal systems.
As a result, constant outbreaks of diseases such as dysentery, typhoid, tuberculosis and cholera sickened and killed people in droves. In the course of my genealogy research, I found one family in the late 1800s who lost all five of their young children in a typhoid outbreak.
State and local health departments began making headway from the 1930s through 1950s in disease prevention through improved sewage disposal, water treatment (such as chlorination) and public health education about food handling and hand washing.
Researchers undertook a massive project to study contagious diseases since the late 1800s to estimate how many lives have been saved by vaccines since 1924. They crunched numbers from before and after vaccines became available for previously common childhood diseases such as measles, rubella, mumps, polio, diphtheria and pertussis (whooping cough).
The results of the study, published in the New England Journal of Medicine, show that vaccines have prevented around 103 million illnesses. The study’s authors caution that this number is likely an underestimate because they didn’t include all possible vaccine-preventable illnesses.
Some of these illnesses caused temporary misery more often than death. Some illnesses caused permanent disabilities. Some of these diseases regularly killed thousands of kids each year.
In 1900, 194 out of every 100,000 U.S. residents died from tuberculosis (a.k.a. TB or consumption). From my own family history, I had a great grandfather who suffered from TB and died at the age of 64. He passed away during the 1940s when antibiotics were just becoming available for medical use.
My sister came down with scarlet fever as a child. A century ago, this disease caused deafness, blindness or death for many a child. For little sis, the doctor cured it with a shot of antibiotics. I have a friend whose appendix burst, something that would have been deadly without antibiotics and surgery.
For years, doctors gave out antibiotics like candy, meaning many people regularly took them for illnesses that antibiotics won’t help, such as the flu, colds and most sinus and ear infections. However, back when they first came out, antibiotics were a miracle drug that regularly saved people from ailments that otherwise would have killed them.
During World War I, sexually transmitted diseases were the second most common reason for disability and absence from duty in the military. Prior to the availability of antibiotic treatment and prevention by using prophylactics (condoms), there were no good treatments for STDs.
Untreated syphilis can lead to heart and central nervous problems and even death. The history of syphilis includes some horrific treatments such as mercury, which is poisonous and can cause symptoms worse than the illness itself.
Soap & Handwashing
Back in the 1800s, doctors routinely went straight from doing an autopsy to delivering a baby. One doctor wondered why so many more women died of childbed fever when doctors were involved than when midwives delivered babies.
By the late 1800s, most doctors had finally accepted “germ theory,” but it took some mass advertising in the early 1900s to convince the public that they could protect themselves from diseases such as tuberculosis by washing their hands.
Improved Disease Testing
In addition to better treatment options, doctors have also had increasingly more accurate ways of diagnosing illnesses. This includes various blood, saliva, urine and skin tests. Without these, diagnosing illnesses was much harder, making wrong diagnoses (and therefore wrong treatments) more likely.
When was the last time you heard of someone with rickets? Very few people in the U.S. suffer such a lack of vitamin D that they develop severe, disabling bone problems.
Scurvy, caused by lack of vitamin C, used to kill hundreds of sailors each year, before someone figured out what was causing this horrifying, disfiguring and often fatal illness. These and other vitamin deficiencies still exist in some poor countries of the world, and many of our ancestors probably encountered them, at least through friends or relatives.
Government Food Safety Regulations
President Abraham Lincoln founded the U.S. Department of Agriculture (USDA) in 1862, but it took decades for the federal government to gradually enact laws protecting the public from bad food. Over the years, Congress eventually passed laws forbidding diseased animals from being used as meat, regulating meat and other foods coming into the U.S. from foreign countries and giving government agencies such as the Food and Drug Administration (FDA) the authority to issue food safety standards.
In addition, widespread pasteurization of milk beginning in the 1950s led to dramatic decreases in illnesses that people were catching from contaminated milk.
Improved Infant and Prenatal Care
A friend of mine developed preeclampsia toward the end of her pregnancy. Without modern treatment, this would have led to full-blown eclampsia and killed her, as it did Sybil in the TV show “Downton Abbey.”
Not that long ago, women often died from childbirth and many babies didn’t survive infancy.
Infants and children surviving to adulthood and women living through childbirth have greatly increased overall human lifespan.
I’ve known several people with type 1 diabetes, the kind that often strikes during childhood or as a young adult. Before the discovery of insulin, diabetes meant almost certain death. Incidentally, a few doctors in the pre-insulin area did have some success in treating diabetes patients – with a high fat, low carb diet.
With insulin injections and now insulin pumps, diabetics can live a much longer lifespan than they did a century ago.
How About You?
How many people do you know who would have died without modern treatments? What would have killed you or your friends and loved ones a century ago?
This post was originally published in December 2015 and updated in April 2020.
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