Extra Life: A Short History of Living Longer
May 4, 2021 8:54 AM Subscribe
How Humanity Gave Itself an Extra Life [ungated link] - "Between 1920 and 2020, the average human life span doubled. How did we do it? Science mattered — but so did activism." (NYT, PBS)
The best estimates suggest that as many as 100 million people died from the Great Influenza outbreak that eventually circled the globe. To put that in comparison, roughly three million people have died from Covid-19 over the past year, on a planet with four times as many people. There was another key difference between these two pandemics. The H1N1 outbreak of 1918-19 was unusually lethal among young adults.also btw...
[W]hat followed was a century of unexpected life...
How did this great doubling of the human life span happen? When the history textbooks do touch on the subject of improving health, they often nod to three critical breakthroughs, all of them presented as triumphs of the scientific method: vaccines, germ theory and antibiotics. But the real story is far more complicated. Those breakthroughs might have been initiated by scientists, but it took the work of activists and public intellectuals and legal reformers to bring their benefits to everyday people. From this perspective, the doubling of human life span is an achievement that is closer to something like universal suffrage or the abolition of slavery: progress that required new social movements, new forms of persuasion and new kinds of public institutions to take root. And it required lifestyle changes that ran throughout all echelons of society: washing hands, quitting smoking, getting vaccinated, wearing masks during a pandemic.
- How Covid Upended a Century of Patterns in U.S. Deaths [ungated link] - "The U.S. death rate in 2020 was the highest above normal ever recorded in the country — even surpassing the calamity of the 1918 flu pandemic." (NYT) Malaria vaccine trial raises hopes of beating disease - "Jab developed by University of Oxford team proves 77% effective in Burkina Faso mid-stage tests." (FT)
Ugh. Sorry but it has to be said. "Average" lifespan is a pretty misleading statistic. It is almost all about childhood mortality.
A better statistic is median lifespan. The improvement is significant, but much less impressive than "doubled." This statistic says that in 1920 half of people lived to be at least 65 years old. Today half of people live to be about 85 years old.
The numbers for retirement age are even less impressive. In 1920 a person who retired at 65 lived on average to age 78. Today the person who retires at 65 lives to age 85. Certainly an improvement but far from "doubling."
The Social Security Administration has some good graphs.
posted by JackFlash at 9:47 AM on May 4, 2021 [26 favorites]
A better statistic is median lifespan. The improvement is significant, but much less impressive than "doubled." This statistic says that in 1920 half of people lived to be at least 65 years old. Today half of people live to be about 85 years old.
The numbers for retirement age are even less impressive. In 1920 a person who retired at 65 lived on average to age 78. Today the person who retires at 65 lives to age 85. Certainly an improvement but far from "doubling."
The Social Security Administration has some good graphs.
posted by JackFlash at 9:47 AM on May 4, 2021 [26 favorites]
Yes, there is a lot of discussion of the effect of childhood mortality on the mean human lifespan in the article.
posted by dfan at 9:52 AM on May 4, 2021 [4 favorites]
posted by dfan at 9:52 AM on May 4, 2021 [4 favorites]
"How humanity gave itself an extra life" is so misleading as to be nearly deceptive. This isn't about human life extension at all.
The extra life is the sister or brother who needed medical intervention (or perhaps that was you) early on. I can think of several cases in my own family for which this is true. Because of childhood inoculations, any one of us could have lost to the odds before the age of 5 or 10, and we'd never know. We'll never have to know which ones of us might have perished to smallpox for instance.
And it's not just life or death, but disability too. My childhood best friend would have been deaf from mumps had he been born a generation earlier. I would have been blind from congenital defects. My father, crippled by polio. Even now, the rubella vaccine prevents the mental damage that afflicted my neighbor, who will never get older than 4 mentally.
This is not about who gets another 10 or 15 years of life, it's about those we never miss, because we never knew we missed them before, either in the grave or homebound from disability. Those are the live vaccines save.
posted by bonehead at 10:15 AM on May 4, 2021 [21 favorites]
The extra life is the sister or brother who needed medical intervention (or perhaps that was you) early on. I can think of several cases in my own family for which this is true. Because of childhood inoculations, any one of us could have lost to the odds before the age of 5 or 10, and we'd never know. We'll never have to know which ones of us might have perished to smallpox for instance.
And it's not just life or death, but disability too. My childhood best friend would have been deaf from mumps had he been born a generation earlier. I would have been blind from congenital defects. My father, crippled by polio. Even now, the rubella vaccine prevents the mental damage that afflicted my neighbor, who will never get older than 4 mentally.
This is not about who gets another 10 or 15 years of life, it's about those we never miss, because we never knew we missed them before, either in the grave or homebound from disability. Those are the live vaccines save.
posted by bonehead at 10:15 AM on May 4, 2021 [21 favorites]
If you want to separate out infant or child mortality, a better measure is remaining life expectancy starting at age 10.
It's weird that this article uses the terminology "average life span." Demographers use "life expectancy" to measure the average length of a life, and we typically use "life span" to refer to the maximum length of life (e.g., 115 years for humans). Life expectancy statistics can be confusing, however, if you don't understand the difference between period life expectancy and cohort life expectancy.
Edit to add: I see the NYT Magazine article also uses the term "average life expectancy," which is redundant.
posted by mikeand1 at 10:39 AM on May 4, 2021
It's weird that this article uses the terminology "average life span." Demographers use "life expectancy" to measure the average length of a life, and we typically use "life span" to refer to the maximum length of life (e.g., 115 years for humans). Life expectancy statistics can be confusing, however, if you don't understand the difference between period life expectancy and cohort life expectancy.
Edit to add: I see the NYT Magazine article also uses the term "average life expectancy," which is redundant.
posted by mikeand1 at 10:39 AM on May 4, 2021
"Average" lifespan is a pretty misleading statistic. It is almost all about childhood mortality.
When I grew up in India I was given to understand that childhood mortality is highly correlated with poor health of surviving children and adults, so it is in fact a good indicator of overall public health. However, that was a while back and I could be wrong; it might also apply differently to developing vs developed countries. Would be interesting to hear what the modern scientific opinion is on this.
posted by splitpeasoup at 11:17 AM on May 4, 2021 [1 favorite]
When I grew up in India I was given to understand that childhood mortality is highly correlated with poor health of surviving children and adults, so it is in fact a good indicator of overall public health. However, that was a while back and I could be wrong; it might also apply differently to developing vs developed countries. Would be interesting to hear what the modern scientific opinion is on this.
posted by splitpeasoup at 11:17 AM on May 4, 2021 [1 favorite]
My childhood best friend would have been deaf from mumps had he been born a generation earlier.
This is what happened to me, two years before the vaccine became available. I also have possibly-related seizures, so if I have one and die (or kill someone) in an accident, that'll be one (or more) death attributable to a spot of bad luck decades earlier.
posted by klanawa at 11:27 AM on May 4, 2021 [6 favorites]
This is what happened to me, two years before the vaccine became available. I also have possibly-related seizures, so if I have one and die (or kill someone) in an accident, that'll be one (or more) death attributable to a spot of bad luck decades earlier.
posted by klanawa at 11:27 AM on May 4, 2021 [6 favorites]
... childhood mortality is highly correlated with poor health of surviving children and adults, so it is in fact a good indicator of overall public health.
Not really. The U.S. has pretty good (not great) public health, but our infant mortality rate is quite high compared to most countries with comparable public health. We're around 5-6 deaths per thousand, compared with 2-3 deaths per thousand for most "developed" countries (meaning Europe, Japan). There's a huge body of literature around this.
(Infant mortality refers to the death rate in the first year of life, which is when it tends to be high. Mortality rates are very low once you get past the first year, so "infant mortality rate" is the statistic to look at here, not "childhood mortality".)
posted by mikeand1 at 11:57 AM on May 4, 2021
Not really. The U.S. has pretty good (not great) public health, but our infant mortality rate is quite high compared to most countries with comparable public health. We're around 5-6 deaths per thousand, compared with 2-3 deaths per thousand for most "developed" countries (meaning Europe, Japan). There's a huge body of literature around this.
(Infant mortality refers to the death rate in the first year of life, which is when it tends to be high. Mortality rates are very low once you get past the first year, so "infant mortality rate" is the statistic to look at here, not "childhood mortality".)
posted by mikeand1 at 11:57 AM on May 4, 2021
…I don’t see how infant mortality and childhood mortality being different undercuts splitpeasoup‘s point about childhood mortality.
posted by clew at 12:06 PM on May 4, 2021 [1 favorite]
posted by clew at 12:06 PM on May 4, 2021 [1 favorite]
Johnson discusses deaths of despair in the article, but he does not link them to another consequence of life extension: wealth consolidation. "Malefactors of great wealth" used to be equal before Death, as he notes, but now that they are not, they and their heirs are free to increase income inequality, either through policies or simply by holding on to positions and real estate.
I am not suggesting anyone should die. This isn't a Boomer joke. It's just that our society's oldest laws and expectations were built in a time when they did. For example, the Founders didn't foresee the tenacity of Supreme Court justices; they expected to lose a few to the poisonous miasma rising off the swamp every so often.
I don't know how to handle this issue in broader society, or how we could possibly have the political will to do it when wealth and power buy the ability to survive. I just don't know.
posted by Countess Elena at 12:53 PM on May 4, 2021 [5 favorites]
I am not suggesting anyone should die. This isn't a Boomer joke. It's just that our society's oldest laws and expectations were built in a time when they did. For example, the Founders didn't foresee the tenacity of Supreme Court justices; they expected to lose a few to the poisonous miasma rising off the swamp every so often.
I don't know how to handle this issue in broader society, or how we could possibly have the political will to do it when wealth and power buy the ability to survive. I just don't know.
posted by Countess Elena at 12:53 PM on May 4, 2021 [5 favorites]
What a good post, kliuless. I appreciate Johnson's point about adding activism and scale to those discoveries. Hopefully the R21 malaria jab can, if it succeeds, rapidly have that kind of impact.
posted by doctornemo at 12:59 PM on May 4, 2021
posted by doctornemo at 12:59 PM on May 4, 2021
Much of the increase can probably be laid at the feet of antibiotics and Virginia Apgar.
posted by rmd1023 at 1:57 PM on May 4, 2021 [1 favorite]
posted by rmd1023 at 1:57 PM on May 4, 2021 [1 favorite]
Clean water
+ vaccines
+ Antibiotics
+ Birth control
== modern life as we know it
posted by St. Peepsburg at 2:47 PM on May 4, 2021 [1 favorite]
+ vaccines
+ Antibiotics
+ Birth control
== modern life as we know it
posted by St. Peepsburg at 2:47 PM on May 4, 2021 [1 favorite]
I've not checked in with Flint MI recently about clean water. Anyone know how clean their water is?
posted by k3ninho at 3:19 PM on May 4, 2021 [2 favorites]
posted by k3ninho at 3:19 PM on May 4, 2021 [2 favorites]
Flint speaker, what do what to know.
posted by clavdivs at 3:45 PM on May 4, 2021 [1 favorite]
posted by clavdivs at 3:45 PM on May 4, 2021 [1 favorite]
By 1921, my grandmother survived the '18 pandemic, graduated from high school, 2 years early, was a driver, aviator ( 2 solo), a teacher, Red Cross volunteer, a fledgling business person, socialite. She was accepted to a local but nice college were she met my grandfather who was funny as hell and kind. She went to grad school ( only one year) in '26. Health, the induction of more grains for breakfast. Better health care and diet. Penicillin, most likely saved her life from a surgery in the 40s So grains and Penicillin and staying at the cabin during part of '18.
above all, a sence of humour.
she lived to 103.
posted by clavdivs at 4:01 PM on May 4, 2021 [4 favorites]
above all, a sence of humour.
she lived to 103.
posted by clavdivs at 4:01 PM on May 4, 2021 [4 favorites]
"Malefactors of great wealth" used to be equal before Death, as he notes, but now that they are not, they and their heirs are free to increase income inequality, either through policies or simply by holding on to positions and real estate.
I don't think this is true. Wealth inequality is rising at a perilous rate, and that doesn't look like slowing down until something pretty drastic happens, but it's currently rising back toward early 20th century levels. And I don't believe there was ever a time when people were equal before death: malnutrition and poor housing have always been major contributing factors to mortality rates (most significantly infant mortality). I think it's easy to forget just how profoundly impoverished an enormous proportion of the population of industrial nations was a century ago.
Things are really fucking bad, but worse than they were in 1920? I just don't think that's true.
posted by howfar at 4:19 PM on May 4, 2021
I don't think this is true. Wealth inequality is rising at a perilous rate, and that doesn't look like slowing down until something pretty drastic happens, but it's currently rising back toward early 20th century levels. And I don't believe there was ever a time when people were equal before death: malnutrition and poor housing have always been major contributing factors to mortality rates (most significantly infant mortality). I think it's easy to forget just how profoundly impoverished an enormous proportion of the population of industrial nations was a century ago.
Things are really fucking bad, but worse than they were in 1920? I just don't think that's true.
posted by howfar at 4:19 PM on May 4, 2021
We were discussing this at dinner with my mother, age 86, and my friend the actuary.
The actuary contributed that there is some thinking that we may have hit a peak of longevity with the older people who are entering their 70s 80s and so on, as they had to survive some pretty rough times as well as having had to do far more physical activity. Even as someone who had a desk job in the 1960s or 1970s, they would have been walking much more, and especially as they would have been far more active in their school years.
My mother contributed that the diet would have had far less meat and processed foods - bread was not white, foods were pickled, not frozen, etc.
posted by Barbara Spitzer at 7:42 PM on May 4, 2021
The actuary contributed that there is some thinking that we may have hit a peak of longevity with the older people who are entering their 70s 80s and so on, as they had to survive some pretty rough times as well as having had to do far more physical activity. Even as someone who had a desk job in the 1960s or 1970s, they would have been walking much more, and especially as they would have been far more active in their school years.
My mother contributed that the diet would have had far less meat and processed foods - bread was not white, foods were pickled, not frozen, etc.
posted by Barbara Spitzer at 7:42 PM on May 4, 2021
"Average" means if you have two chickens, and I none, we each have on average one chicken.
That's what it means, right?
posted by Tom-B at 8:45 PM on May 4, 2021
That's what it means, right?
posted by Tom-B at 8:45 PM on May 4, 2021
I was mildly peeved to see Straus and Jacobi described merely as "German" when obvs they were Jewish and in one way or another that likely informed their outlook.
posted by i_am_joe's_spleen at 2:05 AM on May 5, 2021 [1 favorite]
posted by i_am_joe's_spleen at 2:05 AM on May 5, 2021 [1 favorite]
My great-grandmother lived to 92; of her four siblings, one died at 16 of diphtheria, one at 35 of TB, one at 47 of a heart attack, and one at 71, for an average of 54.4 (not so far off from the average life expectancy in 1900, and ironically the age at which her father, who came to America as a child fleeing the Irish famine, died). Antibiotics would have prevented two of those early deaths and likely would bring the average closer to the modern 75-80.
posted by Pseudonymous Cognomen at 7:34 AM on May 5, 2021 [1 favorite]
posted by Pseudonymous Cognomen at 7:34 AM on May 5, 2021 [1 favorite]
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posted by kliuless at 9:19 AM on May 4, 2021 [2 favorites]