Transcript - Catalyst

The Great Escape:
how societies increased health,
wealth and happiness
CENV 110
Trends in human well-being
• What constitutes well-being
• Basic human necessities
– Food
– Clothing
– Shelter
• Other important factors
– Health, life expectancy, child mortality
– Culture
– Leisure time
Small groups
• List what your group believes would be the
three best “measures” of well-being
Some examples
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Life expectancy
Income
Political Freedom
Social equality
Environmental quality
The life of man, solitary, poor,
nasty, brutish, and short.
Thomas Hobbes
The Leviathan
The ladder of life and measuring
happiness
• Imagine a ladder
with 11 steps of
happiness
• Top is “best
possible life”
• Bottom is “worst
possible life”
Does money buy health?
• Globally richer countries are healthier
• But: Chile and Costa Rica have about the
same health as the U.S., but spend 12% as
much per person
Trends in number of poor people
Do rich countries
get richer?
What was responsible for the
increase?
• By 1850 clean water was generally available so
once you reached 40 you had a good life
expectancy
• Disposal of sewage to prevent the spread of
disease (especially diarrhea)
• Changes in mortality of children
• Note that this was before antibiotics, vaccination
• It was due to better nutrition and living conditions
and understanding disease transmission
• People were skinny and short
But it can’t be largely diet
• Because rich people did not survive longer
until about 1750
• The industrial revolution brought people to
cities which were very unhealthy places
• Sewage was rampant, pollution was
rampant, and clean water hard to find
• It is this period 1750-1850 where the health
of the wealthy increased while the poor did
not
Big changes in the mid 19th
century
John Snow 1813-1858
Founder of modern epidemiology
Showed that a cholera outbreak in
London was largely coming from a
single water pump that was
contaminated.
This work led to public works to
provide clean water and to stop
sewage being dumped everywhere.
Louis Pasteur
Louis Pasteur 1822-1895
Founder of microbiology,
invented vaccines for rabies
and anthrax
Founded the germ theory of
disease, pasteurization of
milk etc.
Ignaz Semmelweis
1818-1865
Austro-Hungarian doctor who showed
that childbed fever which killed many
women after childbirth was due to
disease transmission by doctors.
Showed that the use of antiseptics and
hand cleaning prevented this disease
Why did the rest of the world
catch up so fast
• It is not complex modern medicine that
increases life expectancy so much
• It is public health – which is straightforward
and generally cheap
Changes in average height
Changes in height in Japan
Men
Women
Equity
Does a rising tied lift all boats?
US
In the U.S. the rich get richer
So what caused the great escape?
Health
• Scientific knowledge
– Importance of clean water
– Germ theory of disease
• Government action
– Public health programs
• Better nutrition
– Economic development
– The green revolution
• Less war
Wealth
• Technological development
– Scientific advances
– The industrial revolution
• Better governance
• Increased trade
Culture, freedom and welfare
• Less despotism
• More wealth – more leisure and travel
• Improving air and water quality (in some
places)
• The internet?
Study guide
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Draw a graph where the X axis is GDP (income per person) and the Y axis is peoples rating of their
happiness going from 1 to 11. Draw the general relationship from the data presented in class.
In the last 30 years which countries have grown their economy the fastest?. Which the slowest?
What were the differences or similarities in life expectancy at birth in rich and poor families in
England in 1500.
Draw the following graph. X axis is calendar year going from 1850 to 2000. Y axis is life
expectancy. Scaled from 0 to 80 years. Draw the trend for the U.S. population of life expectancy at
birth. Where did it start in 1850 and where is it now? Draw a trend for the life expectancy if you
reached 70 years of age?
What are the key elements of modern public health?
What is the trend in the height of people in the last 50 years and what country now has the tallest
people in the world?
What is the trend in the proportion of the U.S. population in poverty in the last 40 years
What has been the trend in the last 100 years of the proportion of US income obtained by the top 1%
income group
What are the key factors that have led to increased health and life expectancy around the world in the
last 200 years?