Improving Health

What makes for better health and longer life expectancy in the advanced world in the last century?  Not improvements in medicine, Illich argues.  Rates of tuberculosis, scarlet fever, diphtheria, whooping cough, and measles indicate that “nearly 90 percent of the total decline in mortality between 1860 and 1965 had occurred before the introduction of antibiotics and widespread immunization.”  According to Illich, “by far the most important factor was a higher host-resistance due to better nutrition.”  No matter how much medical aid is available, in poor countries with poor nutrition, “diarrhea and upper-respiratory-tract infections occur more frequently, last longer, and lead to higher mortality.”

In addition to food, “the environment is the primary determinant of the state of general health of any population.”  Various studies show that “food, water, and air, in correlation with the level of sociopolitical equality and the cultural mechanisms that make it possible to keep the population stable, play the decisive role in determining how healthy grown-ups feel and at what age adults tend to die.”