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I don't have a source for this, but I have read that most of the increase in life expectancy has come not from medicine, but from hygiene, and that mostly from improvements brought about by engineers, not the medical profession. Clean water, sewers, landfills, drained swamps, better food supply from using vermin-free transportation and storage (railways and silos), etc.
Improved hygiene and food supplies have limited utility when you are dying of smallpox or typhoid.
Why not both?
Kind of a chicken-and-the-egg question, rustbelt. We'll never know for sure, but improved hygene would mean that there is less of a chance of contracting typhoid, cholera, etc.
Interesting question on the difference on health spending in the US and other rich countries. US per capita GDP, income, what ever, is significantly higher then in Europe -- European living standards are roughly about the same as in the poorest US states. If the good tight relationship between health, life span and income is so strong why is US life expectancy, health care, roughly about the same as in Europe?
The first reaction is to suggest the US clearly is wasting a great deal of resources on health care. Of course, there are other reasons, like life styles but if diet and public health measures are the dominate factors behind better health the
first reaction still seems valid.
Improved food supplies, more frequent washing of bedding, and less crowded living conditions all reduced the effective transmissibility of smallpox and typhoid (not to mention tuberculosis, another major killer). The individually small reductions in transmissibility nonetheless have a dramatic effectic in reducing the incidence of epidemics.
Spencer, you of all people know that your question is disingenuous. Fogel is trying to explain changing health outcomes over the course of a 200 year period (or longer). It is simply not good statistics to assume that these cross section differences are due or not due to the things that have changed outcomes over time.
Second, I think the question of whether "we" are wasting resources on health care has been beat to death. Some suppositions here include excessive spending on the last year of life, better technology that might ease suffering but that does not necessarily improve life spans, better efforts to save premature children which subsequently have a higher mortality risk ... come to mind off the top of my head.
Third, if people want to spend their own money on health care that may or may not benefit them, why should you be upset about this?
I think an interesting issue is the modern evolution of human height, keeping in mind both survival and sexual selection.
While women seem to prefer taller men (enhancing height selection), men do not prefer taller women past a certain point (putting a limit on height selection). There are also costs to being tall (cardiac risks), and the physical survival enhancements of being tall (in combat, for example) may now have turned against the tall.
save_the_rustbelt: insufficient calories make your body work inefficiently, and open it up to diseases. Just getting people enough food makes the more able to resist diseases. Similarly, reducing the numbers of harmful bacteria they're exposed to by properly disposting of excrement also makes people healthier.
"I think an interesting issue is the modern evolution of human height"
The "secular trend" of increasing height has actually mystified researchers. Nutrition, the answer commonly given, doesn't really account for it.
Maybe tall people are having more children? Women, at least, seem to strongly prefer tall men, meaning that short genes are culled from the gene pool.
"and the physical survival enhancements of being tall (in combat, for example)" ... there are many and well documented advangtages to being tall ... fighting prowess is not one of them, put your money on the shorter but stockier fellow - he'll snap 'ol longshanks in two.
Many vetted studies have proven that a diet insufficient (by Western standards) in calories actually extend longevity. I'm not talking about starving to death, of course, but of voluntary "less than satiety" quantities.
And, BTW, I'd like a stacked-up 8'-tall woman...or a stacked-up 4'10" woman. My preferences don't discriminate when it comes to pulchritude.
"and the physical survival enhancements of being tall (in combat, for example)" ... there are many and well documented advangtages to being tall ... fighting prowess is not one of them, put your money on the shorter but stockier fellow - he'll snap 'ol longshanks in two."
Nah. He'll shoot out his kneecaps.