Other factors increase
global life expectancy
I enjoyed Dr. Charles Bryan’s May 2 Commentary column about the greatest health advancements that have prolonged life expectancy. His five fundamental developments came from interviews with department heads at Virginia Commonwealth University's (VCU) School of Medicine. This seems like a reasonable approach for expertise on the subject; however, their answers gave me pause. Did they truly reflect global trends, or merely those in our developed “Western” society?"
As one who has worked in many LMIC (low- and middle-income countries, i.e., developing countries), I can attest that Bryan’s inclusion of germ theory and antibiotic development are two of the most important factors that have doubled global life expectancy from 35 to 70 years in the last past 200 years. Thereafter, I would substitute three other advancements that epidemiology experts deem important:
• Bryan alluded to one: public health factors such as safe water, sanitation and sewage disposal. Many of the cholera pandemics of the past 200 years are attributable to lack of these.
• How could the VCU experts overlook this year’s 800-pound gorilla: vaccinations? Eradication of the killers smallpox and polio could not have been possible without them. Measles still kills 200,000 people per year, but recent World Health Organization data indicate that vaccines have prevented 25 million childhood and maternal deaths since 2000. Once distributed, the new malaria vaccine could save 400,000 lives per year.
• The amazing revolution in providing young women adequate health care and education. That combination has resulted in infant mortality rates falling from more than 50% in the early 1800s to 4.5% globally today. Women no longer need to bear a half-dozen children in order for two to survive, freeing families from poverty and food insecurity, and enabling better-educated children who further perpetuate their society’s health.
David Elliott, M.D.
Doctors Without Borders.
Info: "Factfulness: Ten reasons we’re wrong about the world - and why things are better than you think" by Hans Rosling (2020 Flatiron Books; or local libraries).