By Laura Helmuth Posted Wednesday, Sept. 11, 2013, at 5:10 AM
From Slate.com
Lifespan has doubled in the United States in the past 150 years. This
ridiculously wonderful change in the nature of life and death is something we
tend to take for granted. When we do think about why we’re still alive, some of
the big, fairly obvious reasons that come to mind are vaccines, antibiotics,
clean water, or drugs for heart disease and cancer. But the world is full of
underappreciated people, innovations, and ideas that also save lives. A round
of applause, please, for some of the oddball reasons, in no particular order,
why people are living longer and healthier lives than ever before.
Cotton. One of the major killers of human history was typhus, a
bacterial disease spread by lice. It defeated Napoleon’s army; if Tchaikovsky’s
1812 Overture were historically accurate, it would feature less cannon fire and
more munching arthropods. Wool was the clothing material of choice before
cotton displaced it. Cotton is easier to clean than wool and less hospitable to
body lice.
Satellites. In 1900, a hurricane devastated Galveston, Texas. It killed
8,000 people, making it the deadliest hurricane in U.S. history. In 2008,
Hurricane Ike hit Galveston. Its winds were less powerful at landfall than
those of the 1900 storm, but its storm surge was higher, and that’s usually
what kills people. This time we saw it coming, thanks to a network of
Earth-monitoring satellites and decades of ever-improving storm forecasting.
More than 100 people died, but more than 1 million evacuated low-lying coastal
areas and survived.
Fluoride. There were plenty of miserable ways to die before the
mid-20th century, but dying of a tooth abscess had to be among the worst—a
slow, painful infection that limits your ability to eat, causes your head to
throb endlessly, and eventually colonizes the body and kills you of sepsis. Now
it’s a rare way to go, thanks to modern dental care, toothbrushes, and (unless
you’re in Portland) fluoridated water.
Window screens. Houseflies are irritating today, but they used to be
major vectors of deadly diarrheal disease. Clean water and treatment of sewage
eliminated the most obvious means of transmitting these diseases, but pesky
houseflies continued to spread deadly microbes. By the 1920s, according to
James Riley in Rising Life Expectancy: A Global History, a growing aversion to
insects and the introduction of window screens reduced this risk.
The discovery of unconscious bias. The reason we trust double-blind,
placebo-controlled clinical trials to tell us which medical treatments actually
work is that we know we can’t trust ourselves. If you take a sham drug that you
think will alleviate your symptoms, it will—that’s the placebo effect. If you
think the drug will cause side effects, it will—that’s the nocebo effect. If
you’re a clinician and think you’re administering a real drug, you will send
all kinds of signals, unintentionally, to tell the patient you think the
treatment will work. If you’ve seen anecdotal evidence for a treatment, you
notice confirmatory evidence rather than cases that make you revise your
original hypothesis. When analyzing the data, it’s all too easy to squint at
the numbers in a way that confirms your expectations. Double-blind trials
overcome these biases by preventing both patient and clinician from knowing
whether a tested drug is real or not.
Botts’ Dots. Those raised ceramic reflectors between road lanes were
invented by Elbert Botts, a chemist who worked for the California Department of
Transportation. The dots help motorists see the edge of their lane even in the
dark or when it’s raining. Botts died in 1962, four years before the first
Botts’ dots were installed on California highways.
Morbidity and Mortality Weekly Report. That’s the no-nonsense name of
one of the most important publications most people have never heard of. The
Centers for Disease Control and Prevention has been publishing it since 1952 to
provide “timely, reliable, authoritative, accurate, objective, and useful
public health information and recommendations.” When a new disease or danger
emerges—such as AIDS or a new strain of influenza—the MMWR is often the first
to identify it.
Air-conditioning. As Dan Engber pointed out in a two-part ode to A/C
last summer, heat is deadly and we don’t respect it enough. A Chicago heat wave
killed more than 700 people in one week in 1995. The National Weather Service
issues heat alerts, and cities have started to offer air-conditioned cooling
centers for people who would overheat at home. A recent study shows that air
conditioning has cut the death rate on hot days by 80 percent since 1960.
The residents of Framingham, Mass. In 1948, researchers signed up more
than 5,000 adults for a long-term study of heart disease. Nobody anticipated
just how long-term the study would be—it’s still going strong and now includes
the children and grandchildren of the original cohort. It taught us much of
what we know about heart disease. Before the study, high blood pressure was
thought to be a sign of good health; now it’s recognized as a risk factor for
heart attacks and strokes. Thanks to the generosity and commitment of volunteers
in Framingham and other studies, we know the dangers of high cholesterol,
obesity, inactivity, and smoking.
Pasteurization. This should be an obvious lifesaver, right up there
with hand-washing and proper nutrition. But the rise of the raw milk movement
suggests that a lot of people take safe dairy products for granted.
Contaminated milk was one of the major killers of children, transmitting
typhoid fever, scarlet fever, diphtheria, tuberculosis, and other diseases. One
of the most successful public health campaigns of the late 19th and early 20th
centuries was for pure and pasteurized milk—so successful that we don’t really
remember how deadly milk can be.
Shoes. Hookworms are parasites that enter the human body through bare
feet—often by biting into the soft skin between the toes (shudder). The disease
was common in the Southeast, spread when people walked barefoot across ground
that was contaminated with feces of people who were already infected. Education
initiatives at the beginning of the 20th century encouraged people to build
sanitary outhouses and wear shoes.
Cows. I mentioned in an earlier story that the Midwest—including
Michigan!—once had some of the worst malaria outbreaks in the country.
Anopheles mosquitoes had always flourished in the damp lowlands around streams
and melting snow, and when settlers came, some of them carried Plasmodium
parasites that the mosquitoes spread widely. The settlers’ farming practices
made for even more stagnant water, and their sod and log houses were perfect
habitat for biting pests. After farmers had exhausted the soil, they started
raising cows rather than crops—and mosquitoes prefer to suck bovine blood even
more than that of humans, helping break the malaria cycle. In the South and
other parts of the country, larvicides, pesticides, better drainage, bug-proof
housing, mechanized agriculture that replaced human labor, and fewer people
living in lowlands helped eliminate malaria.
Oppressive, burdensome, over-reaching government regulations. People
like to complain about the government, but when you start looking through the
alphabet soup of agencies, you realize that most of them are there to save your
life. The National Oceanic and Atmospheric Administration runs the National
Weather Service and warns you about hurricanes. The Environmental Protection
Agency enforces the Clean Air Act and has dramatically reduced the amount of
deadly pollutants in the air you breathe. The Occupational Safety and Health
Administration keeps you safe at work. The National Highway Traffic Safety
Administration and National Transportation Safety Board investigate vehicles
and accidents and make recommendations so accidents don’t happen again. The
Food and Drug Administration keeps deadly microbes out of your food. The
Consumer Product Safety Commission recalls toys that could kill your child. The
Centers for Disease Control and Prevention tracks and tries to cure or avert
basically any health hazard, and the National Institutes of Health supports
some of the most important biomedical research in the world.
Goodness. Philosopher Daniel Dennett had an epiphany after emergency
surgery a few years ago. It wasn’t a religious epiphany—instead of thanking
God, he realized he should thank human goodness:
“To whom, then, do I
owe a debt of gratitude? To the cardiologist who has kept me alive and ticking
for years … the surgeons, neurologists, anesthesiologists, and the
perfusionist, who kept my systems going for many hours under daunting
circumstances. To the dozen or so physician assistants, and to nurses and
physical therapists and x-ray technicians and a small army of phlebotomists so
deft that you hardly know they are drawing your blood, and the people who
brought the meals, kept my room clean. … I remember with gratitude my late
friend and Tufts colleague, physicist Allan Cormack, who shared the Nobel Prize
for his invention of the CT scanner. Allan—you have posthumously saved yet
another life, but who's counting? The world is better for the work you did.
Thank goodness. Then there is the whole system of medicine, both the science
and the technology. … So I am grateful to the editorial boards and referees,
past and present, of Science, Nature, Journal of the American Medical
Association, Lancet, and all the other institutions of science and medicine
that keep churning out improvements, detecting and correcting flaws.”
These are just a few of the countless ways people have made life safer,
healthier, less painful—and longer—than we ever could have imagined a few
centuries ago. Thank goodness.
–30–
I am grateful for modern medicine on many occassions. Antibiotics have saved my life countless
times. The earliest serious infection I
remember was at age 12 when a dog my brother Bryce bit me and I got an infection
in my jaw. At 16, I had a potentially
fatal flu that was alleviated by IV antibiotics and fluids. After being paralyzed at 22, I have had
countless bladder infections that would have all been fatal prior to the advent
of sulfa drugs and penicillin. I am
currently on two mild antibiotics for the rest of my life due my comprised
immune system.
BONUS
For fans of quackery err alternative medicine, here
is a video that ‘splains it all…
