How health innovations have increased life expectancy - and could continue to do so
I am a big fan of health innovations. I owe my life, and the lives of my wife and three children, to excellent modern health care systems. I am going to link to an excellent post about new treatments that are emerging at the end of this piece. This is a good news post to focus on what is going well, and some optimism for improvements.
Before I do that, I want to highlight some of the innovations of the last 100 years that have had the most dramatic effect on life expectancy. The early part of the 20th century - from 1900 to roughly the end of the second world war, saw a series of catastrophes. The first world war, the Spanish ‘flu pandemic, the depression, the Holodomor, and then the second world war, including The Holocaust. Life expectancy took a beating - google charts of life expectancy for Western Europe - you will see the dips especially in France. In some places you see long periods where there is an absence of data, which perhaps tells an even more horrific story. But over the last 100 years there have been some incredible innovations which has enabled a dramatic improvement in the life expectancy across developed nations - and substantial improvements in virtually all nations, some developing nations, and even in many that remain desperately poor.
Historical Context: Top Interventions of the Last 100 Years
Sanitation and Clean Water (Early to Mid-20th Century) - Municipal water treatment and widespread adoption of sanitation systems dramatically reduced deaths from waterborne illnesses like cholera and typhoid.
Antibiotics and Infection Control (1940s onward) - The discovery of penicillin and subsequent antibiotics revolutionized the treatment of bacterial infections, which were major causes of mortality in the early 20th century. Advances in surgical antisepsis and sterile techniques further reduced infection-related deaths.
Vaccines (20th Century onwards ) - Immunization programs virtually eradicated diseases like smallpox and drastically reduced others, including polio, measles, and tetanus. Widespread childhood vaccination campaigns have saved millions of lives, particularly in developing nations. It is a shame that vaccination rates in this country have been falling for some time – bringing a resurgence in diseases such as whooping cough.
Improvements in Cardiovascular Health (Mid-20th Century onwards) -Advances in understanding heart disease and hypertension led to effective treatments, such as statins, beta-blockers, and minimally invasive surgeries like angioplasty. Lifestyle interventions and public health campaigns reduced smoking, significantly decreasing cardiovascular deaths. If only we could push on and work on our obesity epidemic, we could continue to make rapid progress in this area. Some of the new weight loss medicines (see below) offer some help in the battle of the bulge – which has a huge effect on cardiovascular health, and cancer rates.
Cancer Screening and Treatment (Late 20th Century onward)
The development of chemotherapy, radiation, and surgical techniques, combined with early detection through screening, significantly improved cancer survival rates. Now we have a whole new suite of cancer medicines which look set to dramatically improve survival rates once again. But more on those later.
Advances in Maternal and Neonatal Care (20th century)
The introduction of prenatal care, safe delivery practices, and neonatal medicine has dramatically improved survival rates for mothers and infants, contributing to longer average lifespans globally. A nod should be given to safety improvements in care of children here too, which has helped not only in the first year of life, but also in the first five years.
It is hard to say exactly how much – as combinations of factors (positive and negative) have created the great outcomes we have today. In aggregate, the shift has been incredible - expectations for life expectancy at birth in the UK were about 48 for males and about 52 for females in 1900. Today they are about 82 years, about a 78% improvement. In New Zealand, the shift has been similar. I haven’t event talked about quality of life yet. Estimates vary, but the big ones have been estimated, in the UK, to have had the following contribution ranges in impact (estimates are as a percentage of the total gain in mortality).
· Sanitation and Hygiene: 20–25%
· Cardiovascular Disease Treatments: 15–20%
· Antibiotics: 10–15%
· Vaccination Programs: 10–12%
· Maternal and Neonatal Care: 8–10%
Can the rate of gains continue?
Absolutely, yes. We did a piece of work in 2023 estimating how many deaths, annually, could be saved by bringing our health system performance up to either a) the OECD average or b) the OECD leader. The gains are substantial, and are not just about later life treatments – but saving hundreds of deaths, for example, of women in their 30s, 40s, and 50s, from breast cancer.
Plus, there are so many great new innovations. For that, I want to link to this external article, which details some incredible new discoveries, which are worth reading about:
(1) Five medical breakthroughs in 2024 - by Saloni Dattani
If you would like to read the biography for Saloni Dattani, you can find a brief one here: Saloni Dattani - Our World in Data
Overall, for most people, life has become longer, better, and wealthier. At the same time, it remains true that there is much more to be done. Even just improving access