I am from France, and noticed recently that many people I know - friends, family - would have died young without today's medicine. Apparently, in 1900, life expectancy at birth (LEB) in France was about 50 years old. I didn't do the maths (I have little data and I cannot say for sure that disease X would have killed a patient a century ago) but 50 years old average seems high compared to my personal experience.

If today, in developed countries, we had to revert to using only 1900 medicine and surgery (we can discard the medical practices that were actually making things worse), with the same environment, would we live longer or shorter?

Some random ideas of what could make LEB increase apart from medicine:

  • Environment is better (food is better and more available, hygiene)
  • Better genes (mixing of populations..?)
  • Social and technological progress (better working conditions)

What could make it decrease:

  • Environment has degraded (unhealthy food and lifestyles, pollution?)
  • Genes have degraded (?)
  • I believe it would be much better and more natural way of living.
    – kenorb
    Commented Jul 16, 2015 at 8:55

1 Answer 1


Your question is too big to be answered with a formal analysis. So here is a back of the envelope assessment:

[A] We are worse off today (vs. 1900) because of:

  • tobacco use
  • obesity
  • iPods (every adult will be deaf in 20 years)
  • motor vehicle accidents, gun violence, immense wars

[B] We are better off today (vs. 1900) because of:

  • better nutrition (hunger was common in the USA even into the 1960s)
  • public health improvements (e.g. clean water, shoes for all).
  • refrigeration (stomach cancer was #1 in 1900, owing to widespread pickling of foods).
  • safer work conditions.

[C] Important medical developments since 1900:

  • antibiotics
  • anti-tuberculous medicines
  • hypertension control
  • vaccines
  • infant mortality
  • everything else is rounding error

[D] Not a factor:

  • genes
  • alcohol (bad, but probably same vs. 1900)

So, life in 2015 = C + B - A. Your question is whether B - A is better than life in 1900.

Comparing survival curves, the biggest change in survival is the huge improvement in living to age 5.

  • 20% of people dead by age 5 (USA whites, 1900)
  • 8% of people dead by age 5 (USA whites, 1930)
  • 5% of people dead by age 5 (USA whites, 1940)
  • 40% of people dead by age 5 (British India, 1921-1930)

If you look at the curves from 1900 vs. 1940, there is not that much difference once the initial large difference is subtracted. I was too lazy to go looking for more recent curves, but I doubt it would be much different. The median survival in 1940 was 70 years for USA whites.

I do not think this early life difference can be explained by an improvement in medical care. It was public health, i.e. improved living conditions (including adequate food).

You can find interesting historical survival curves in the book Ageing: The Biology of Senescence, 1964.

  • 1
    Actually, I would expect that alcohol was a much bigger problem in 1900 than it is today. I would move that to the [B] group. I would also add insulin and other diabetic drugs to the [B] group.
    – Carey Gregory
    Commented Jul 6, 2015 at 20:21

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