Reasons for the decline in the death rate
Reasons why the death rate declines during the 20th century:
- Tranter (1996) stated that over three-quarters of the decline in death rate between 1850 and 1970 was due to a reduction in the number of deaths from infectious disease, i.e. diphtheria, measles ,smallpox ,typhoid and tuberculosis. (these diseases usually killed the young so this means a reduction in infant mortality aswell).
- By the 1950s diseases of affluence (wealth) which include heart disease and cancer had generally replaced infectious diseases as the major cause of death, these diseases also mainly affected the middle aged and elderly.
- The most likely reason why the decline in death from infectious occured is due to social reforms rather than natural resistance.
- Thomas Mckeown (1972) argued that improved nutrition was what cause up to 50% of the reduction in the death rate, and was vital in the reduction of deaths from tuberculosis.
- Better nutrition increased resistance to infection by bolstering the immune system and greatly increasing the chances of survival of those that contracted infections.
- However, Mckeown failed to explain why females, who typically consumed a smaller percentage of the family's food supply, lived longer lives than their male counterparts and why infections from diseases such as measles and infant diarrhoea, actually continued to kill people and actually rose in occurence during this period of increased nutrition.
After the 1950s increases in medical knowledge and technique reduced the death rates from disease including :
- the introduction of antibiotics (like penicillin, that green mold that grows on bread), immunisation, blood transfusion, improved maternity services.
- the setting up of the national health service (NHS) in 1948.
More recent medical advances have been aimed at diseases of affluence, with improved medication & the development of bypass surgery reducing deaths from heat disease by 33%.
Smoking and diet
- Sarah Harper (2012) argues that the greatest fall in death rates in recent history is due to a reduction in the number of people smoking rather than from medical advances.
- In the 21st century however, obesity has replaced smoking as the new (toxic) lifestyle epidemic, though despite the fact that obesity levels have increased exponentially deaths from the condition have been relatively low due to drug therapy.
- Harper believes we may be developing an 'american' health culture of an unhealthy lifestyle but still maintaining a long lifespan due to expensive medication.
Public health measures
During the 20th century, the effectiveness of the central and local governing bodies increased greatly allowing them to create and enforce laws that resulted in a large number of improvements in the health of the populace and quality of life, these included:
- Housing - better ventilation, less overcrowded homes creates drier homes which means no mould, reduced amount of disease transmission.
- Purer drinking water - reduces contraction of waterborne disease
- pasteurisation of milk - reduced risk of contracting typhoid, tuberculosis, diphtheria
- improved sewage disposal methods - reducing typhoid
- 1952clean air act, reduced air pollution (Smog had previously killed around 4000 people over five days that same year).
Other social changes
These social changes also played an integral role in reducing the death rate uring the 20th century
- The decline in dangerous manual occupations such as mining which typically caused respiratory disease such as miner's lung.
- smaller family size reduced the rate of disease transmission increasing the amount of control over the spread of disease.
- Greater public knowledge of the causes of illness
- Lifestyle changes i.e. reduction in the number of men that smoke
- higher incomes, resulting in healthier lifestyles
Life expectancy - the average age to which the population lives. it is expressed in terms of years. since the death rate has declined the life expectancy has increased
- Males born in England during the early 20th century could expect to live up to around 50 (57 for females).
- Males born in England during the 21st century can expect to live up to around 90.7 (94 for females).
During the last 200 years the average life expectancy has increased by 2 years every decade.
One reason why the life expectancy during the early 20th century was so low was due to extremely high mortality rate with infants and young children. It should be noted that a newborn today has a much higher chance of reaching its 65th birthday than a newborn born in the 20th century had to reach its 1st birthday.
If this trend of increasing life expectancy continues Harper predicts we will achieve 'radical longevity' i.e. there will be a large increase in centenarians (people aged over 100 years).
Class, gender and regional differences
Although death rate has fallen greatly over the past century and life expectancy has increased greatly over the last two centuries there are still differences within class, gender and location.
- Women on average live longer than men - the gap however has reduced due to employment changes (reduction in the amount of men doing debilitating manual labour such as mining) and the increase in women smoking.
- Individuals living in the north of England and in scotlan have on average a lower life expetancy than those that love in the south, with working class men in unskilled or routine employment are three times more likely to die before the age of 65 than those in professional jobs.
- Walker (2011) people living in the poorest areas in England die on average seven years earlier than their richer counterparts.