What’s the good news about global health?

1: This week we’ve been exploring the incredible medical advances against infectious diseases and the incredible increase in human health. Yesterday we looked at diseases which have been eradicated or are on the verge of eradication, including small pox, rinderpest, polio, elephantiasis, river blindness, and blinding trachoma.

But there’s more good news.

“Even diseases that are not obliterated are being decimated,” writes Steven Pinker in Enlightenment Now. “Between 2000 and 2015, the number of deaths from malaria (which in the past killed half the people who had ever lived) fell by 60 percent. The World Health Organization has adopted a plan to reduce the rate by another 90 percent by 2030… The Bill and Melinda Gates Foundation has adopted the goal of eradicating it altogether.”

2: In the 1990s the prevalence of HIV/AIDS reversed humanity’s progress in lengthening life spans. “But the tide turned in the next decade, and the global death rate for children was cut in half, emboldening the UN to agree in 2016 to a plan to end the AIDS epidemic (though not necessarily to eradicate the virus) by 2030,” Steven observes.

Beginning in the year 2000, there has been a massive reduction in the number of children dying from the four most lethal infectious diseases, including pneumonia, diarrhea, malaria, and measles. “In all, the control of infectious disease since 1990 has saved the lives of more than a hundred million children,” writes Steven.

3: As spectacular as the conquest of infectious disease in Europe and America, the continuing advances among the global poor is even more amazing. “Part of the explanation lies in economic development, because a richer world is a healthier world,” Steven observes.

The other driving factor?

“The expanding circle of sympathy, which inspired global leaders such as Bill Gates, Jimmy Carter, and Bill Clinton to make their legacy the health of the poor in distant continents rather than glittering buildings close to home,” Steven notes. “George W. Bush, for his part, has been praised by even his harshest critics for his policy on African AIDS relief, which saved millions of lives.”

The Nobel laureate, Angus Deaton “notes that even the idea that lies at the core of the Enlightenment—knowledge can make us better off–may come as a revelation in the parts of the world where people are resigned to their poor health, never dreaming that changes to their institutions and norms could improve it.”

More from Steven Pinker in weeks to come.

________________

Reflection: Take a moment to be grateful for the advances in medical care and resulting increase in human life

Action: Share this information with a friend or colleague.

Smallpox was.  Past tense.

1: From Wikipedia: “Smallpox was an infectious disease caused by either of two virus variants, Variola major and Variola minor.”

Yes, “smallpox was.”

“The disease that got its name from the painful pustules that cover the victim’s skin, mouth, and eyes and that killed more than 300 million people in the 20th century has ceased to exist,” writes Steven Pinker in Enlightenment Now: The Case for Reason, Science, Humanism, and Progress.  

The last case was diagnosed in Somalia in 1977.

“For this astounding moral triumph we can thank, among others, Edward Jenner, who discovered vaccination in 1796, the World Health Organization, which in 1959 set the audacious goal of eradicating the disease, and William Foege, who figured out that vaccinating small but strategically chosen portions of the vulnerable populations would do the job,” comments the economist Charles Kenny.

The total, ten-year cost of the program?

$312 million.  Or about 32 cents per person in infected countries.  The equivalent of the cost of the wing of a B-2 bomber.  Talk about a colossal return on investment.

2: “But this stupendous achievement was only the beginning,” Steven observes.  Rinderpest or cattle plague, which starved millions of farmers throughout history by wiping out their livestock?  Was.  Past tense.  

“Polio?  From 350,000 cases in 1988 to less than 1,500 in 2020.  Guinea worm, a three-foot-long parasite for which the only treatment consists of pulling the worm out over several days or weeks?  From 3.5 million in 1986 to just twenty-five cases in 2016.

“Elephantiasis, river blindness, and blinding trachoma, whose symptoms are as bad as they sound, may also be defined in the past tense by 2030,” Steven notes.  “Measles, rubella, yaws, sleeping sickness, and hookworm are in epidemiologist’s’ sights as well.

“And in the most ambitious plan of all, a team of global health experts led by the economists Dean Jamison and Lawrence Summers have laid out a roadmap for “a grand convergence in global health” by 2035, when infectious, maternal, and child deaths everywhere in the world could be reduced to the levels found in the healthiest middle-income countries today,” Steven shares.

3: The most powerful contributor to this string of incredible successes?  Science.  “It is knowledge that is the key,” says Nobel Prize winning economist Angus Deaton.  

The benefits of science are not “just high-tech pharmaceuticals such as vaccines, antibiotics, antiretrovirals, and deworming pills,” Steven writes.  “They also comprise ideas; ideas that may be cheap to implement and obvious in retrospect, but which save millions of lives.”  

Many of the health-related breakthroughs over the past decades are decidedly “low tech” and relatively inexpensive.  Millions of lives have been saved as a result.

Ideas like “boiling, filtering, or adding bleach to water; washing hands; giving iodine supplements to pregnant women; breast-feeding and cuddling infants; defecating in latrines rather than in fields, streets, and waterways; protecting sleeping children with insecticide-impregnated bed nets; and treating diarrhea with a solution of salt and sugar in clean water,” notes Steven.

More tomorrow.

______________________

Reflection:  Take a moment to be grateful for the advances in medical care and resulting increase in human life.    

 Action:  Share this information with a friend or colleague.

Scientists as superheroes?

1: On April 12, 1955, a team of scientists declared Jonas Salk’s vaccine against polio, a disease which killed thousands each year, paralyzed President Franklin Roosevelt, and sent many children into iron lungs, had been proven safe.  

“People observed moments of silence, rang bells, honked horns, blew factory whistles, fired salutes, . . . took the rest of the day off, closed their schools or convoked fervid assemblies therein, drank toasts, hugged children, attended church, smiled at strangers, and forgave enemies,” Richard Carter states in Steven Pinker‘s Enlightenment Now.  

New York City proposed honoring Jonas with a ticker-tape parade, which he politely declined.

2: “When I was a boy,” writes Steven, “a popular literary genre for children was the heroic biography of a medical pioneer such as Edward Jenner, Louis Pasteur, Joseph Lister, Frederick Banting, Charles Best, William Osler, or Alexander Fleming.”

How much thought have we given lately to Karl Landsteiner? Steven asks.  

“Karl who? He only saved a billion lives by his discovery of blood groups,” he writes.

What about Abel Wolman and Linn Enslow who discovered chlorination of water, saving an estimated 177 million lives?  

Or William Foege who’s smallpox eradication strategy has saved 131 million lives?  What about Maurice Hilleman who’s discovery of eight vaccines saved an estimated 129 million lives?  Or John Enders and the measles vaccine which has saved 120 million lives?

Researchers have identified one hundred or so scientists who collectively have saved more than five billion lives.  So far.

3: “Of course hero stories don’t do justice to the way science is really done,” writes Steven.  “Scientists stand on the shoulders of giants, collaborate in teams, toil in obscurity, and aggregate ideas across worldwide webs.”

Steven’s point?  We take so much for granted in our modern world.  

“Whether it’s the scientists or the science that is ignored, the neglect of the discoveries that transformed life for the better is an indictment of our appreciation of the modern human condition,” Steven states.

More tomorrow.

____________________________

Reflection:  Take a moment to be grateful for the advances in medical care and resulting increase in human life.     

Action:  Share this information with a friend or colleague.

Wealth and power are no match for what?

1: Many people believe we live in the “worst of times.”  The data shows otherwise.  

Today we continue our exploration of the many and momentous ways life has improved over the past 200 years by looking at our health.  

“For most of human history, the strongest force of death was infectious disease, the nasty feature of evolution in which small, rapidly reproducing organisms make their living at our expense and hitch a ride from body to body in bugs, worms, and bodily effluvia,” writes Steven Pinker in Enlightenment Now: The Case for Reason, Science, Humanism, and Progress.

Millions of people died because of epidemics, which wiped out entire civilizations and brought misery to local populations.  One example?  Yellow fever, a viral disease transmitted by mosquitoes, was named because its victims turned yellow before dying in misery.

Steven shares an account of an 1878 epidemic in Memphis, where those infected by yellow fever “crawled into holes twisted out of shape, their bodies discovered later only by the stench of their decaying flesh. . . . [A mother was found dead] with her body sprawled across the bed . . . black vomit like coffee grounds spattered all over . . . the children rolling on the floor, groaning.”

Wealth provided no protection against infectious disease: The wealthiest man in the world, Nathan Mayer Rothschild, died of an infected abscess, in 1836.

Nor did power: different British monarchs died from dysentery, smallpox, pneumonia, typhoid, tuberculosis, and malaria.  

American presidents were not immune: William Henry Harrison died of septic shock in 1841, thirty-one days after his inauguration.  James Polk died from cholera three months after leaving office in 1849.  In 1924, the sixteen-year-old son of a sitting president, Calvin Coolidge Jr., died of an infected blister he got while playing tennis.

2: “But starting in the late 18th century with the invention of vaccination, and accelerating in the 19th with acceptance of the germ theory of disease, the tide of battle began to turn,” Steven writes.  “Handwashing, midwifery, mosquito control, and especially the protection of drinking water by public sewerage and chlorinated tap water would come to save billions of lives.

“Before the 20th century, cities were piled high in excrement, their rivers and lakes viscous with waste, and their residents drinking and washing their clothes in putrid brown liquid,” Steven notes.

Then, in 1854, John Snow figured out that cholera-stricken Londoners were getting their drinking water from a pipe that was downstream from an outflow of sewage.  His findings brought about changes to the water and waste systems of London, which led to changes in other cities and an overall significant improvement of public health around the world.

3: The other silent killer?  Medical care itself.

Prior to the discovery of anesthesia, antisepsis, and blood transfusions, “surgery was a source of torture and mutilation as opposed to a cure,” Steven writes.

“Doctors themselves used to be a major health hazard as they went from autopsy to examining room in black coats encrusted with dried blood and pus, probed their patients’ wounds with unwashed hands, and sewed them up with sutures they kept in their buttonholes,” Steven writes.  

Then, Ignaz Semmelweis and Joseph Lister proved the importance of sterilizing hands and equipment.  The world would truly never be the same.  Doctors and nurses were transformed from taking lives to saving lives.   

More tomorrow.

____________________________

Reflection: Take a moment to be grateful for the advances in medical care and resulting increase in human life.     

Action:  Share this information with a friend or colleague.

Does living longer just mean more years spent “senile in a rocking chair”?

We are living longer.  A lot longer.  Worldwide, the average lifespan is now 71.6 years.  Infant mortality is down.  Way down.  Everywhere across the world, writes Steven Pinker in Enlightenment Now.

Which brings up two questions:

1: Is the increase in life expectancy due mostly to the reduction in infant mortality?  

No.  

Those of us who survive the difficulties of childbirth and childhood live longer than our compatriots of earlier eras.  

No matter how old we are, we have more years ahead of us than people of our age did in earlier decades and centuries.  A British baby who survives their first year of life would have lived to 47 in 1845, 57 in 1905, 72 in 1955, and 81 in 2011.  

“A 30-year-old could look forward to another thirty-three years of life in 1845, another thirty-six in 1905, another forty-three in 1955, and another fifty-two in 2011,” Steven observes.  “If Socrates had been acquitted in 1905, he could have expected to live another nine years; in 1955, another ten; in 2011, another sixteen. An 80-year-old in 1845 had five more years of life; an 80-year-old in 2011, nine years.” 

The trend is the same in every part of the world.  “For example, a 10-year-old Ethiopian in 1950 could expect to live to 44; a 10-year-old Ethiopian today can expect to live to 61.” 

“The improvements in health among the global poor in the last few decades are so large and widespread that they rank among the greatest achievements in human history.  Rarely has the basic well-being of so many people around the world improved so substantially, so quickly. Yet few people are even aware that it is happening,” notes Georgetown professor and economist Steven Radelet.

2: Will these extra years be spent “senile in a rocking chair”?

Once again, the answer is no.  “Of course the longer you live, the more of those years you’ll live as an older person, with its inevitable aches and pains,” writes Steven.  “But bodies that are better at resisting a mortal blow are also better at resisting the lesser assaults of disease, injury, and wear. As the life span is stretched, our run of vigor is stretched out as well, even if not by the same number of years.”

The Global Burden of Disease project has compiled not just the number of people who drop dead from 291 diseases and disabilities, but how many years of healthy life they lose according to the degree to which each condition impacts the quality of their lives.  In 1990, the project estimated that 56.8 of the 64.5 years of life that an average person could be expected to live were years of healthy life. In 2010, of the 4.7 additional years gained in those two decades, 3.8 were healthy years.

There is good news in many areas involving health and disease,  including “a decline in the death rate from cancer over the past twenty-five years of around a percentage point a year, saving a million lives in the United States alone,” Steven writes.

“For many people the greatest fear raised by the prospect of a longer life is dementia,” Steven notes.  “But another pleasant surprise has come to light: between 2000 and 2012, the rate among Americans over 65 fell by a quarter, and the average age at diagnosis rose from 80.7 to 82.4 years.”

In 2001 George W. Bush appointed a President’s Council on Bioethics to deal with the looming threat of biomedical advances that promise longer and healthier lives.  Its chairman, physician Leon Kass, decreed that “the desire to prolong youthfulness is an expression of a childish and narcissistic wish incompatible with a devotion to posterity,” and that the years that would be added to other people’s lives were not worth living.  

“Would professional tennis players really enjoy playing 25 percent more games of tennis?” he asked.

Steven’s reply?

“Most people would rather decide that for themselves, and even if he is right that ‘mortality makes life matter,’ longevity is not the same as immortality.” 

More later!

______________________

Reflection:  How does the prospect of living more years impact my overall life goals and aspirations?

Action: Journal about my response to the question above.

A triumph of human well-being

1: Consider this fact: Well into the 19th century, in Sweden, one of the world’s wealthiest countries, between a quarter and a third of all children died before their fifth birthday.  And, in some years the death toll was close to 40%, Steven Pinker shares in his powerful book Enlightenment Now.

This week we are continuing our review of the incredible progress human beings have made following the Industrial Revolution.  Many people believe we live in the “worst of times.”  The data tells us otherwise.  Today, we look at infant mortality.

Our chart shows the decline in child mortality in five countries in from different continents.  What Steven refers to as the “spikiness” of the curve before 1900 shows the difficulty of life for most of human history: ” An epidemic, war, or famine could bring death to one’s door at any time.”

Tragedy struck all parts of society.  Charles Darwin lost two children in infancy and his beloved daughter Annie at the age of 10.

2: Then, something incredible happened.  “The rate of child mortality plunged a hundredfold, to a fraction of a percentage point in developed countries, and the plunge went global,” Steven notes.  The greatest innovation of the Industrial Revolution was innovation itself.  

“In sub-Saharan Africa, the child mortality rate has fallen from around one in four in the 1960s to less than one in ten in 2015, and the global rate has fallen from 18 to 4 percent–still too high, but sure to come down if the current thrust to improve global health continues.”

One counter-intuitive result of this trend is when fewer children die, parents have fewer children because they do not have to “hedge their bets against losing their entire families,” Steven writes.  

“So contrary to the worry that saving children’s lives would only set off a ‘population bomb’ (a major eco-panic of the 1960s and 1970s, which led to calls for reducing health care in the developing world), the decline in child mortality has defused it,” notes Steven.

3: And, on a more personal note: when fewer children die, human happiness increases exponentially.  “The loss of a child is among the most devastating experiences,” Steven notes.  “Imagine the tragedy; then try to imagine it another million times.  That’s a quarter of the number of children who did not die last year alone who would have died had they been born fifteen years earlier.  Now repeat, two hundred times or so, for the years since the decline in child mortality began.”

The lines on our graph represent “a triumph of human well-being whose magnitude the mind cannot begin to comprehend.”  Amen.

More tomorrow.

______________________

Reflection:  What surprises me about the data shared above?  Why does it surprise me?

Action:  Share this information with a friend or colleague who is convinced we live in the “worst of times.”

Is all the wealth just going to the rich?

Why does it matter that Gross Domestic Product (GDP) per capita has gone up so dramatically?  After stagnating at around $500 for thousands of years, it has increased 20 fold to over $10,000 in the 200 years since the Industrial Revolution.

“Though it’s easy to sneer at national income as a shallow and materialistic measure, it correlates with every indicator of human flourishing,” notes Steven Pinker in Enlightenment Now, including “longevity, health, and nutrition”.  

“Less obviously, it correlates with higher ethical values like peace, freedom, human rights, and tolerance.  Richer countries, on average, fight fewer wars with each other, are less likely to be driven by civil wars, are more likely to become and stay democratic, and have greater respect for human rights (on average, that is; Arab oil states are rich but repressive).  The citizens of richer countries have greater respect for “emancipative” or liberal values such as women’s equality, free speech, gay rights, participatory democracy, and protection of the environment.  Not surprisingly, as countries get richer they get happier; more surprisingly, as countries get richer they get smarter.”

But what about economic inequality?  Is all the wealth just going to the rich?  

Economic inequality has become an obsession, Steven observes.  Between 2009 and 2016, New York Times articles containing the word inequality soared tenfold, reaching 1 in 73.  Steven quotes Pope Francis who called inequality “the root of social evil.”  

Self-described socialist Bernie Sanders proclaimed “a nation will not survive morally or economically when so few have so much, while so many have so little.”  While running for President in 2016, Donald Trump, claimed the United States had become “a third-world country”.  He “blamed the declining fortunes of the working class not on Wall Street and the one percent but on immigration and foreign trade,” Steven notes.

“The left and right ends of the political spectrum, incensed by economic inequality for their different reasons, curled around to meet each other,” Steven writes.

So, what are the facts?  “Has rising inequality really immiserated the majority of citizens?” asks Steven.

“The new conventional wisdom is that the richest one percent have skimmed off all the economic growth of recent decades, and everyone else is treading water or slowly sinking,” Steven writes.

Not so fast, says Steven.  He dedicates a chapter of his book to this topic “because so many people have been swept up in the dystopian rhetoric and see inequality as a sign that modernity has failed to improve the human condition.  As we will see, this is wrong, and for many reasons,” he notes.

“The starting point for understanding inequality in the context of human progress is to recognize that income inequality is not a fundamental component of well-being,” notes Steven.  “It is not like health, prosperity, knowledge, safety, peace, and the other areas of progress.”

The reason is captured in an old joke from the Soviet Union…  

Igor and Boris are poor peasants, barely growing enough crops from their small plots of land to feed their families.  The only difference between them is that Boris owns one scraggly goat.  One day a fairy appears to Igor and grants him a wish.  Igor says, “I wish that Boris’s goat would die.”

The point of the joke is while the two peasants have become more equal, neither is better off.

“Indeed, a narrow focus on economic inequality can be destructive if it distracts us into killing Boris’s goat instead of figuring out how Igor can get one,” Steven writes.

Inequality and poverty are not the same.

“The confusion of inequality with poverty comes straight out of the lump fallacy—the mindset in which wealth is a finite resource, like an antelope carcass, which has to be divvied up in zero-sum fashion, so that if some people end up with more, others must have less,” Steven notes. 

As we’ve seen, wealth has expanded exponentially since the Industrial Revolution.  

Imagine a standard nine-inch pie pan.  It is the year 1700.  This pie represents all of the world’s wealth and prosperity at the time.

Today, the pie pan would be ten feet in diameter.

Put another way: of this ten foot diameter pie, “if we were to surgically carve out the teeniest slice imaginable-say, one that was two inches wide at its widest point-it would be the size of the entire pie in 1700,” Steven observes.

The data also shows that as countries become wealthier they “devote a substantial chunk of their wealth to health, education, pensions, and income support,” Steven notes.  The median percentage of social spending across twenty western democracies is 22 percent.

“Those who condemn modern capitalist societies for callousness toward the poor are probably unaware of how little the pre-capitalist societies of the past spent on poor relief,” writes Steven.  “It’s not just that they had less to spend in absolute terms; they spent a smaller proportion of their wealth.

A much smaller proportion.

“From the Renaissance through the early 20th century, European countries spent an average of 1.5 percent of their GDP on poor relief, education, and other social transfers. In many countries and periods, they spent nothing at all.”

____________________________

Reflection:  Am I surprised by the data above?  Why or why not?  

Action: Share this information with a friend or colleague who is convinced we live in the “worst of times.”

Is globalization the enemy?

This week we are exploring the reasons behind the incredible drop in worldwide extreme poverty: from 90% in 1800 at the beginning of the Industrial Revolution to less than 10% today.  

And falling.

The United Nations has set a target of “ending extreme poverty for all people everywhere” by 2030.  

What accounts for this incredible drop?

Yesterday, we looked at three reasons outlined by Steven Radelet, author of The Great Surge: The Ascent of the Developing Worldas quoted in Steven Pinker‘s Enlightenment Now.

Today, we turn to reasons four and five.

Reason #4 for the dramatic decline in worldwide extreme poverty: Globalization.  “In particular the explosion in trade made possible by container ships and jet airplanes and by the liberalization of tariffs and other barriers to investment and trade,” writes Steven Pinker.  “As countries specialize in different goods and services, they can produce them more efficiently, and it doesn’t cost them much more to offer their wares to billions of people than to thousands.  At the same time buyers, shopping for the best price in a global bazaar, can get more of what they want.

“Notwithstanding the horror that the word elicits in many parts of the political spectrum, globalization, development analysts agree, has been a bonanza for the poor,” notes Steven.  He quotes Nobel-winning economist Angus Deaton, who said: “Some argue that globalization is a neoliberal conspiracy designed to enrich a very few at the expense of many.  If so, that conspiracy was a disastrous failure—or at least, it helped more than a billion people as an unintended consequence…” 

“While working on the factory floor is often referred to as sweatshop labor,” observes economist Steven Radelet, “it is often better than the granddaddy of all sweatshops: working in the fields as an agricultural day laborer.” 

He shares his own experience visiting Indonesia in the early 1990’s to conduct research:  “I arrived with a somewhat romanticized view of the beauty of people working in rice paddies, together with reservations about the rapidly growing factory jobs.  The longer I was there, the more I recognized how incredibly difficult it is to work in the rice fields.  

“It’s a backbreaking grind, with people eking out the barest of livings by bending over for hours in the hot sun to terrace the fields, plant the seeds, pull the weeds, transplant the seedlings, chase the pests, and harvest the grain.  Standing in the pools of water brings leeches and the constant risk of malaria, encephalitis, and other diseases.  So, it was not too much of a surprise that when factory jobs opened offering wages of $2 a day, hundreds of people lined up to get a shot at applying.”

Kavita Ramdas, the head of the Global Fund for Women, said in 2001 that in an Indian village “all there is for a woman is to obey her husband and relatives, pound millet, and sing. If she moves to town, she can get a job, start a business, and get education for her children.”

Steven Pinker shares data from a Bangladesh study which confirms women who worked in the garment industry (as Steven’s grandparents did in 1930s Canada) “enjoyed rising wages, later marriage, and fewer and better-educated children.  Over the course of a generation, slums, barrios, and favelas can morph into suburbs, and then working class can become middle class.”

Industrialization of the developing world has produced poor working conditions that are “harsh by the standards of modern rich countries and have elicited bitter condemnation,” notes Steven.

Consumer protests and pressure from trade negotiators has resulted in “measurably improved working conditions in many places, and it is a natural progression as countries get richer and more integrated into the global community,” notes Steven.

Progress does not mean “accepting every change as part of an indivisible package—as if we had to make a yes-or-no decision on whether the Industrial Revolution, or globalization, is a good thing or bad thing, exactly as each has unfolded in every detail,” Steven observes.  

“Progress consists of unbundling the features of a social progress as much as we can to maximize the human benefits while minimizing the harms,” writes Steven.

Reason #5:  Science and technology.  “Life is getting cheaper, in a good way.  Thanks to advances in know-how, an hour of labor can buy more food, health, education, clothing, building materials,” Steven writes.  

“As for good advice on health, farming, and business: it’s better than cheap; it’s free.” 

More than half of the adults worldwide own a smartphone.

“In parts of the world without roads, landlines, postal service, newspapers, or banks, mobile phones are more than a way to share gossip and cat photos; they are a major generator of wealth,” Steven writes.  “They allow people to transfer money, order supplies, track the weather and markets, find day labor, get advice on health and farming practices, and even obtain a primary education.”  

Access to information about medicine, electronics, crop varieties, and best practices in agriculture, business, and public health has made a huge impact. 

“According to one estimate, every cell phone adds $3,000 to the annual GDP of a developing country,” Steven writes.

But what about growing income inequality?

More tomorrow.

______________________

Reflection:  Am I surprised by the data above?  Why or why not?  

Action: Share this information with a friend or colleague who is convinced we live in the “worst of times.”

Why has worldwide prosperity increased so dramatically? 

Today we take it for granted if we want some milk, we can walk into a convenience store and it will be waiting for us on refrigerated shelf.  We know the milk won’t be diluted or tainted.  The price will be something we can afford.  And, the store’s owner will let us walk out with it after swiping a card, even though we’ve never met, may never see each other again, and have no friends in common to vouch for us, Steven Pinker observes in Enlightenment Now: The Case for Reason, Science, Humanism, and Progress

“A few doors down I could do the same with a pair of jeans, a power drill, a computer, or a car,” writes Steven.

This reality is a recent phenomenon.

For thousands of years, in the words of Thomas Hobbes, life for human beings was “nasty, brutish, and short.” 

This week we’ve been exploring ideas around the Industrial Revolution and the truly revolutionary increase in prosperity that capitalism has created. RWD Monday, RWD Tuesday, RWD Wednesday.

How did this happen?

“The most obvious cause was the application of science to the improvement of material life,” Steven tells us.  “The machines and factories of the Industrial Revolution, the productive farms of the Agricultural Revolution, and the water pipes of the Public Health Revolution could deliver more clothes, tools, vehicles, books, furniture, calories, clean water, and other things that people want than the craftsmen and farmers of a century before.”

As historian William Rosen writes: The greatest innovation of the Industrial Revolution was innovation itself.  “Not simply a huge increase in the number of new inventions, large and small, but also the process of invention itself.” 

One innovation created another innovation which created another innovation, and on and on and on…

“The invention of the barometer in 1643, which proved the existence of atmospheric pressure, eventually led to the invention of steam engines,” Steven writes.  “Other two-way streets between science and technology included the application of chemistry, facilitated by the invention of the battery, to synthesize fertilizer, and the application of the germ theory of disease, made possible by the microscope, to keep pathogens out of drinking water and off doctors’ hands and instruments.”

It begins with science but two other innovations also played a key role. 

“One was the development of institutions that lubricated the exchange of goods, services, and ideas – the dynamic singled out by Adam Smith as the generator or wealth,” Steven writes.  “In 18th century England, cronyism gave way to open economies in which anyone could sell anything to anyone, and their transactions were protected by the rule of law, property rights, enforceable contracts, and institutions like banks, corporations, and government agencies that run by fiduciary duties rather than personal connections.”

Also important was a third factor: a change in societal values.  

“Aristocratic, religious, and martial cultures have always looked down on commerce as tawdry and venal,” Steven observes.  “But in 18th-century England and the Netherlands, commerce came to be seen as moral and uplifting.”  Focus shifted to propriety, thrift, self-restraint, and an orientation toward the future rather than the past.  In time, dignity and prestige were given to merchants and inventors rather than just soldiers, priests, and courtiers, Steven notes.

What Steven calls “the Great Escape” in Britain and the Netherlands was quickly followed by escapes in the Germanic states, the Nordic countries, and Britain’s colonial offshoots in Australia, New Zealand, Canada, and the United States. 

In the last fifty years, he notes the Great Escape has become the Great Convergence:  “Countries that until recently were miserably poor have become comfortably rich, such as South Korea, Taiwan, and Singapore. (My Singaporean former mother-in-law recalls a childhood dinner at which her family split an egg four ways,” Steven recalls). 

“Since 1995, 30 of the world’s 109 developing countries, including countries as diverse as Bangladesh, El Salvador, Ethiopia, Mongolia, Mozambique, Panama, Rwanda, Uzbekistan, and Vietnam, have enjoyed economic growth rates that amount to a doubling of income every eighteen years.

“Another 40 countries have had rates that would double income every thirty-five years, which is comparable to the historical growth rate of the United States,” Steven comments.  

“By 2008 the world’s population, all 6.7 billion of them, had an average income equivalent to Western Europe in 1964.  

“And no, it’s not just because the rich are getting even richer,” Steven observes.  “Extreme poverty is being eradicated, and the world is becoming middle class.”

More to come in future Rise With Drew posts.  

___________________________

Reflection:  Take a moment to be grateful to be alive at this moment in history.

Action:  Journal about it.

What causes wealth?

Today, most discussions about poverty involve who is to blame for it, observes Steven Pinker in Enlightenment Now: The Case for Reason, Science, Humanism, and Progress

This line of thinking is misguided, he believes.  

Poverty needs no explanation.

“In a world governed by entropy and evolution, it is the default state of humankind.  Matter does not arrange itself into shelter or clothing, and living things do everything they can to avoid becoming our food,” Steven observes.  

“As Adam Smith pointed out, what needs to be explained is wealth,” writes Steven. 

To put it succinctly, “Poverty has no causes.  Wealth has causes,” the economist Peter Bauer tells us. 

This week RWD Monday and RWD Tuesday we’ve looked at the graph showing human progress over time.  Prosperity did not improve gradually.  There was little or no progress for thousands of years.  Then, around 1800, the Industrial Revolution happened, and nothing has been the same since.

What was life like – for thousands of years – prior to the Industrial Revolution?

The endurance of poverty was the reality.  “If you could afford to buy bread to survive another day, you were not poor,” writes Steven referencing historian Johan Norberg.

Johan quotes the childhood reminiscence of a contemporary of one of his ancestors from 1868 in Sweden, one of the wealthiest countries in the world at the time:  “We often saw mother weeping to herself, and it was hard on a mother, not having any food to put on the table for her hungry children.  Emaciated, starving children were often seen going from farm to farm, begging for a few crumbs of bread.  

“One day three children came to us, crying and begging for something to still the pangs of hunger.  Sadly, her eyes brimming with tears, our mother was forced to tell them that we had nothing but a few crumbs of bread which we ourselves needed.  When we children saw the anguish in the unknown children’s supplicatory eyes, we burst into tears and begged mother to share with them the crumbs that we had.  Hesitantly she acceded to our request, and the unknown children wolfed down the food before going on to the next farm, which was a good way off from our home.  The following day all three were found dead between our farm and the next.”

“In wealthy Genoa, poor people sold themselves as galley slaves every winter,” writes Steven.  “In Paris, the very poor were chained together in pairs and forced to do the hard work of cleaning the drains.  In England, the poor had to work in workhouses to get relief, where they worked long hours for almost no pay. Some were instructed to crush dog, horse and cattle bones for use as fertilizer, until an inspection of a workhouse in 1845 showed that hungry paupers were fighting over the rotting bones to suck out the marrow.”

These anecdotes capture the reality of human life for many less than two hundred years ago.

“We are led to forget the dominating misery of other times in part by the grace of literature, poetry, romance, and legend, which celebrate those who lived well and forget those who lived in the silence of poverty,” writes economist Nathan Rosenberg and legal scholar L. E. Birdzell Jr.  “The eras of misery have been mythologized and may even be remembered as the golden ages of pastoral simplicity.  They were not.”

Our political debates today surround how wealth should be distributed.  This presupposes, Steven observes, that wealth worth distributing exists in the first place.

“Economists speak of a ‘lump fallacy'” writes Steven, “in which a finite amount of wealth has existed since the beginning of time, like a lode of gold, and people have been fighting over how to divide it up ever since.”

How much as human wealth, progress, and prosperity increased?

“If the pie we were dividing in 1700 was baked in a standard nine-inch pan, then the one we have today would be more than ten feet in diameter,” Steven reflects.  “If we were to surgically carve out the teensiest slice imaginable – say, one that was two inches at its widest point-it would be the size of the entire pie in 1700.”

Many people today believe we are living in the worst of times.  The data tells a very different story.  

More tomorrow.

________________________________

Reflection:  Why has capitalism made such an impact on worldwide prosperity and the quality of human life?

Action: Journal about it.