Was the lower life expectancy of yore pretty much all due to infant mortality?

Factual Questions
1

I’ve often read that the average life expectancy has gone up which I don’t doubt. What I wonder about though is whether this is due to the fact that adults live significantly longer or if it’s mainly due to the fact that fewer young children die. In days past, once you got past the age of 5, could you roughly expect to live about* as long as you do today?

*“about” being important here. Even if the higher life expectancy is mainly due to lower infant mortality, accidents and diseases are better treated today than in the past which has an effect on adults.

2

Largely, yes. I think that in the US there are statistics going back to the 1930s (for purposes of calculating Social Security) about how many working adults would reach a given age, and the increase in adult longevity since then isn’t remarkable- maybe about ten years IIRC.

Note how many children a woman might bear in her lifetime and then note that not allowing for population growth, on average only two would survive to reproduce themselves. Infant and childhood mortality used to be brutal.

3

Depends on what you mean by “yore” - sure, infant mortality used to be a much bigger issue, but if you go back far enough you also have death in childbirth as a major cause, not to mention wars.

4

I’ve seen some interesting figures on demographics in sixteenth- and seventeenth-century London (derived from guild records, so the individuals concerned were all males who had survived at least to adolescence, and all more-or-less middle class and gainfully employed, so not likely to die of malnutrition). IIRC, death rates among guild members in their mid-teens through early sixties remain relatively steady, and relatively low; the only big spikes are related to epidemics. At around age 65, the death rates start to climb sharply, and remain high; very few men survive past 80.

5

If we look at present third world countries, the infant mortality is the biggest factor, and they have a lot of the same problems as people in previous centuries (although people in the Western world have learned about hygiene, the average poor person in a 3 world country either doesn’t, or doesn’t have the opportunity - if you have neither soap nor water, you can’t practise hygiene. Digging good latrines and wells for safe drinking water are continuious projects by aid org.s).

Also, we’ve had several Dopers who are medieval experts claim that the low average life expectancy in olden times was the high infant mortality, but once you got past that (and wars and epidemics), you get expect to get older than 40 years.

6

However, until IIRC the 12th century in Europe the male life expectancy was longer than the female, chiefly because of death in childbirth, even though the brunt of war death was borne by men.

7

No. Cite: Click the link, and flip through the link to Table 11.

Years of remaining life at various ages: US




Age              1900-1902         2006
0                    49             78
5                    55             73
20                   43              59
40                   28              40
65                   12              19

The most dramatic improvements have been at young ages, but even a 40 year old can expect to live 12 years more today than in 1900.

The improvements have been fairly gradual, for years of life remaining at age 5. I made an Excel chart. http://wm54.inbox.com/thumbs/3d_130b81_c588c8d_oP.png.thumb

8

Short answer? germs.

I agree that poor hygiene and general unsanitary conditions contributed, as well as no treatment of drinking water and improper disposal of wastes.

According to WHO:

(my bolding). From here.

9

I posted this in another thread last month, you might find it interesting.*

According to this chart shows that life expectancy at 60 has only increased about 4-6 years (depending on race) since the late 1930’s. It has increased from 75 to 81 for white males.*

Also, based on my ancestors - you could live to a ripe old age if you avoided childhood or childbirth diseases and accidents. My ‘founding’ paternal ancestors died in 1705 and 1722 - both at the age of 90, with 10 living children. Others lived equally long lives.

10

For the elderly, the most dramatic recent increases have been in the quality of life, not the quantity: I am 34, and when I was a child it was not at all uncommon for a person in their 70s to be a virtual shut-in: arthritis alone could trap a person in their home for decades, and walkers and canes were ubiquitous. If you fell and broke your hip at 60, that was it–your mobility was over.

Over the last 20 years, the combination of better drugs and much better surgeries has transformed those years. I have a good friend who is 65. In the last five years she’s had both knees and a shoulder operated on laproscoptically. Just a generation ago, she’d be a cripple, stuck in her home for the rest of her life. Now, she’s a world traveler.

11

Years of Life Remaining at Age 65, US, all races:

1900…11.9
1930…12.2
1960…14.4
1990…17.3
2006…18.5

Some of this is framing. Within living memory there have been reductions in mortality as well as morbidity among the elderly. But because we think in ratios, the life expectancy figures appear less dramatic:

Live Expectancy at Age 65, US, all races:

1900…76.9
1930…77.2
1960…79.4
1990…82.8
2006…83.5

12

I just don’t think it’s useful to just be talking about the last hundred years, unless that’s really what the OP is after.

13

Perhaps it is. I haven’t much of an idea. I suspect that the life expectancy increase from 1900 to 2010 is not mainly due to the same causes as the life expectancy increase from 2000BCE to 1900CE.

14

There’s some data on this. The late Angus Maddison devoted his life to assembling estimates of demographic changes and economic growth. The OECD published a roundup near the turn of the millennium.

Life Expectancy at Birth, Group A Countries: (Japan, Europe and Europe’s Offshoots)
1000…24
1820…36
1900…46
1999…78

So between 1000 and 99 we gained 54 years. 59% of that happened in the last 100 years – so it seems that antibiotics and the advance of medicine is a big part of human progress in life expectancy.

19% occurred between 1820 and 1900 – together that implies that 78% of the progress has occurred since 1820. That’s the bulk of the story, though of course the remaining 22% (1000-1820) would be interesting to learn about as well.

In 1976 the US published the Bicentennial edition of Historical Statistics of the United States: it’s available online at the Census website. Table B 126-135 shows life expectancy profiles for Massachusetts – we can sample 1850 and 1900-02. How does life expectancy at birth compare with life expectancy at age 20?

Years of remaining life at various ages: Massachusetts




Age              1850       1900-1902
            Male  Female      Male  Female
0            38.3   40.5       46.1   49.4
20           40.1   40.2       41.8   43.7
40           27.9   29.8       27.2   28.8

Sheesh, this is tough dataset to interpret. Females in Massachusetts live longer than males as early as 1850. From what I understand, females were increasingly valued in New England during post-Colonial times as literacy rates increased, because the mother traditionally was responsible for the kids’ education.

Anyway, the data seems consistent with the infant mortality reduction story. Total gain in life expectancy at birth was 7.8 years for males and 8.9 years for females. After age 20 males gained only 1.7 years while females gained 3.5 years. But after age 40 there’s a reversal! Life expectancy at age 40 drops after 1880 for both genders. Is this an artifact of the data? Perhaps the effect was this driven by immigration, migration or shifting urbanization rates. Maybe we could google for another dataset.

For the moment, we might note that 60% of the progress in life expectancy has occurred in the past 100 years or so, and that all ages of benefited. But before 1900, it might have mostly been an infant mortality story. Data! We need more data!

15

I understand that another big factor was women dying in childbirth (most often due to puerperal fever or to being too young), and that once you’d survived your first delivery your life expectancy went up greatly, but I’m afraid I don’t have any cites. Mind you: by the time you got to be 15 and delivering a baby, you might already have survived half your siblings; the childbirth factor wasn’t as big as the child-death factor simply because it came second in temporal terms. Also, the “being too young” part would be much more important in cultures where your first blood marked you as “marriageable” than in those that waited until you had “a woman’s shape”.

16

Regarding more ancient times, yes, low life expectancies mentionned are for a significant part due to high infant mortality.

However, this is often exagerated. Some statements would let you believe that if they lived past childhood, people during say, the middle age or the enlightements, were living for almost as long as in the 20th century which is false.

This is often due to a selection bias. People think of/mention famous historical figures and point at them dying at a ripe age. However, in most cases those people became famous for a good part precisely because they lived long enough for their accomplishments.

For instance, if you look at the most famous kings (of whatever country), they are almost always those who had the longest reigns (hence plenty of time to fight several wars, face many intrigues, implement reforms, etc…). All those who died at 42after a 6 years long reign are forgotten. Similarly, scientists lived long enough to make their discoveries, statemen to grab power, writers to have many works widely published, generals to reach their high ranks and command during important wars, painters to fill our museums with their artworks, and so on…
I once calculated the average age of death of french kings from 1000 to 1500, for instance (no violent deaths and I excluded a king who died as a toddler). IIRC, they died on average at 46, and the longest lived died in his early 60s. Even though kings aren’t representative, they probably had better living conditions than most. And as already mentioned, dying while giving birth wasn’t uncommon for women.
So, in earlier eras, even though the very low life expectancy figures might give an innacurate idea due to childhood mortality, dying at what is by our modern standards a young age (30s, 40s, 50s) was common enough and reaching what we consider old age was indeed quite rare.

17

Clairobscur, that’s fascinating. What sort of things were they non-violently dying of? I’m going to assume it’s fevers and such that we now easily cure with antiobiotics, would that be correct? Is there anything in their lifestyles that hastened their end (wine, women and hunting related injuries??).

18

Sort of. Yes, they were dying of infectious disease. Progress in fighting this scourge was due to a) the discovery of the germ theory of disease, b) public health campaigns in the 19th century, including sanitation, public works and greater use of soap and c) 20th century medical advance.

We can focus on the past 200 years, because the bulk of the increase in life expectancy occurred during that time. Massachusetts has cause of death data dating back to 1842. Here’s a chart, taken from a powerpoint presentation on the web:
http://wm54.inbox.com/thumbs/3e_130b80_293626d_oP.png.thumb

Disease led to ~50-60% of all deaths before ~1880. Now it is under 5%. The era of massive progress in that regard dated from 1880-1950. Note that antibiotics were introduced in a big way only after 1940, so other factors must explain the bulk of the reduction in death from disease.

19

Anyone seriously interested in this topic should try googling “Global health transition”. The start of it is dated from 1800. A decent 2001 treatment appears to be Rising Life Expectancy: A Global History by James Riley (I have not read it). Here’s a review.

This abstract from a 2006 article by Riley is interesting: “At the initiation of their health transitions, most countries had a life expectancy between 25 and 35 years. Countries that began later made gains at a faster pace. Those faster gains are usually associated with the dissemination of Western medicine. But rapid gains occurred in the period 1920–50, largely before the availability of antibiotics or modern vaccines. Especially rapid gains came in the years immediately after World War II in countries where the leading causes of death were communicable diseases that could be managed with antibiotics but also in countries where the leading causes of death were degenerative organ diseases. Both periods of rapid gain await satisfactory explanation.” Emphasis added.