# What contributed the most to increased longevity--medicine or sanitation?
**URL:** https://boards.straightdope.com/t/what-contributed-the-most-to-increased-longevity-medicine-or-sanitation/1033264
**Category:** Great Debates
**Created:** [September 21, 2026, 11:28pm UTC](https://boards.straightdope.com/t/what-contributed-the-most-to-increased-longevity-medicine-or-sanitation/1033264 "2026-09-21T23:28:01Z")
**Posts on this page:** 2
**Page:** 2
### Author:  [@puzzlegal](https://boards.straightdope.com/u/puzzlegal)
#### Post date: [September 22, 2026, 4:08pm UTC](https://boards.straightdope.com/t/what-contributed-the-most-to-increased-longevity-medicine-or-sanitation/1033264/21 "2026-09-22T16:08:43Z")
> [@Hari\_Seldon](#):
>
> Actually polio is a bad example. Until modern sanitation came along virtually everyone caught polio during the first year of life and it was very rarely paralytic. When it was, it was called infantile paralysis, which is what polio was called when I was growing up. With the growth of modern sanitation, more and more people caught it a later age when it was much more severe. In an infant it was typically just a cold.
Yeah, Hepatitis A is similar. There are a bunch of diseases that aren’t that serious to most of the population if you catch them as an infant. Sanitation actually made polio _worse_, as people who catch it at 14 have a much worse prognosis than people who catch it at 1. For those diseases, vaccines are basically a safer way to achieve the same effect.
I think improvements in sanitation (especially the sanitation of _doctors_) made a huge improvement in the mortality rate of women of child-bearing age, and anyone who has had surgery, though.
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### Author:  [@Jackmannii](https://boards.straightdope.com/u/Jackmannii)
#### Post date: [September 22, 2026, 4:10pm UTC](https://boards.straightdope.com/t/what-contributed-the-most-to-increased-longevity-medicine-or-sanitation/1033264/22 "2026-09-22T16:10:17Z")
> [@Hari\_Seldon](#):
>
> Basically, what I am asking is whether clean water and sewage contributed more to increasing life span than advances in medicine.
Clean water and proper sewage disposal/treatment are inseparable from advances in medicine.
Physicians like John Snow, William Budd and [William James](https://www.adph.org.uk/resources/the-history-of-decontaminating-our-water/) were at the forefront of alerting authorities to the need for sanitation and safe water supplies.
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