How Do We Find the Next 11 Centimetres?

It’s not exactly an earth-shattering revelation, but a new study in the Oxford Economic Papers finds, surprise surprise, that people have gotten substantially healthier since 1870 or so. Over the course of the 20th century, the paper’s author finds, the average European gained 11 centimetres in height. It’s when the big increases in height came about—and why—that’s intriguing.

For one, if you think that health is simply about wealth, the growth happened at the wrong times: during the first half of the 20th century, the European continent went through a bit of a rough patch, what with an unbroken string of calamities starting in the fall of 1914 and extending until well after the end of World War II. An enormous amount of wealth was destroyed in successive cataclysms both military and economic, and yet author Timothy Hatton finds people stretched upwards most rapidly in that period, faster even than the period from 1955-1980.

How did that happen? Hatton notes that even while economic growth was mostly lethargic during the interwar years in Europe, that’s not to say that people’s lives didn’t get better: The early trucks and more established trains moved food to cities faster, especially important for milk. Even if people weren’t getting richer as fast as they would from the 1950s on, the cost of food came down with early industrialization of farms. The poor were still poor, but their kids could get better food and more of it.

The great expansion of human lifespans, and the general increase in health, is a victory that has many fathers. Which makes some of the current public health problems in the developed world so hard to wrap our minds around: Poor American white women without a high school diploma have lost five years of their life expectancy this generation, a stunning decline that implies many middle-aged women are dying young. Why? We don’t know, but one answer may be that it’s gotten a lot harder to be a poor person without a high school diploma since 1990.

Then there’s our general confusion about how best to address the package of heart disease, obesity and diabetes that we collectively call “diseases of affluence.” There’s been a lot of talk in recent years about “food deserts,” places where fresh produce has surrendered the market to processed foods—as if we could solve the health problems of the urban poor by zoning them out of existence.

Alas, the picture is more complicated than that. According to researchers Alison Hope Alkon et al., the urban poor are entirely capable of walking or taking the bus to find produce—they just lack the money to do so. Another shocking discovery, courtesy of science: Poverty is the state of not having enough money, not the absence of a Whole Foods.

The health problem of the early 20th century was a conceptually simple one to solve, even if it wasn’t actually easy to execute: Get cheaper food to more people and watch infant mortality rates drop. The health problems of the 21st century aren’t going to be nearly as straightforward, in part because we don’t have easy technological fixes like synthetic fertilizers or refrigerated milk trucks. Instead, our health problems increasingly look like social justice problems that need a social justice fix.

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