I’VE ALWAYS WONDERED …
by DR EMMA SECOMB
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Recently I came across a slip of paper that got me thinking and I hope will be of wider interest. It listed the birth and death dates of my ancestors who emigrated from Cornwall to Port Macquarie in the 1840s. The figures tell a story of what was, at the time, a very ordinary tragedy.
Aged 25 and 19 respectively, Edward Secomb and Elizabeth Eva married in 1844 and within their first year of marriage emigrated to Australia on the Cornwall. They had a total of 10 children over the next 19 years, the second of whom was born on board the Cornwall. Of these, four died in infancy and their first daughter died aged only 34. These facts reveal a suffering unthinkable in today’s terms but 150 years ago across the globe life expectancy was in the low 40s at best, infant mortality was 25 per cent and another 25 per cent of children died prior to puberty. So what happened?
In the late 19th century life expectancy in the wealthiest parts of the world began to rise steadily, and within 100 years doubled to close to 80. In time, almost all countries across the globe have followed this overall trajectory.
Many factors converged and compounded to create this “health transition point”. Colonisation and formation of empires in western Europe afforded states with incredible wealth, power began to shift from the hands of feudal monarchs and religious institutions towards democratically accountable institutions, and the value afforded to scientific and technological expertise began to rise as religious power waned.
Koch’s germ theory of infectious disease and the explosion of knowledge about infectious disease transmission came at a time when engineering genius and construction capacity allowed states to create public health infrastructure projects providing clean water and waste management, mass transportation of food and energy, and education systems for the growing middle classes. Cholera and typhoid gradually became diseases of war rather than of the everyday. Anaesthesia facilitated the expansion of safe surgery. Death from appendicitis was once commonplace, now it’s incredibly rare. Midwifery and obstetric care became systematised and widely available, with death from bleeding or obstructed labour also rare, though once common. The availability of effective contraception saw the birth rate per woman drop from seven to two, with huge impacts on the post-partum death rate and women’s health overall. Vaccinations for measles, polio, whooping cough and smallpox saw childhood mortality plummet from 25 per cent to 0.1 per cent. In wealthy countries enough calories for even the poorest people became feasible due to advances in agricultural science, transportation systems, food storage and governance around food distribution.
All of this complex and connected science, innovation and infrastructure has relied on good governance – the transfer of power from feudal monarchies to variations of democracy where the majority expect enough to eat, an education and measures that support their collective and individual good health.
As I drive down the mountain looking at the volcanic tors of the Glass House Mountains I often think about how lucky I am to live in this brief fragment of time. Our principal challenge now lies in sustaining our wellbeing within the constraints of the planet that supports us all, and continuing to drive movement towards greater equality. We need good governance and collective effort more than ever – vote wisely!
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