Naming the Problem

The argument is clearly not scientifically sound. We all know that correlation does not mean causation. Even if there is some arbitrary point that can be defined as the “beginning” of capitalism, the question still remains about the extent to which any positive changes in well-being and health can be attributed to capitalism itself. However, the fact remains that life expectancy globally has increased dramatically over the past 200 years. So explaining why these advances have occurred is important both to ensure that these gains continue and so that these improvements can also occur in parts of the world that have not experienced similar growths in life expectancy. Fortunately, Steven Johnson makes a compelling case in Extra life: A short history of living longer for the variety of advances that have resulted in improved life expectancy over the past 200 years. In each chapter, Johnson documents an innovation that he argues contributed to these improvements in life expectancy. Far from suggesting that these advances are due to capitalism, Johnson’s book suggests that it has been capitalism itself that has created some of the most persistent challenges to health. In turn, many of the advances that have helped us live longer required actions of activists, doctors, and public health practitioners to counter these effects. As Johnson describes early in his book, for most of human history, especially since the agricultural revolution, there were no major changes in life expectancy: “millennia pass with almost no meaningful change, followed by a sudden, unprecedented spikes over the past two centuries (p. xxxi).” When these changes did begin to occur, they were not shared equally. While such a sad fact seem obvious to us now, where we have witnessed the most pernicious effects of the COVID-19 along with many other causes of death, like heart disease and cancer, fall disproportionately on the poor and disadvantaged, the reality of inequitable increases in life expectancy was not always apparent. In the 1960s, Johnson describes how researchers using death records from the British Aristocracy found how unequal life expectancy was: