Determinants of Changes in Life Expectancy

Nicola Oliver

The gains in life expectancy experienced in developed countries since the early part of the 20th century owe much to medical endeavour and understanding. This is not confined simply to the discovery of new pharmaceuticals, for instance, but comes from a wide range of disciplines. These include the public health efforts in the early 20th century, which focused on housing and sanitation, the introduction of welfare and accessible healthcare and increased access to education for longer.

In the 1950s, the link between cigarette smoking and lung cancer was established (Hill and Doll 1954), which eventually led to a decline in smoking prevalence and a subsequent reduction in smoking-related disease and death. The introduction of improved treatments for heart disease and greater understanding of its mechanisms throughout the latter part of 20th century, as well as the development of advanced diagnostics into the 21st century, finds us in a position where certain chronic diseases are much more treatable, and perhaps even curable in the longer term.

However, we are now faced with a new set of challenges, and, with declines in mortality improvement observed in some countries, we must

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