The long and the short of it
One of the great advances in the course of human history has been the increase in life expectancy. It may be argued that life was never quite as nasty, brutish and short as Thomas Hobbes once claimed, but the average human lifespan has clearly increased over the millennia and centuries, having more than doubled in the last two hundred years or so. Moreover, it is a matter of not just living longer but of doing so in a better condition too: people who reach the age of sixty now are likely to be healthier and fitter than their parents, and especially their grandparents, were at the same age. Nevertheless, there is a great deal to be said about the determinants and limits on lifespans under capitalism.
Many figures could be cited to demonstrate the improvements. For instance, in 1820 life expectancy at birth was around 29 globally, and 36 in Europe. By 1970 the averages were up to 60 and over 70 respectively. The global chances of a child dying in their first five years are down from 18 percent in the 1960s to 4 percent now. Improved health care and sanitary conditions have clearly been one of the main reasons for these changes. The germ theory of disease led to big reductions in cholera, for instance, in the nineteenth century, when proper sewage systems also resulted in far fewer deaths from typhoid. Infectious diseases have in the ‘rich world’ become less important as causes of death, while chronic conditions such as heart disease and cancer have become more crucial. In some countries, the improvements have been more recent: life expectancy in India rose from 32 to 51 between 1950 and 1968, partly caused by decline in deaths from cholera (and the figure now is 70).
Yet things are not quite as bright and wonderful as is sometimes suggested. Life expectancy varies greatly across nations, and within countries on the basis of such characteristics as skin colour, education and poverty. In some cases, lifespans have been stagnating or even getting shorter. For instance, between 1990 and 2008, life expectancy for white US men without a college degree fell by three years. In general, better educational qualifications imply more years of life, and poverty of course shortens lives. In the US again, black people live on average fewer years than white people, though the gap is narrowing. Unemployment leads to earlier deaths, even when factors such as smoking and previous health conditions are taken into account.
However, in developed countries there is no simple correlation between life expectancy and average income. The US has a high average income but is near the bottom for life expectancy. People in Sweden are less well-off than those in Norway, but have slightly longer lifespans. In The Spirit Level, Richard Wilkinson and Kate Pickett argue that the determining factor is inequality, which is associated with lower life expectancy, lower birthweights and higher rates of infant mortality: more unequal countries have worse outcomes in these (and many other) areas.
In 2006–08, life expectancy at birth was far higher in Kensington & Chelsea than in Glasgow: thirteen years in the case of men and eleven years for women. This figure is taken from Danny Dorling’s So You Think You Know About Britain? where it is suggested that premature death was in 2010 ‘the great measurer of the North-South divide’, which involved a line drawn from just north of the Wash to the Bristol Channel, with Grimsby on the northern side and Lincoln on the southern. Dorling argues that other contributory factors to a longer life include occupation, height, periods of unemployment, sleeping rough, eating fruit every day, amount of exercise, and weight. Personal lifestyle can make a difference, but a person’s social situation is clearly of great importance too.
Of course the largest differences in lifespan on a global scale do depend on how ‘developed’ a country is. According to worldometers.info, the two countries with the highest life expectancy are Hong Kong and Japan, with over 85 years each. Figures descend via the UK (over 81) and the US (over 79) to Afghanistan (just below 66), Haiti (just under 65) to the Central African Republic (54). Countries in Africa cluster towards the bottom of the list. It is hardly controversial to say that living standards, health care and access to adequate food are crucial here.
One point that applies in every country is that women on average live longer than men (just over three extra years in the UK). Quite why this should be the case is not clear. It did not hold in rich countries in the nineteenth century, and the difference in Russia is now a remarkable ten years. Various reasons have been suggested, but probably it is the combination of various factors. More men than women smoke; differences in child mortality between girls and boys may make a small contribution; biological factors can apply, such as men having more fat surrounding their organs, which increases the extent of cardiovascular disease. One interesting suggestion is that ‘women do not live longer than men only because they age more slowly, but also because they are more robust when they get sick at any age’: women spend more time in hospital than men but still live longer (article by Esteban Ortiz-Ospina and Diana Beltekian at ourworldindata.org).
There can be no doubt that capitalism impacts people’s lives in one of the most fundamental ways, namely how long you will live for. From impoverished countries with short lifespans to places where poverty and living conditions affect a person’s likely years of life, capitalism is simply bad for you. We cannot predict what will happen to life expectancy in socialism, or just what the consequences would be of increasing numbers of elderly people. But we can say that the massive global inequalities will, after a while, cease to exist. Society will be concerned to ensure that everyone leads as long, healthy and rewarding a life as possible.