Which leads directly toThursday's Wonkblog:In honor of its 200th Anniversary, The New England Journal of Medicine has published a fascinating review of how our ideas about death, and the causes of death, have changed over the past 200 years. We no longer worry so much about dying from spontaneous combustion, or near-misses from cannonballs.
Instead, our attention has shifted to new threats, many of which have been come from changes to our lifestyle and environment.How we die, and how we categorize the various ways we come to shuffle off this mortal coil, are very much akin to how language changes over time. As medical insight advances, so too does our ability to better describe and quantify those diseases that afflict us, and how they result in our deaths.Expand
Back in 1812 when the NEJM published its inaugural issue, doctors had to deal with a number of health problems that we remain all too familiar with, conditions like cancer, diabetes, angina, burns, asthma, and epilepsy. At the same time, however, they also had to contend with deaths caused by such things as apoplexy (a syndrome of fainting spells), spontaneous combustion (especially of "brandy-drinking men and women"), drinking cold water (your guess is as good as mine), and near-misses from cannonballs (yes, seriously – they believed that the close contact could shatter bones and even cause blindness).Exactly one hundred years later, NEJM celebrated the observation of the previous year which they described as "the healthiest of which there is any record." Physicians started noticing that more people were living past age 100, while lauding the success of U.S. athletes at the Stockholm Olympics – an achievement that was accounted for by "American racial vigor." Indeed, this was a time of great optimism, the dawn of modern health practices – and the rise of eugenics. Anticipating the future, one editorial speculated about what might come:Perhaps in 1993, when all the preventable diseases have been eradicated, when the nature and cure of cancer have been discovered, and when eugenics has superseded evolution in the elimination of the unfit, our successors will look back at these pages with an even greater measure of superiority.At the same time, however, the medical establishment started to become increasingly concerned about changing lifestyle factors and how that was impacting on health. Take for example the rise of "automobile knee", a shorthand way of expressing their concern that cars were starting to create a largely sedentary society -– a change in routine that we are still dealing with today, in part owing to the rise of television and computer culture....MORE
Our coming deficits are driven by old people, not health inflation
