In the early 1970s, British researcher Thomas McKeown developed a theory that would shape public debates on the subject of growth and social development for many years. McKeown has been working intensively on historical changes in life expectancy and examined extensive data from the UK. He noticed that after theseventies of the nineteenth century had an extraordinary increase in life expectancy. This increase was an unprecedented improvement in the historical course, which had not been observed in this way up to now. Like many scientists of his, McKeown was interested in finding out what triggered this remarkable trend and what factorswere responsible for this development.
The search for causes: medicine, prosperity and the mystery of progress
At first, it made sense for many observers to see the reason for the increase in life expectancy in the advances in medicine. New medical discoveries, vaccinations and treatment methods seemed to be the obvious reason for the improved health of the population. But McKeown’s detailed analysis provided hardly any convincing evidence for this. Rather, he found evidencethat the improvement of living conditions was related to economic change. The Industrial Revolution brought with it an increase in gross domestic product, the average income grew and the resulting prosperity seemed to be the central moment that sustainably improved the living conditions of many people. On this basis, McKeown developedHis hypothesis, according to which economic growth and the improvement of living standards were the decisive driving forces for increased life expectancy.
The Echo in International Research: Preston Curve and Growth Ideology
This view was in contrast to many previous assumptions and therefore met with great interest. At the same time, American demographer Samuel Preston presented an observation that seemed to support Mckeown’s thesis. The Preston curve showed that countries with a higher gross domestic product per capita generally also have a higher averagehad life expectancy. This led to a widespread belief that economic growth is directly related to the well-being of society and the health of the population. At a time when the ideology of economic growth began to prevail during the Cold War, these arguments were specifically used to help political and economicjustify strategies. Capitalism was propagated as a guarantor of progress and development, and international institutions such as World Bank and International Monetary Fund were willing to take this view.
Global health policy and economic strategies
As a result, countries in the Global South were repeatedly pointed out that they should focus less on the expansion of public health systems to improve social indicators such as life expectancy and child mortality, and rather on economic growth. The recommendation was to take all measures to promote growth – even if this meantNeglecting environmental protection, restricting labor rights or reducing social expenses. The hope was that prosperity would ultimately ensure a better quality of life by itself. This attitude shaped international relations and influenced development policy significantly, especially during the 1980s and 1990s. Structural Adaptation Programswere propagated as a panacea, although in many countries they led to massive social problems.
Revision of the thesis of growth: historical perspectives and criticism
However, over time, doubts arose about the correctness of these assumptions. Recent research showed that McKeown had not included long-term historical data in his life expectancy analysis. If you look at capitalism since the fifteenth century, it becomes clear that the expansion of capitalist structures often leads to social uprooting, poverty and evenled to a deterioration in living conditions. Enclosure movements in Europe, colonization, slave trade and famines had a serious impact on health and life expectancy. For centuries, the standard of living for broad sections of the population remained low, while only a few benefited from the growth gains.
The importance of public goods: Sanitary measures as a turning point
The turnaround came when simple but effective sanitary measures were introduced in the nineteenth century. The separation of wastewater and drinking water, the construction of public water pipes and the improvement of hygiene standards led to a drastic decline in life-threatening diseases. However, it was necessary to use public funds for the implementation of these measuresmobilize, restrict private interests and establish the state as a healthcare player. Decades of resistance from landowners and entrepreneurs were only overcome when broad sections of the population received political co-determination rights. With the expansion of the right to vote and the establishment of trade unions, it was possible to hold the state more accountableand to provide public goods for everyone.
Social change through political movements and government engagement
In the further course of the twentieth century, this social change made it possible to introduce further public services such as health care, vaccination programs, free education, social housing and safe working conditions. These measures went beyond just ensuring survival and led to a sustainable improvement in quality of life.New research results, including Simon Szreter, have shown that access to such public goods has made a significant contribution to increasing life expectancy. The impact of these interventions has been confirmed in numerous countries and over different periods of time, so that there is now a broad consensus on their importance.
Importance of education and care for the well-being of the population
With the increasing implementation of sanitation and the expansion of public health care, it became clear how closely social well-being is linked to access to education and medical care. In particular, education, and above all education for women, proved to be a strong driver for a further improvement in life expectancy. The better peoplewere trained, the more conscious and healthier they lived, which was reflected in an increased average lifespan. In addition, it was shown that social programs, vaccination campaigns and the promotion of equal opportunities contributed significantly to the living conditions of broad sections of the population.
Critical reassessment of the connection between growth and well-being
Although high incomes and economic growth are generally associated with increased life expectancy, historical analysis shows that there is no direct, causal relationship between these factors. Rather, the development of human potential depends on how societies deal with their resources, how they distribute goods and what political forcesdetermine action. Progress was always made when social movements and governments have specifically worked towards creating public goods and securing fair working conditions. In phases in which these forces were weak or lacking, economic growth did not lead to a better life, but often intensified social inequality.
Social priorities and sustainable progress
The comprehensive consideration of historical developments suggests that the improvement of health and life expectancy was achieved less through pure economic growth and rather through targeted investments in public infrastructure, education and social justice. It is the task of society and politics to use the potential created by growth in such a way thatthat it benefits the entire population. This is the only way to achieve sustainable progress in the long term, which is not based solely on economic indicators, but on a real improvement in living conditions for everyone.
