The adverse effects of material deprivation on health are well documented. Specifically the correlation between tuberculosis (TB) and crowded housing and typhoid fever and impure water appear most often. Yet, the long-term health effects of exposure to deprivation has not been researched as thoroughly. Karen Clay and Werner Troesken explore the hypothesis that exposure to deprivation, TB and typhoid from poor living conditions, early in life can increase the risk of other health factors later such as cancer, heart disease, kidney disease and stroke. Prior contraction of TB is a risk factor for cancer and stroke while typhoid leaves survives with damaged hearts and kidneys. Using mortality rates on the before-mentioned diseases in 1900, the authors find evidence that contact with infectious diseases early in life adversely affects the health of individuals 15 years later by increasing their risk of age-related and chronic pathologies. Clay and Troesken find that if TB and typhoid had been eradicated in 1900, 1915 levels of cancer, stroke, heart disease and kidney disease would have been 32%, 32%, 21% and 23% lower, respectively.
The authors use United States Mortality Statistics to gather mortality rates from infectious (TB, typhoid) and age-related disease (cancer, stroke, heart and kidney disease) from a sample of 110 American cities in both 1900 and 1915. The two years are chosen specifically because it was a time when there was a move from high mortality from infectious disease to low mortality from chronic diseases. Chronic disease replace infectious disease as the leading cause of death. While the total mortality feel around 20% from 1900 to 1915, cancer increased 50%, heart disease increase 6% and kidney disease increased 38%. This time period, known as the Urban Mortality Transition, allows the authors to more easily separate the effects from prior disease contract(1900 contact) from then current effects (1915 effects) on mortality rates in 1915. The authors reject germ theory dissemination, economic growth and the introduction of antibiotics as reasons for the transition and instead claim public works initiatives such as public water and sewer systems was the main reason for the lowered mortality.
An airborne disease, TB can affect any part of the body, but mostly attacks the lungs. Certain conditions increase the possibility of contracting TB, such as poor ventilation, crowded housing, dusty work environment and poor diet. As mentioned before, the evidence connecting crowded housing and poor diet with TB is strong. Unlike many other diseases, prior exposure does not give protection later on. Those that don’t die of TB can have further health problems later. The main effect of TB is cancer as prior lung disease is a noted risk factor for lung cancer. Cases also exist where TB increased the risk of prostate cancer and brain tumors. In addition, strong evidence links inflammatory infections like TB to stroke, another age-related disease. The authors find that unusually high rate of TB in 1900 resulted in elevated rates of cancer and stroke in 1915 even after controlling for contemporaneous measures such as population levels. With the strong correlation between crowded housing and TB and TB and later stroke and cancer levels, the authors argue that if TB had been eradicated through improving housing and nutrition in 1900, the levels of deaths from stroke and cancer would have been reduced by 32% each.
Contracted most commonly through drinking water tainted by human waste, typhoid fever is associated with impure water systems and inadequate sewer systems. These scenarios happen in many poverty stricken areas when human waste becomes mixed in the drinking water source (privy seeps into the well). Typhoid results extremely high temperatures that places extreme strain on the body. As typhoid only kills 5-10% of those who contract it, the rest remain with numerous health problems such as distressed kidneys and a cardiovascular system. The authors find unusually high rate of typhoid in 1900 lead to elevated rates of heart and kidney disease 1915. Clay and Troesken argue that if public water purification initiatives had occurred earlier, say in 1900, the death rate for heart disease and kidney disease would have decrease by 21% and 23%.
When we look at third world countries, we see diseases such as typhoid and TB because of the lack of sanitation and the density of people in one place. These diseases lead to other diseases that attack one later (cancer, stroke) if one survives the first round (TB, typhoid). I almost feel like nature is trying to tell us something: that earth cannot handle this many people. With so many people, man has had to invent technologies to push the boundaries of earth’s capacity. Plumping, water sanitation and housing codes were specifically created to address TB and typhoid. How much further can we push? At morbid as it sounds, imbalances in nature are often death with through disease. If too many wolves are roaming in packs, a sickness will pull back the population as the proximity of wolves will let the sickness spread.
In the movie The Matrix, one of the characters likens the human race to a virus, where humans are sucking the life out of earth, taking over everything with no balance or time for regrowth. This paper made me think of these topics as typhoid and TB are indicators that a problem exists in the way humans live. At a certain point, I wonder if technology will be enough. Maybe we are just overpopulating the earth.