September 5, 2023 • 14 mins
EXTRA LIFE: A Short History of Living Longer by Steven Johnson is a fascinating look at the milestones of human progress and a deep dive into how human life expectancy has been doubled in just one hundred years. Steven Johnson is the bestselling author of thirteen books, including Where Good Ideas Come From, Farsighted, and The Ghost Map.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:02):
Welcome to Get Connected with Nina delRio, a weekly conversation about fitness,
health and happenings in our community onone oh six point seven Light FM.
Good morning and thanks for listening toget connected. So, even given the
last few years of pandemic, humansare living longer as a species. We've
(00:22):
doubled our life's expectancy in just onehundred years. Modern advances have given us
each an extra twenty thousand days tolive on average, which is an astonishing
measure of human progress. The bookExtra Life, A Short History of Living
Longer by Stephen Johnson, is afascinating look at the milestones of this progress.
Stephen Johnson, thank you for beingon the show. Oh my pleasure.
(00:45):
So during the pandemic, we hearda lot about the last pandemic,
which was nineteen sixteen to nineteen twenty. How did the two pandemics compare.
Let's start there by the numbers.The last was worse, well, it
was much worse, and it wasmuch worse than on a couple of levels.
We don't really know how many peopledied. Probably the best guess is
(01:06):
around fifty million people, but somegood estimates suggest one hundred million people.
Died, and this was a pointat which there were only two billion people
on the planet. So in termsof the overall death poll, it was
far far exceeds anything that we willsee with COVID, almost certainly, But
it also had a different demographic profile, and that it was it was unusually
(01:27):
dangerous for young people, particularly peoplekind of in the in the prime of
their young adult life, like twentyfive year olds died at at a at
a terrible rate. It actually didn'taffect many people over seventy so it's kind
of the inverse of COVID in thatway, but that really dragged down the
life's expectancy numbers because so many peoplewere dying at a young on the age
(01:51):
of its disease. So it wasit was a terrible thing, and of
course we had no you know,there was no mRNA vaccines comes to the
rescue. After a year, it'skind of just kind of burned itself out
eventually. It's interesting as you lookat the last one hundred years. Of
course, more than that in thebook, you know, of us living
longer, humans have basically doubled ourlife expectancy. As you say, in
the last one hundred is it thatadults are living longer or children are dying
(02:15):
not so soon after birth. It'sit's both. It's a great question.
So a major part of it isthe reduction in childhood mortality, which you
know, we just forget how differentit was. Right, forty percent of
children would die before reaching adulthood,you know, that was the reality of
life really anywhere on the planet.That was the reality of life until about
(02:38):
one hundred and twenty years ago,one hundred and thirty years ago. So
two out of five of your kidswould die, that was the average.
And you know, now childhood mortalityin the United States is less than one
percent, so we made extraordinary progress, and even globally it's it's less than
four percent. So we improved thatby a factor of ten. And we
(02:59):
just forget how dangerous it was tobe a child at that point. You
know, you would get tuberculosis,or you would get pneumonia, or you
would get cholera, or you wouldget smallpox, and you know, you'd
be dead in five days. Butit is also true, and it's particularly
become, you know, increasingly true, that we are extending life at the
other end of the spectrum as well. And so even in nineteen twenty,
(03:23):
if you lived to the age oftwenty, you could expect to live on
average to the age of sixty.Right, if you made it through childhood,
your average lifespan would be about sixty. Now, if you make it
to twenty, your average lifespan issomething like eighty five. In some places
it's ninety. So that's that's alot of life, right, that's an
extra that's a whole generation. Basically, that's the difference between living to see
(03:44):
your grandchildren and living to see yourgreat grandchildren. And the progress will see
going forward, assuming there is progress, will be at that the later stages
of life, not at the earlystages. One of the interesting things about
your books, so many interesting thingsin this book is a look at how
medical advances have allowed us to livelonger, but also who has the benefit
(04:04):
and it's and who is you know, on the other side of those equations.
The average lifespan between the total populationand the aristocracy diverges at various points
throughout history. They live longer andthey live shorter than everyone else, the
European aristocracy for a time. Whyis that? Yeah, I mean,
(04:24):
I think one of the things thatreally shocked me when I began to research
this history that until about seven fifty, there was seventeen fifty, there was
no there was no real health inequalityin society. So you had massive wealth
inequality, right, you had kingsand queens and paupers and hunters gatherers,
But in terms of how long theylived and how you know, what the
(04:47):
childhood mortality numbers were, there wasno difference. The richest person in the
world average life expectancy was thirty five. The poorest person in the world average
life especially for thirty five, itdidn't really matter. And what starts to
happen in the middle of the eighteenthcentury is that the elites start to live
longer and and a gap starts toopen ups. On the one hand,
(05:08):
you're seeing progress, like, oh, some people are actually extending their lives
in a predictable way. Generation aftergeneration. They're living longer. That's amazing.
We've never done that before as aspecies, we've never done that before.
But it opens up this gap,as you say, this health inequality
gap. And actually, during thenineteenth century in Europe and the United States,
(05:30):
the working class their lives to shorterbecause industrialization. It's so dangerous and
cities are so dangerous, and thatgap opens up around the world. So
you have the you know, theEurope and the United States living longer as
a society, but you know subSaharan Africa living average life expectancies with twenty
five or thirty. Now what's changedin the last thirty or forty years is
(05:55):
that the global gap has narrowed,and there's been tremendous progress, really the
fastest progress in the history of theworld in what we call the Global South,
in places like India, obviously,places like China, but he's also
in Africa as well, as it'srecovered from the epidemics, and so the
gap is still there, but it'snarrowing, which is a good, which
(06:17):
is you know, a major measureof progress. I want to stick with
this part of the conversation, butlet me remind everyone who we're speaking with.
It's Stephen Johnson. He's the bestseller author of thirteen books, including
Where Good Ideas Come From, Farsighted, and The Ghost Map. His new
book is Extra Life, A ShortHistory of Living Longer. Be listening to
get connected on one oh six pointseven light FM. I'm Nina del Rio.
(06:41):
Even in America, though that thethe inequality has sort of been built
into our society. Can we talkabout W. E. B. Du
Boys and what he found when helooked at mortality rates in Philadelphia during his
time. Dubois is a big He'sa big hero of the book and of
the show actually because you know,we know of the Boys is this pioneering
(07:02):
African American intellectual and you know,founder of a double ACP and many other
things. But he was also apioneering scholar of health and equalities early in
his career. Really in some ways. The first thing he did professionally is
he did this in depth study ofa neighborhood in Philadelphia that was largely African
(07:24):
American and he documented that, youknow, there was this tremendous gap in
terms of the health outcomes for peopleliving in that community compared to the rest
of Philadelphia. And what he didwas he showed that that was not you
know, he was battling this incredibleThis is eighteen ninety six and so you
know, there's even more racism insociety then, and he was battling this
(07:46):
idea that there was something intrinsically youknow, less healthy to the African American
people. And he showed that thephysical environment that they lived in, their
access to clean drinking water, theiraccess to proper sanitation, the crowding in
their homes were just completely different fromthe white neighborhoods around it. And it
(08:07):
was really an environmental problem. Itwasn't something specific to the you know,
the African American race, as peoplewere arguing at the time. And he
did it through data. Really hedid it was you know, it's important
lesson in the power of data toshine a light on these kinds of mental
qualities. So it was the wholeside of the boys that I don't think
as many people know about it.I certainly hadn't really appreciated it until I
(08:28):
really dove into the story, andit's just it's just remarkable. I'd like
to go back a little bit intime too and talk about another person in
another situation that was remarkable, varyelation and the woman who helped spread the
practice in Europe as preventative for smallpox. Yeah, Lady Mary Montague. So,
varilation is a crucial predecessor of vaccines. Vary elation basically, which was
(08:54):
developed to convert smallpox, which wasjust one of the most terrifying diseases in
the history of our life on Earth. Vary elation was a procedure where you
took a small amount of the smallpoxvirus and deliberately infected a child with it.
The idea was it was a smallenough amount that they would develop immunity,
but they wouldn't get sick. Abouttwo percent of the time they would
(09:16):
get thick and they would die.But the risk of small fox was so
much worse it killed about thirty percentof people who got it, that it
was better to be vary related.But it was a controversial procedure, but
had been developed outside the West.It was it was practiced in Africa,
it was practiced in India, waspracticed in China, and it spread to
(09:37):
the West through this fascinating figure LadyMary Montague, who was incredibly talented and
charismatic British aristocrat who traveled to Constantinoplewith her husband in the early seventeen hundreds,
and she saw this practice, andshe herself had had smallpox, and
(09:58):
she had young children, and shewas terrified that her children were going to
die of this sise and so shehad her children vary related or inoculated as
sometimes called and then she brought thistechnique back to England and eventually convinced the
Princess of Wales to inoculate her children, and because of that example, the
practice spread through England, had amajor impact in reducing childhood deaths from smallpox
(10:24):
and eventually led to the invention ofvaccines later in the century, when Edward
Jenner came up with a smallpox vaccinevery much influenced by the practice of variolation.
As vaccination laws were being written inthe mid eighteen fifties, there were
celebrities who kind of stood up forit, like Charles Dickens, but there
was also, just like today,a parallel anti vax movement. Can you
(10:46):
talk a little bit about the beliefsof those anti vaxers and how they may
be compared to today. It's afascinating thing. I mean, anti vax
movements are as old as vax.It's always been here, and I think
that we have to recognize, evenpeople who are very pro vaccination as I
am, that there's something about thenature of vaccination that is intrinsically troubling to
(11:11):
people, which is the sense thatyou are making a medical intervention with someone
who is healthy, and that isdifferent from other forms of medicine where you
have someone who's sick and then youtry and treat them. With vaccination,
you're taking a perfectly healthy body andthe healthy body of a young child offen
your child, and you're in somecases in the old days, you're giving
them some cousin or relatives of thevirus that could kill them. Today mRNA
(11:37):
vaccines, for instance, you know, have no actual virus in them at
all, which is part of whythey're so incredibly safe. But back in
the day, it was just,you know, ethically, it seemed like
a tough thing to do as aparent, but we were able to show
over time that the numbers were justoverwhelming, that it made your your children
(12:01):
so much safer. And it tooka kind of a faith in those numbers
and a faith in the institutions thatshowed us those numbers to ultimately persuade people
to take things like the polio vaccine, which is a very successful campaign.
And I think, look, weare making we have a lot of Americans
who are vaccinated in a very shortamount of time. It should be easier
(12:22):
to get to one hundred. Butyou know, we should also remind ourselves
that we are making progress. Yeah, I think that's that's actually notable when
you go through the book and youfor instance, smallpox, it finally was
eradicated, but not till nineteen seventynine. Pasteurization chlorinization, which are different
things but are both trying some chemistrythat had painfully slow adoption rates. I
(12:43):
think it's interesting to note too thatthe tipping point for these things were sometimes
just individual events or individual people.Yeah. You know the producer of the
TV shows wonderful woman, Jane RudeoI've worked with over the years, she
always said model for this whole projectwas like, this is a story about
how change happens, like real change, like big, big change in society.
(13:07):
And on the one hand, youcan look at this story and say,
well, change happens because of science, right in medicine, and people
come up with inventive vaccine, orthey figure out how to chlorinate drinking water,
or they figure out how to pasteurizemilk, which was a big killer
in the nineteenth century. But theother side of it is that those changes,
the science isn't enough, right.It doesn't matter if you come up
(13:28):
with the technique, if nobody adoptsit. I mean, pasteurization was invented
in the eighteen sixty five, butwe didn't have you know, mandated pasteurized
milk on our shelves for fifty years. And that's because people had to,
you know, persuade the world toadopt this technique, and people had to
go through legal reforms to make surethat milk had to be pasteurized, and
(13:50):
the milk industry had to be youknow, persuaded to change its ways,
and consumers had to be persuaded.So I tried in the book to really
celebrate both sides as that achievement,those change agents or and not just have
it be a celebration of science itself. The book is Extra Life, A
Short History of Living Longer by StephenJohnson. Thank you for being on Get
(14:13):
Connected, Oh My Pleasure, greatculture. This has been Get Connected with
Nina del Rio on one oh sixpoint seven Lightfm. The views and opinions
of our guests do not necessarily reflectthe views of the station. If you
missed any part of our show orwant to share it, visit our website
for downloads and podcasts at one Osix seven lightfm dot com. Thanks for listening.
Welcome to Get Connected with Nina delRio, a weekly conversation about fitness,
health and happenings in our community onone oh six point seven Light FM.
Good morning and thanks for listening toget connected. So, even given the
last few years of pandemic, humansare living longer as a species. We've
(00:22):
doubled our life's expectancy in just onehundred years. Modern advances have given us
each an extra twenty thousand days tolive on average, which is an astonishing
measure of human progress. The bookExtra Life, A Short History of Living
Longer by Stephen Johnson, is afascinating look at the milestones of this progress.
Stephen Johnson, thank you for beingon the show. Oh my pleasure.
(00:45):
So during the pandemic, we hearda lot about the last pandemic,
which was nineteen sixteen to nineteen twenty. How did the two pandemics compare.
Let's start there by the numbers.The last was worse, well, it
was much worse, and it wasmuch worse than on a couple of levels.
We don't really know how many peopledied. Probably the best guess is
(01:06):
around fifty million people, but somegood estimates suggest one hundred million people.
Died, and this was a pointat which there were only two billion people
on the planet. So in termsof the overall death poll, it was
far far exceeds anything that we willsee with COVID, almost certainly, But
it also had a different demographic profile, and that it was it was unusually
(01:27):
dangerous for young people, particularly peoplekind of in the in the prime of
their young adult life, like twentyfive year olds died at at a at
a terrible rate. It actually didn'taffect many people over seventy so it's kind
of the inverse of COVID in thatway, but that really dragged down the
life's expectancy numbers because so many peoplewere dying at a young on the age
(01:51):
of its disease. So it wasit was a terrible thing, and of
course we had no you know,there was no mRNA vaccines comes to the
rescue. After a year, it'skind of just kind of burned itself out
eventually. It's interesting as you lookat the last one hundred years. Of
course, more than that in thebook, you know, of us living
longer, humans have basically doubled ourlife expectancy. As you say, in
the last one hundred is it thatadults are living longer or children are dying
(02:15):
not so soon after birth. It'sit's both. It's a great question.
So a major part of it isthe reduction in childhood mortality, which you
know, we just forget how differentit was. Right, forty percent of
children would die before reaching adulthood,you know, that was the reality of
life really anywhere on the planet.That was the reality of life until about
(02:38):
one hundred and twenty years ago,one hundred and thirty years ago. So
two out of five of your kidswould die, that was the average.
And you know, now childhood mortalityin the United States is less than one
percent, so we made extraordinary progress, and even globally it's it's less than
four percent. So we improved thatby a factor of ten. And we
(02:59):
just forget how dangerous it was tobe a child at that point. You
know, you would get tuberculosis,or you would get pneumonia, or you
would get cholera, or you wouldget smallpox, and you know, you'd
be dead in five days. Butit is also true, and it's particularly
become, you know, increasingly true, that we are extending life at the
other end of the spectrum as well. And so even in nineteen twenty,
(03:23):
if you lived to the age oftwenty, you could expect to live on
average to the age of sixty.Right, if you made it through childhood,
your average lifespan would be about sixty. Now, if you make it
to twenty, your average lifespan issomething like eighty five. In some places
it's ninety. So that's that's alot of life, right, that's an
extra that's a whole generation. Basically, that's the difference between living to see
(03:44):
your grandchildren and living to see yourgreat grandchildren. And the progress will see
going forward, assuming there is progress, will be at that the later stages
of life, not at the earlystages. One of the interesting things about
your books, so many interesting thingsin this book is a look at how
medical advances have allowed us to livelonger, but also who has the benefit
(04:04):
and it's and who is you know, on the other side of those equations.
The average lifespan between the total populationand the aristocracy diverges at various points
throughout history. They live longer andthey live shorter than everyone else, the
European aristocracy for a time. Whyis that? Yeah, I mean,
(04:24):
I think one of the things thatreally shocked me when I began to research
this history that until about seven fifty, there was seventeen fifty, there was
no there was no real health inequalityin society. So you had massive wealth
inequality, right, you had kingsand queens and paupers and hunters gatherers,
But in terms of how long theylived and how you know, what the
(04:47):
childhood mortality numbers were, there wasno difference. The richest person in the
world average life expectancy was thirty five. The poorest person in the world average
life especially for thirty five, itdidn't really matter. And what starts to
happen in the middle of the eighteenthcentury is that the elites start to live
longer and and a gap starts toopen ups. On the one hand,
(05:08):
you're seeing progress, like, oh, some people are actually extending their lives
in a predictable way. Generation aftergeneration. They're living longer. That's amazing.
We've never done that before as aspecies, we've never done that before.
But it opens up this gap,as you say, this health inequality
gap. And actually, during thenineteenth century in Europe and the United States,
(05:30):
the working class their lives to shorterbecause industrialization. It's so dangerous and
cities are so dangerous, and thatgap opens up around the world. So
you have the you know, theEurope and the United States living longer as
a society, but you know subSaharan Africa living average life expectancies with twenty
five or thirty. Now what's changedin the last thirty or forty years is
(05:55):
that the global gap has narrowed,and there's been tremendous progress, really the
fastest progress in the history of theworld in what we call the Global South,
in places like India, obviously,places like China, but he's also
in Africa as well, as it'srecovered from the epidemics, and so the
gap is still there, but it'snarrowing, which is a good, which
(06:17):
is you know, a major measureof progress. I want to stick with
this part of the conversation, butlet me remind everyone who we're speaking with.
It's Stephen Johnson. He's the bestseller author of thirteen books, including
Where Good Ideas Come From, Farsighted, and The Ghost Map. His new
book is Extra Life, A ShortHistory of Living Longer. Be listening to
get connected on one oh six pointseven light FM. I'm Nina del Rio.
(06:41):
Even in America, though that thethe inequality has sort of been built
into our society. Can we talkabout W. E. B. Du
Boys and what he found when helooked at mortality rates in Philadelphia during his
time. Dubois is a big He'sa big hero of the book and of
the show actually because you know,we know of the Boys is this pioneering
(07:02):
African American intellectual and you know,founder of a double ACP and many other
things. But he was also apioneering scholar of health and equalities early in
his career. Really in some ways. The first thing he did professionally is
he did this in depth study ofa neighborhood in Philadelphia that was largely African
(07:24):
American and he documented that, youknow, there was this tremendous gap in
terms of the health outcomes for peopleliving in that community compared to the rest
of Philadelphia. And what he didwas he showed that that was not you
know, he was battling this incredibleThis is eighteen ninety six and so you
know, there's even more racism insociety then, and he was battling this
(07:46):
idea that there was something intrinsically youknow, less healthy to the African American
people. And he showed that thephysical environment that they lived in, their
access to clean drinking water, theiraccess to proper sanitation, the crowding in
their homes were just completely different fromthe white neighborhoods around it. And it
(08:07):
was really an environmental problem. Itwasn't something specific to the you know,
the African American race, as peoplewere arguing at the time. And he
did it through data. Really hedid it was you know, it's important
lesson in the power of data toshine a light on these kinds of mental
qualities. So it was the wholeside of the boys that I don't think
as many people know about it.I certainly hadn't really appreciated it until I
(08:28):
really dove into the story, andit's just it's just remarkable. I'd like
to go back a little bit intime too and talk about another person in
another situation that was remarkable, varyelation and the woman who helped spread the
practice in Europe as preventative for smallpox. Yeah, Lady Mary Montague. So,
varilation is a crucial predecessor of vaccines. Vary elation basically, which was
(08:54):
developed to convert smallpox, which wasjust one of the most terrifying diseases in
the history of our life on Earth. Vary elation was a procedure where you
took a small amount of the smallpoxvirus and deliberately infected a child with it.
The idea was it was a smallenough amount that they would develop immunity,
but they wouldn't get sick. Abouttwo percent of the time they would
(09:16):
get thick and they would die.But the risk of small fox was so
much worse it killed about thirty percentof people who got it, that it
was better to be vary related.But it was a controversial procedure, but
had been developed outside the West.It was it was practiced in Africa,
it was practiced in India, waspracticed in China, and it spread to
(09:37):
the West through this fascinating figure LadyMary Montague, who was incredibly talented and
charismatic British aristocrat who traveled to Constantinoplewith her husband in the early seventeen hundreds,
and she saw this practice, andshe herself had had smallpox, and
(09:58):
she had young children, and shewas terrified that her children were going to
die of this sise and so shehad her children vary related or inoculated as
sometimes called and then she brought thistechnique back to England and eventually convinced the
Princess of Wales to inoculate her children, and because of that example, the
practice spread through England, had amajor impact in reducing childhood deaths from smallpox
(10:24):
and eventually led to the invention ofvaccines later in the century, when Edward
Jenner came up with a smallpox vaccinevery much influenced by the practice of variolation.
As vaccination laws were being written inthe mid eighteen fifties, there were
celebrities who kind of stood up forit, like Charles Dickens, but there
was also, just like today,a parallel anti vax movement. Can you
(10:46):
talk a little bit about the beliefsof those anti vaxers and how they may
be compared to today. It's afascinating thing. I mean, anti vax
movements are as old as vax.It's always been here, and I think
that we have to recognize, evenpeople who are very pro vaccination as I
am, that there's something about thenature of vaccination that is intrinsically troubling to
(11:11):
people, which is the sense thatyou are making a medical intervention with someone
who is healthy, and that isdifferent from other forms of medicine where you
have someone who's sick and then youtry and treat them. With vaccination,
you're taking a perfectly healthy body andthe healthy body of a young child offen
your child, and you're in somecases in the old days, you're giving
them some cousin or relatives of thevirus that could kill them. Today mRNA
(11:37):
vaccines, for instance, you know, have no actual virus in them at
all, which is part of whythey're so incredibly safe. But back in
the day, it was just,you know, ethically, it seemed like
a tough thing to do as aparent, but we were able to show
over time that the numbers were justoverwhelming, that it made your your children
(12:01):
so much safer. And it tooka kind of a faith in those numbers
and a faith in the institutions thatshowed us those numbers to ultimately persuade people
to take things like the polio vaccine, which is a very successful campaign.
And I think, look, weare making we have a lot of Americans
who are vaccinated in a very shortamount of time. It should be easier
(12:22):
to get to one hundred. Butyou know, we should also remind ourselves
that we are making progress. Yeah, I think that's that's actually notable when
you go through the book and youfor instance, smallpox, it finally was
eradicated, but not till nineteen seventynine. Pasteurization chlorinization, which are different
things but are both trying some chemistrythat had painfully slow adoption rates. I
(12:43):
think it's interesting to note too thatthe tipping point for these things were sometimes
just individual events or individual people.Yeah. You know the producer of the
TV shows wonderful woman, Jane RudeoI've worked with over the years, she
always said model for this whole projectwas like, this is a story about
how change happens, like real change, like big, big change in society.
(13:07):
And on the one hand, youcan look at this story and say,
well, change happens because of science, right in medicine, and people
come up with inventive vaccine, orthey figure out how to chlorinate drinking water,
or they figure out how to pasteurizemilk, which was a big killer
in the nineteenth century. But theother side of it is that those changes,
the science isn't enough, right.It doesn't matter if you come up
(13:28):
with the technique, if nobody adoptsit. I mean, pasteurization was invented
in the eighteen sixty five, butwe didn't have you know, mandated pasteurized
milk on our shelves for fifty years. And that's because people had to,
you know, persuade the world toadopt this technique, and people had to
go through legal reforms to make surethat milk had to be pasteurized, and
(13:50):
the milk industry had to be youknow, persuaded to change its ways,
and consumers had to be persuaded.So I tried in the book to really
celebrate both sides as that achievement,those change agents or and not just have
it be a celebration of science itself. The book is Extra Life, A
Short History of Living Longer by StephenJohnson. Thank you for being on Get
(14:13):
Connected, Oh My Pleasure, greatculture. This has been Get Connected with
Nina del Rio on one oh sixpoint seven Lightfm. The views and opinions
of our guests do not necessarily reflectthe views of the station. If you
missed any part of our show orwant to share it, visit our website
for downloads and podcasts at one Osix seven lightfm dot com. Thanks for listening.
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