IT'S GETTING BETTER ALL THE TIME

CATO INSTITUTE

Contents

List of Figures.......................................................................viiForeword..............................................................................xiPreface...............................................................................xvAcknowledgments.......................................................................xviiIntroduction..........................................................................1Section I Health.................................................................25Section II Diets and Nutrition....................................................49Section III Wealth.................................................................57Section IV The State of Poor Americans............................................73Section V The State of Children and Teens........................................81Section VI The American Worker....................................................91Section VII Leisure, Recreation, and Entertainment.................................105Section VIII Housing................................................................117Section IX Transportation and Communications......................................129Section X Invention, Innovation, and Scientific Progress.........................145Section XI The Information Age....................................................151Section XII Education..............................................................159Section XIII Safety.................................................................171Section XIV Environmental Protection...............................................183Section XV Natural Resources: An Age of Abundance.................................195Section XVI Social and Cultural Indicators.........................................207Section XVII Human Achievement in Sports............................................223Section XVIII The Remarkable Gains by Women..........................................231Section XIX The Decline of Racism..................................................241Section XX Freedom and Democracy..................................................253Section XXI The American People: The World's Greatest Resource.....................261Notes.................................................................................267Index.................................................................................287

Chapter One

"Health is the first wealth," Emerson once wrote. The health of Americans improved in ways during the 20th century that can only be described as miraculous. Death and infant mortality rates plunged; life expectancy rose by 64 percent; and almost all of the killer diseases throughout human existence were conquered over the course of the century. This was a century that can and should be celebrated as "an epidemic of life." Yes, health is the first wealth, and in few other areas of life has the human condition improved so universally.

In the 1980s and 1990s the AIDS virus has understandably frightened the public because of its fatal consequences. AIDS has served as a humbling reminder of the vulnerability of human beings to deadly contagious diseases. Throughout most of history plagues and epidemics were killers of much greater magnitude than they are today. In some cases plagues and diseases could wipe out a fourth to a half of a country's population in the span of a decade. Even as recently as the beginning of the 20th century, the death toll from infectious diseases was about 700 per 100,000 population per year. Today, despite new diseases such as AIDS, infectious diseases kill about 50 per 100,000-a stunning 14-fold reduction in death from infectious disease in this century.

Here is another example of modern health improvement. For about the past 30 years, sudden infant death syndrome (SIDS) has been an indiscriminate, traumatizing, and mysterious killer of newborns. However, better education and prevention have resulted in a threefold decline in the SIDS death rate of children under age 5 over the past 15 years and have provided huge relief and comfort to their to parents.

Humankind has made gigantic progress in enabling us to live longer and healthier lives as a result of advancements in modern medicine.

1. Lengthening Human Life

Throughout most of human history, death came at an early age-25 to 30 years was a typical lifespan. The essential element of the human condition was a day-to-day struggle to fend off death. Hence, the most amazing demographic fact-and the greatest human achievement in history in our view-is that human beings have almost won the battle against early death. We are not alone in this assessment. Several years ago the New York Times Magazine called the doubling of life expectancy since the start of the industrial revolution "the greatest miracle in the history of our species."

Longer life expectancy reflects a multitude of improvements in health care, nutrition, sanitation, safety, and wealth. Increasing life expectancy at birth from the lower 20s to the high 20s around 1750 took thousands of years. Over the next two centuries, life expectancy in the richest countries suddenly accelerated and tripled. From the mid-18th century to today, life spans in the advanced countries jumped from less than 30 years to about 75 years.

In 1900 the average life expectancy in the United States was just under 50 years. Today it is 77 years. This means that we have expanded the time horizon for a typical human life by 50 percent in the past 100 years. And life expectancy for blacks has moved up from only 30 years in 1900 to a bit less than that of whites.

Women have made greater gains in life expectancy than men in this century. In 1900 women on average lived two years longer than men. In 1950 they lived 5 years longer and today women on average live 6 years longer than men.

Life expectancy has also increased at every age. For example, a 45-year-old American could have expected to live 25 more years in 1900. Now a 45-year-old can expect to live 34 more years, as shown in the table.

The gains in life spans in industrialized countries are now also showing up in the poorest nations as well. As recently as 1950, the life expectancy of a citizen of a less developed country like China or India was about 40 years. Today it is 63 years. This is a stunning 50 percent gain in life expectancy in just 50 years.

2. Reducing Infant Death

Dear to the hearts of all parents is the safety of their children. Parents who have experienced the joy of bringing a healthy baby into the world can imagine the agony that other parents suffer when they lose a baby at birth. The figure shows the heartening course of the rate of infant mortality in the United States. In 1900, early death was the fate of more than 1 birth in 10. In some areas of the country infant mortality was as high as 1 in 4. Today, only 1 in about 150 babies dies within the first year.

Although solidly reliable data for the United States are not available before 1915, according to Kenneth Hill, professor of public health at Johns Hopkins University, "In the now-developed countries of Europe and North America, the probability of dying before...