‘In Manchester and Liverpool, the two giants of capitalist industrialisation, life expectancy collapsed.’ Children in Hulme, Manchester, 1954. Photograph: Picture Post/Getty Images
In recent years prominent pundits including Steven Pinker, Jordan Peterson and Bill Gates have invoked the progress in global life expectancies to defend capitalism against a growing tide of critics.
Certainly there’s a lot to celebrate on this front. After all, average human life expectancy has improved a great deal. “Intellectuals are apt to do a spit take when they read a defense of capitalism,” Pinker writes in his recent book, Enlightenment Now. But it’s “obvious,” he claims, that “GDP per capita correlates with longevity, health, and nutrition.”
It’s a familiar story. The prevailing narrative is that capitalism was a progressive force that put an end to serfdom and set off a dramatic rise in living standards. But this fairytale doesn’t hold up against the evidence.
Serfdom was a brutal system that generated extraordinary human misery, yes. But it wasn’t capitalism that put an end to it. As the historian Silvia Federici demonstrates, a series of successful peasant rebellions across Europe in the 14th and 15th centuries overthrew feudal lords and gave peasants more control over their own land and resources. The fruits of this revolution were astonishing in terms of wellbeing. Wages doubled and nutrition improved. It was a period of dramatic social progress by the standards of the time.
Then the backlash happened. Upset at the growing power of peasants and workers, and angry about rising wages, a nascent capitalist class organised a counter-revolution. They began enclosing the commons and forcing peasants off the land, with the explicit intention of driving down the cost of wages. With subsistence economies destroyed, people had no choice but to work for pennies simply in order to survive. According to the Oxford economists Henry Phelps Brown and Sheila Hopkins, real wages declined by up to 70% from the end of the 15th century all the way through the 17th century. Famines became commonplace and nutrition deteriorated. In England, average life expectancy fell from 43 years in the 1500s to the low 30s in the 1700s.
In short, the rise of capitalism generated a prolonged period of immiseration. It was among the bloodiest, most tumultuous times in world history. Yet Pinker behaves as if none of this happened. Instead he jumps straight to the modern industrial period. It was industrial capitalism, he says, that really delivered progress in life expectancy.
But here too historians have a more complex story to tell. Simon Szreter, one of the world’s leading experts on historical public health data, shows that industrial growth through the 19th century triggered not an improvement in life expectancy but rather a striking deterioration. “In almost every historical case,” Szreter writes, “the first and most direct effect of rapid economic growth has been a negative impact on population health.”
“The evidence of this trauma,” he continues, “remains clearly visible in the form of a generation-long, negative discontinuity in the historical trends of life expectancy, infant mortality, or height attainments.” Drawing on a wide range of studies, Szreter shows that populations directly affected by industrial growth in Britain experienced a steady decline in life expectancy, from the 1780s through the 1870s, down to levels not seen since the Black Death in the 14th century.
In fact, it was precisely where capitalism was most developed that this disaster was most pronounced. In Manchester and Liverpool, the two giants of industrialisation, life expectancy collapsed compared with in non-industrialised parts of the country. In Manchester it fell to a mere 25.3 years. In rural Surrey, meanwhile, people could expect to live a full 20 years longer.
And it’s not only in Britain that we see this pattern playing out. According to Szreter, the same thing happened in “every one of the countries where it has been researched”, including Germany, Australia and Japan. Similar catastrophes occurred during this same period in colonies such as Ireland, India and the Congo, as they were forcibly roped into the European industrial system.
It would be difficult to overstate the suffering that these figures represent. They tell the story of whole populations that were dispossessed by the capitalist class and reduced to servitude in the sweatshops and plantations of the industrial revolution. And yet none of this appears in Pinker’s rosy narrative.
It wasn’t until the 1880s that urban life expectancies finally began to rise – at least in Europe. But what drove these sudden gains? Szreter finds it was down to a simple intervention: sanitation.
Public health activists had discovered that health outcomes could be improved by separating sewage from drinking water. And yet progress toward this goal was opposed, not enabled, by the capitalist class – libertarian landlords and factory owners refused to allow officials to build sanitation systems on their properties, and refused to pay the taxes required to get the work done.
Their resistance was broken only once commoners won the right to vote and workers organised into unions. Over the following decades these movements leveraged the state to intervene against landlords and factory owners, delivering not only sanitation systems but also universal healthcare, education and public housing. According to Szreter, access to these public goods spurred soaring life expectancy throughout the 20th century.
Pinker makes no mention of this movement. His argument relies instead on a scatter plot known as the Preston curve, which shows that countries with higher GDP per capita tend to have higher life expectancies. But he asserts causation where there’s no evidence for it. In fact, new research finds that the causal factor behind the Preston curve isn’t GDP at all, but education.
Of course, social services require resources. And it’s important to recognise that growth can help toward that end. But the interventions that matter when it comes to life expectancy do not require high levels of GDP per capita. The European Union has a higher life expectancy than the United States, with 40% less income. Costa Rica and Cuba beat the US with only a fraction of the income, and both achieved their greatest gains in life expectancy during periods when GDP wasn’t growing at all. How? By rolling out universal healthcare and education.
“The historical record is clear that economic growth itself has no direct, necessary positive implications for population health,” Szreter writes. “The most that can be said is that it creates the longer-term potential for population health improvements.”
Whether or not that potential is realised depends on the political forces that determine how income is distributed. So let’s give credit where credit is due: progress in life expectancy has been driven by progressive political movements that have harnessed economic resources to deliver robust public goods. History shows that in the absence of these progressive forces, growth has quite often worked against social progress, not for it.
Jason Hickel is an economic anthropologist and author of The Divide: A Brief Guide to Global Inequality and its Solutions