Health and Evolution

If we are trying to account for the evolution of human health, we must consider its development over the course of the history of the human species. In doing so, we have to try to make the best of the knowledge acquired so far concerning our past, covering a time span of some 6,000 generations — or more than 100,000 generations if we consider the human genus in its entirety — under changing environmental and cultural conditions. In this chapter, I argue that health is the product of evolution, and that success in evolutionary strategies explains much of the present state of global health. Throughout human history, and most markedly with respect to modern humans and since the inception of history proper, cultural evolution has increasingly gained the edge over biological evolution, to the extent that life expectancy and the unequal distribution of disease burden largely depend upon unbalances in the development of different regions of the world, rather than upon any lack of medical knowledge or healing skills. Finally, I conclude that universal health education, imparted from a very early age, and an awareness of the need to control births, are key policy objectives in any attempt to improve the general state of human health.