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Medics, Monarchs and Mortality, 1600-1800: Origins of the Knowledge-Driven Health Transition in Europe

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  • S. Ryan Johansson

Abstract

Medical knowledge - defined broadly to include both its private and public forms - has been the driving force behind the historical transitions that have raised life expectancy in modern Europe. Advances in knowledge, rather than better nutrition (particularly the escape from caloric insufficiency) deserve greater emphasis because the very first groups to undergo anything recognizable as a secular risk in longevity were the rich and well fed, rather than the poor and chronically malnourished. At the beginning of the 16th century Europe's ruling elites lacked virtually any reliable information about how best to use their ample material resources to prevent, manage and cure the ill-health that caused so many premature deaths among them. The advance of medical knowledge and practice accelerated in Western Europe after c. 1500, with a succession of discoveries that were quite useful (as judged by modern standards) in preventing disease, reducing "life-style" risks, managing illness and providing cures for a few debilitating and deadly diseases - severe dysentery, syphilis, malaria, scurvy and, finally, smallpox, being the principal diseases affected. Yet, access to most of the available innovative medical care remained closely restricted. Medical expertise was limited and highly priced, and many of the measures prescribed were unaffordable even to town-dwelling middling-income families in environments that exposed them to endemic and epidemic disease. Along with the poor, they therefore were left at a grave health disadvantage vis-a-vis adult members of the wealthy urban families to whose conditions the doctors were attending. The London-based ruling families of England in this epoch benefited to an exceptional degree among the European elites from the contemporary progress of medicine. Their improved chances of survival in adulthood were the major factor raising royal life expectancy at birth (males and females, combined) from 24.7 years for the cohort born during the 1600s to 49.4 years for those born during the 1700s.

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  • S. Ryan Johansson, 2010. "Medics, Monarchs and Mortality, 1600-1800: Origins of the Knowledge-Driven Health Transition in Europe," Oxford Economic and Social History Working Papers _085, University of Oxford, Department of Economics.
    • Handle: RePEc:oxf:esohwp:_085
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    2. Cormac Ó Gráda, 2016. "Did Science Cause the Industrial Revolution?," Journal of Economic Literature, American Economic Association, vol. 54(1), pages 224-239, March.
    3. Francisco J. Marco-Garcia & Víctor A. Luque de Haro, 2023. "The persistence of social inequality in adult mortality in rural Spain, death cohorts 1546-2010," Working Papers 0238, European Historical Economics Society (EHES).
    4. Schneider, Eric B., 2013. "Real wages and the family: Adjusting real wages to changing demography in pre-modern England," Explorations in Economic History, Elsevier, vol. 50(1), pages 99-115.
    5. Eric B. Schneider, 2014. "Prices and production: agricultural supply response in fourteenth-century England," Economic History Review, Economic History Society, vol. 67(1), pages 66-91, February.
    6. Schneider, Eric B., 2013. "Real wages and the family: Adjusting real wages to changing demography in pre-modern England," Explorations in Economic History, Elsevier, vol. 50(1), pages 99-115.
    7. Cummins, Neil, 2017. "Lifespans of the European Elite, 800–1800," The Journal of Economic History, Cambridge University Press, vol. 77(2), pages 406-439, June.
    8. Eric B. Schneider, 2014. "Prices and production: agricultural supply response in fourteenth-century England," Economic History Review, Economic History Society, vol. 67(1), pages 66-91, February.

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