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Дописи каналу
One way to show the DRAMATIC increase in nutritional status in England after 1900 is to visualise nutritional sufficiency as a conical bucket.
The portion B of the bucket (from 1700 to 1900) holds a volume of nutrition not too different to the entire volume of nutrition in portion A.
In addition, specific nutrients like Vitamin A were found mainly after 1910.
By merely "filling up" total calories by 10% and vitamins by perhaps 50% after 1900, a dramatic upsurge in mortality ensued. Of course, better housing (people were much richer by 1940, than in 1900) added to the effect.
Sanitation could not possibly have played a very prominent role since it only affected a few of the many infectious diseases. Diseases not carried via water (such as TB, measles, scarlet fever, smallpox) are largely immune to sanitary improvements.
| 2 | In this context, it is important to note that internationally, in dire emergencies, the MINIMUM food requirement for a human is set at 2,100 calories.
https://iris.who.int/server/api/core/bitstreams/c6f336b9-0c36-4431-80fd-840c05344817/content
This means that with the average British citizen consuming 3,300 calories in ~1940, they had achieved SUBSTANTIAL FOOD FOR EVERYONE.
Most importantly for my thesis, pasteurization of milk had made this MOST VITAL FOOD widely available to children (mainly by making it cheap and affordable).
Complete nutritional sufficiency was probably achieved in England only by ~1960, but even by 1940, food was sufficient to contribute significantly to life expectancy improvements.
As I've also noted, photographs of children and of the poor show a sharp decline in dire poverty by 1940.
We know that VIRTUALLY NO MEDICAL ADVANCE had occurred prior to 1940, therefore almost the entire contribution to life expectancy till that time can be attributed to food (and improved housing and clothing/ shoes) - and from 1890, a portion of it to sanitation and water. | 7 |
| 3 |  Немає тексту... | 9 |
| 4 |  I do need to prove my thesis that nutritional sufficiency dramatically increased in England in the first half of the 20th century.
Here are two charts, taken from a 2010 paper and a 1936 book:
https://nber.org/system/files/working_papers/w15875/w15875.pdf
and
https://fao.org/fileadmin/templates/library/docs/613_OR7.pdf
My thesis has two parts (a) total calorific intake in England increased sharply, (b) nutrient deficiencies were dramatically reduced (via pasteurized milk).
I think it is quite self-evident that a society which could eat 2230 calories per day in 1700 and 3250 calories by 1934 (i.e. 46% more!) PLUS had high quality milk for children was going to have very low child mortality and hence overall mortality.
THIS INCREASE IN FOOD + ITS QUALITY, IS WHAT EXPLAINS OVER 50% OF THE INCREASE IN LIFE EXPECTANCY IN THE WEST. Just food. | 8 |
| 5 |  Немає тексту... | 13 |
| 6 | To date I've not tried to accurately fit real life expectancy data with the main causes, merely used tables and arithmetical calculations. This is my first attempt to do so, for the UK.
This chart broadly validates other calculations made in the book, but it seems to me that there is a bigger component for "everything else".
Of course, these lines are purely subjective, based on information that's inside my head - and others might make slightly different lines based on their own understandings.
EXPLANATION FOR THE LARGE BUMP IN NUTRITION from 1910: I've identified a particularly large bump in nutrition in early 20th century - since photographic and other evidence suggests significant elimination of dire poverty in the UK during this period (ability to buy food, healthier food such as pasteurised milk, and mass-scale production of food). That's the period when diseases like measles were virtually entirely eliminated, and TB etc. brought under great control. (Housing played a key role in TB and many other infectious diseases.)
VIRTUALLY NO MEDICAL CONTRIBUTION PRE-1900:
There is virtually no positive medical contribution before 1900 (killings probably exceeded lives saved), and a small increase since the 1940s with antibiotics and vaccines; then it picks up pace, but by now it is stagnating: it is virtually impossible at this stage to further increase life expectancy with medical advance. | 11 |
| 7 |  I'd amend to: Not attempting to punish evil is equivalent to authorizing it.
The problem is that the outcome "to punish" is VERY UNLIKELY IN THIS ULTRA-EVIL WORLD. All one can do is to try. 99.99% of the corrupt thugs that rule this world will escape any attempts to punish them. That doesn't mean one should not try. | 14 |
| 8 | The concluding chapter on life expectancy is the opportunity to summarise key findings from the book about various factors that determine human health.
The estimates continue to be rubbery - because it is close to impossible to perfectly unpack the causes of long term changes in mortality. However, these estimates are probably in the right ballpark. We know, for instance, that almost all improvements in infectious disease occurred long before "medical advance" (e.g. vaccines), and in fact, vaccines hugely delayed the eradication of smallpox.
We also know that there has been very little improvement in mortality rates for non-infectious diseases. Medical science is fighting an uphill battle in the West - having reached severely diminishing returns.
The ultimate resource in all this has been human inventiveness. Political and economic freedom enabled people to challenge authority, invent new things, and create new resources and markets. Those ideas and inventions (not medical) contributed to almost all improvements in life expectancy. Medical science did a bit as well, but at least till the end of the 19th century, it killed more than it saved. | 19 |
| 9 |  The concluding chapter on life expectancy is the opportunity to summarise key findings from the book about various factors that determine human health.
The estimates continue to be rubbery - because it is close to impossible to perfectly unpack the causes of long term changes in mortality. However, these estimates are probably in the right ballpark. We know, for instance, that almost all improvements in infectious disease occurred long before "medical advance" (e.g. vaccines), and in fact, vaccines hugely delayed the eradication of smallpox.
We also know that there has been very little improvement in mortality rates for non-infectious diseases. Medical science is fighting an uphill battle in the West - having reached severely diminishing returns.
The ultimate resource in all this has been human inventiveness. Political and economic freedom enabled people to challenge authority, invent new things, and create new resources and markets. Those ideas and inventions (not medical) contributed to almost all impro | 18 |
| 10 |  I've finished a preliminary cut of chapter 36 and will now move to ch.37 (in which I will conclude the discussion on the drivers of life expectancy). https://sanjeev.sabhlokcity.com/Misc/Textbook-SPH-draft_Part2.pdf | 19 |
| 11 |  Here's a further refinement of the NTD data problem.
The NTD count is hugely problematic. They try to add up the delivered NTDs and stillbirths. But an unknown number of ill-formed babies ARE NATURALLY ABORTED.
And since ultrasound became more widely available, ill-formed babies are consciously aborted - but these are not always added up.
In other words, even to know whether NTDs are diminishing from the use of folic acid, is close to impossible. A lot of guesswork prevails in this area of "science". | 19 |
| 12 |  I HAVE A LAW, THAT CAN BE CALLED SABHLOK'S LAW:
"freedom comes closest to being measured objectively through its effect on the physical flow of people from a lower to higher levels of freedom. We can predict this flow with almost the same precision with which we predict the flow of water which flows, instead, from a higher to a lower level."
NO COUNTRY HAS EVER BREACHED THIS LAW. Nor will.
Around 250-300,000 Chinese FLEE CHINA each year. Around 2-6 MILLION people immigrate into USA each year.
Q.E.D.
China is a HELL HOLE. (And of course, India).
https://www.macrotrends.net/global-metrics/countries/chn/china/net-migration | 19 |
| 13 |  Chapter 36 is turning out to be much more work than I had initially thought.
Much ado about nothing, is what it is. The net effect of fortification (voluntary or even mandatory) on life expectancy is SO MINOR it is literally impossible to count it (maybe a few weeks + or -). But there is a HUGE industry (doctors, chemists, public health "experts", health economists) who earn their living by analysing fortification. Almost all of them funded by taxpayers.
Even as my main conclusion remains unchanged (i.e. VERY LITTLE EFFECT ON LIFE EXPECTANCY), I need to outline the topic sufficiently in the textbook.
Topics with a red line are under process, the ones in green are mostly done. ... I do want to finish this chapter and move on within the next day or two.
https://sanjeev.sabhlokcity.com/Misc/Textbook-SPH-draft_Part2.pdf | 16 |
| 14 |  Bentham's focus was unambiguous: on the SAFETY of food. Wiley went further, by adding a "purity" test - something possible only in natural foods.
While pure food is safe, not all safe food needs to be "pure". To that extent Wiley was over-ruled by American legislators. I don't think we will ever go back to a Pure Food Act. Innovations in food can't be stopped in the name of safety.
What we need is a system by which SAFETY is paramount - and that is the main reason to oppose mandatory fortification, which can be unsafe for some. | 15 |
| 15 |  Updated chart to reflect different regulatory regimes for these two types of "fortification" in the USA.
Inevitably, I'll also need to outline the American regulatory system for biotechnology which - in my view - is a gross over-interference in markets. Such regulation was fine when the technology was new but with trillions of GM meals being consumed since the 1990s, there is a need to vastly tone down such regulation. | 15 |
| 16 | HARVEY WILEY (1844-1930) SHOULD BE CONSIDERED A FOUNDING FATHER OF FOOD SAFETY - and he would firmly oppose folic acid fortification. He was clearly NOT a socialist and was focused on SAFETY, not "doing good".
Cara Westmark's 2026 paper brought Harvey Wiley to my attention. Wiley laid the foundations in the USA of the branch of government which ultimately became the FDA.
https://wmjonline.org/123no6/westmark/
I've now found a book by Harvey Wiley in which he discusses historical issues and how (in his opinion) the FDA had started POISONING the people. (Book: https://archive.org/details/historyofacrimeagainstthefoodlawharveywashingtonwiley1929/page/n37/mode/2up?q=add)
I asked ChatGPT to summarise Wiley's key concepts and principles (https://chatgpt.com/share/6a960759-fe10-83ec-a41c-07460e8568c1). These are the EIGHT PRINCIPLES of Wiley:
1. Food should be what it purports to be
2. The manufacturer should not be allowed to decide what is acceptable
3. Scientific evidence should precede permission to add substances to food
4. "Technological usefulness" is not sufficient justification
5. The consumer has a right to know what he is buying
6. Government regulators themselves must obey the law
7. Regulatory capture is a greater danger than inadequate regulation
8. Public health requires resisting both commercial and political interests
UNDOUBTEDLY, WILEY WOULD HAVE OPPOSED FDA'S 1998 DECISION ON FOLIC ACID.
I'll try to extract his key principles in his own words for the early part of chapter 36, but this little bit caught my attention - regarding food preservatives. The principle is that when different experiments yield inconsistent results, take a conservative approach. If there is evidence that folic acid can cause harm in excess (and there IS), the @FDA should have allowed only a level sufficient to restore what is lost during milling.
cc. @ClareCraigPath - this book by Wiley might be of interest to you. I'm going to use AI to zoom into issues of interest, since I want to close the topic soon - in a day or two. But given your interest, you might consider writing a piece on the history and principles of food safety. You could discuss in detail how public health moved from negative health (safety focus) to positive health ("doing good"). The @WHO is FIRMLY driven by the socialist concept of health, so are almost ALL economists (who follow Pigou) - including American economists. | 13 |
| 17 |  Немає тексту... | 14 |
| 18 |  I'll now reorganise chapter 36 into the following categories.
ALL of these are voluntary categories. Any mandatory category is immediately ruled out.
Btw, the USA (including FDA and USDA) has a PERFECTLY DEFENSIBLE policy on these matters, with a few minor exceptions. An exception is their folic acid policy (that goes beyond restoration) and also their over-regulation of GM crops (although US policy on GMOs is least restrictive among all countries of the world).
I won't go into details on GMO regulation (something which I've written about extensively elsewhere), since this is a general textbook on PH that can't possibly go into all details. But I will comment in some detail on the folic acid policy. | 18 |
| 19 |  This is what modern "public health" is entirely missing: the BIG PICTURE. Getting that back is the aim of scientific public health. | 18 |
| 20 |  I was looking for a visual method to distinguish between the OBSESSIVE style of "doctors" from the broad, context-seeking style of genuine public health/ economics.
ChatGPT has done a good enough job for me to include this image in the first (or second) chapter of my textbook.
https://chatgpt.com/share/6a93ea9f-07dc-83ec-a9c6-1af91e28396d | 22 |
