Was what ail'd ya what kill'd ya?

Making use of those Union Army veterans for whom death certificates are available, we compare the conditions with which they were diagnosed by Civil War pension surgeons to the causes of death on the certificates. We divide the data between those veterans who entered the pension system early because of war injuries and those who entered the pension system after the 1890 reform that made it available to many more veterans. We examine the correlation between specific medical conditions rated by the surgeons and death causes to gauge support for the hypothesis that death is attributable to something specific. We also examine the correlation between the accumulation of rated conditions to the length of time until death to gauge support for the "insult hypothesis." In general, we find support for both hypotheses. Examining the hazard ratios for dying of a specific condition, there is support for the idea that what ail'd ya' is what kill'd ya'.

Major Findings from The Changing Body: Health, Nutrition, and Human Development in the Western World since 1700.

This paper discusses findings from The Changing Body: Health, Nutrition, and Human Development in the Western World since 1700 (Cambridge University Press) The book is built on the authors' work with 300 years of height and nutrition data and discusses their findings in the context of technophysio evolution, a uniquely modern form of rapid physiological development, the result of humanity's ability to control its environment and create technological innovations to adapt to it.

Changes in the disparities in chronic diseases during the course of the 20th century.

Longitudinal studies support the proposition that the extent and severity of chronic conditions in middle and late ages are to a large extent the outcome of environmental insults at early ages, including in utero. Data from the Early Indicators Project, undertaken at the Center for Population Economics, suggest that the range of differences in exposure to disease has narrowed greatly over the course of the 20th century, that age-specific prevalence rates of chronic diseases were much lower at the end of the 20th century than they were at the beginning of the last century or during the last half of the 19th century, and that there has been a significant delay in the onset of chronic diseases over the course of the 20th century. These trends appear to be related to changes in levels of environmental hazards and in body size. These findings have led investigators to posit a synergism between technological and physiological improvements. This synergism has contributed to reductions in inequality in real income, body size, and life expectancy during the 20th century.

Secular trends in physiological capital: implications for equity in health care.

Over the past three centuries, there has been a rapid accumulation of physiological capital in Organisation for Economic Cooperation and Development (OECD) countries. Enhanced physiological capital is tied to long-term reduction in environmental hazards and to the conquest of chronic malnutrition, since both nutritional status and the quality of the external and intrauterine environments appear to be linked to the quality of organ development and to the onset of chronic diseases later in life. Data on heights and birth weights suggest that physiological capital has become more equally distributed, thereby reducing socioeconomic disparities in the burden of disease. These developments have a number of health care policy implications: (1) enhanced physiological capital has done more to reduce inequities in health status than has wider access to health care; (2) the main contribution of more advanced medical treatment so far has been to retard depreciation in individuals' physiological capital; (3) prenatal and early childhood care and environmental issues are key for interventions aimed at enhancing physiological capital and at affecting its rate of depreciation; (4) lifestyle change is the most important issue affecting health equity in rich countries; and (5) greater access to clinical care should be promoted through aggressive outreach, since expanded insurance coverage by itself is inadequate.