Nobel economist Fogel predicts better health, longer lives in future

Nobel economist Robert Fogel tells students that new research will extend their healthy lives well beyond past predictions, in a talk held Oct. 18 in 105 Ives Hall. Kevin Stearns/University Photography

By Linda Myers

"You have a 50-50 chance of living to be 100 in good health," Robert Fogel, 1993 Nobel laureate in economics, announced to a packed house of mostly students in 105 Ives Oct. 18, during his University Lecture.

"Does that startle you?" he asked. "It should. The greatest minds got it wrong. In the 1920s the chief actuary at Metropolitan Life said that the cap was 65 years for men. But over the past century, average life expectancy has risen three years per decade, which is why yours will be close to 100."

Fogel, a Cornell alumnus, Class of 1948, doesn't balk at startling others with his assertions. His studies proving the profitability of the U.S. slave trade, and hence its endurance, made the University of Chicago professor a controversial figure for decades. During his Cornell talk, he shared the results of his forthcoming book on the health and longevity of Americans and its relationship to economic and social gains, which is also likely to spur debate.

His overall point: Economic gains and good public policy have not only reduced infant mortality and improved health and longevity dramatically in the United States in the past 130 years, but those same results will occur in developing regions in a much shorter time span, perhaps 40 years. People will continue to live longer worldwide, and diseases once viewed as incurable will be wiped out, thanks to cross-disciplinary research and the money to spend on it.

"The advances in the first half of the 20th century have been greatly underestimated because economists have concentrated on wealth but ignored gains in health and longevity and improvements in the infant mortality rate," said Fogel. Most economists view an hour of a doctor's time in the late 19th century as an "input" identical to an hour of a doctor's time today, despite giant strides in health and medicine. Aiming to change that, Fogel studied three cohorts: one from the Civil War era; one born in the 1920s (himself included); and one he called the IT (information technology) generation of current undergraduate and graduate students.

"Life for the Civil War cohort was short and nasty," Fogel said. Because of poor sanitation, contaminated water supplies and lack of such processes as pasteurization of milk, the group's health was so poor that one-quarter died in infancy, half didn't live beyond 30 and those who survived were frequently ill with lifelong respiratory and gastrointestinal illnesses or fell prey to malaria, typhus and typhoid and, if they lived in cities, tuberculosis. They also were required to work up to 78 hours a week, with no regular vacations and no retirement.

Everything changed for Fogel's generation. "Notice that I'm still around at 76?" he joked. His cohort has fared significantly better mainly because of environmental improvements: the cleaning up of the water supply, the purification of water with chlorine, the switch from raw to pasteurized milk, from 1890 through the 1950s, and the improvement of maternal health. The work week also got shortened significantly, making room for leisure activities. And life expectancy rose to more than 60, a change due mainly to gains of the poor through environmental improvements, said Fogel. Such gains "are reversible if you let the environment deteriorate," he warned, noting the return of tuberculosis to some U.S. urban areas.

Of the current IT generation, Fogel said: "Today, only 13 percent of your income is spent on food, clothing and shelter, compared with 75 percent of the income of cohort one. The rest is spent on health care and leisure. We're able to spend more [in those areas] because we have more."

Fogel said: "I believe that the vast expansion of expenditures on health care will pay off in promising new medicines through the marriage of biology and IT technology." He predicted the IT generation would see the intermingling of human cells and microchips to overcome deficits in particular organs, and genetic engineering to treat previously untreatable diseases and further spur longevity and good health. His caveat: "Provided that you develop appropriate lifestyles. Without that, everything is reversible."