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The early origins of the Mortality Revolution: a perspective from evolutionary biology

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One of the most profound changes of the last two centuries has been the ‘Mortality Revolution’, the dramatic decline in mortality that has resulted in a more than doubling of life expectancy globally. In now-developed countries the most significant improvements occurred before the development of antibiotics and before routine immunisation against most childhood diseases. This paper examines the early stages of the Mortality Revolution from an evolutionary point of view, in terms of the trade-offs between virulence and disease transmission. For diseases that are transmitted person-to-person and cannot persist outside a host then there is evidence of strong selective pressure against high host lethality. However for pathogens which don’t depend on their human host for transmission or that can persist outside a human host (including plague, typhus, cholera, typhoid, smallpox and malaria) then the conflict between virulence and dispersal is reduced. Fortuitously, the properties that permitted these diseases to be so lethal also made it easier in many cases for relatively weak interventions to break the chain of disease transmission. The early control of these major diseases was associated with large reductions in mortality, but also shifted the distribution of causes of death towards the less virulent diseases of the extremes of age and of poverty, thus increasing socioeconomic inequalities in survival.

This talk is part of the Wolfson College Science Society series.

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