Apples and Oranges

You can’t directly compare conditions a hundred or two hundred years ago to today.  At first glance, this seems obvious, and yet I consistently see people doing this.  The comparisons are made when we talk about vaccination, obesity, infant mortality, childbirth methods, autism, child labor, and probably half a dozen other topics that I can’t grasp at the moment.  The argument usually goes like this:  “A hundred years ago, before we had x, bad outcome y happened.  Today, if we didn’t have x, bad outcome y would happen all over again.”

Sorry, it doesn’t work that way.

First off, when you talk about anything involving health, you have to consider the whole picture of health, not just a piece of it.  Absolutely anything and everything that makes us sick today is more survivable than it was a hundred years ago because of a broad spectrum of basic health care improvements, including antibiotics, good nutrition, basic sanitation, and an understanding of germ theory.  These four things alone probably account for 90% of the increase in longevity and the decrease in mortality across all age groups. Whatever happens to you, you are less likely to die of it now than at any point in history, period.

This means you can’t take some one advance and say that removing or changing it will suddenly throw us back into the dark ages of health care.  If women go back to planning to have all their babies out of the hospital, neonatal and maternal mortality will not climb back to 1900 levels.  If we stop vaccinating altogether as a society, children will not die of the measles and polio at 1900 levels.

Socially, culturally, we are not the same society that we were a hundred years ago.  We’re not even the same culture as we were in the 1970’s when I was born.  The level of acceptance for “others” in our society today is so high it would have been absolutely unbelievable back then.  Information is readily available to anybody in search of it, one way or another, faster, cheaper, more accurately, and more efficiently than ever before.  Low birth and death rates have led us to cherish every life more dearly, to care more about every individual.

You can’t say that if laws against child labor were repealed we would suddenly have children working and dying in coal mines again.  You can’t say that if hate crime laws were repealed we would have a spate of lynchings.  Society doesn’t function the same way now as it did back then.  Trying to make these arguments is no more intellectually honest than a conservative saying that if gays are allowed to marry that suddenly nobody will live in nuclear families anymore and Christians will be forced to live in polygamous marriages with dolphins (or whatever the last crazy argument on that one was).

We live in a chaotic world, a world full of thousands, millions, even billions of factors, all interacting in billions of different ways.  There are eddies and currents, whirlpools and waterfalls, as information, disease, human interaction, and evolution mingle.  One person can make a difference in the lives of millions of people, and yet sometimes millions of people believing a thing can’t seem to make a difference for anybody outside their direct sphere of influence.  Ripples expand, waves reinforce each other and cancel each other out.  The beauty in this chaos is that so many different things can happen, so many different ideas can be tried out, forces tested, evolutionary paths explored in nature and in society.

But in a chaotic world, the same conditions never exist twice, and the same action almost never produces an identical reaction.

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