The health revolution is not just a good in itself. It has beneficial consequences, the most important of which is the transformation of women’s lives. As child mortality tumbles, so does fertility: fewer births are needed to achieve a given family size. This is irrespective of religion: in Muslim Iran, for example, the number of children per woman fell from 6.5 in 1980 to 1.9 in 2017; similarly, in Catholic Brazil it fell from 6.2 in 1960 to 1.8 in 2017. As women live longer and have fewer children, they can invest more in each child and pursue their own careers. Thus the health revolution underpins another of the revolutions of our era: the change in the role of women.
健康革命的好处并不仅限于改善健康状况本身。它带来多种好处,其中最重要的一点是改变了女性的生活。随着儿童死亡率大幅下跌,生育率也大幅下降:创建一定规模的家庭所需生育的孩子减少了。这种现象不受宗教影响:比如,在信仰伊斯兰教的伊朗,每个女性生育的孩子的数量,从1980年的6.5个降至2017年的1.9个;类似的,在信仰天主教的巴西,这个数字从1960年的6.2个降至2017年的1.8个。随着女性寿命延长、生育孩子的数量减少,她们可以在每个孩子身上投入的更多,也可以追求自己的事业。因此,健康革命支撑了我们这个时代的另一场革命:女性角色的改变。
What has driven the improvements in health, particularly among the middle aged? A decline in smoking is a factor. Improved treatment for heart disease is another. Even cancer is succumbing to treatment. Increasingly, in high-income countries, the remaining diseases are those of old age, including dementia. But in most developing countries the old afflictions linger, including poor sanitation, contaminated water and malaria.
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