One of the most revealing cases is measles.

At present, Canadian and

American children do not often get measles because they are vaccinated
against it, but a generation ago every schoolchild had measles, yet death
from measles was extremely rare. In the nineteenth century, measles was the
major killer of young children, and in many African countries today it
remains the highest cause of death among children. Measles is a disease that
everyone used to contract, for which there is no known cure or medical
treatment, and which simply stopped being fatal to children in advanced
countries.
The progressive reductions in the death rate were not a con-sequence, for
example, of modern sanitation, because the diseases that were the major
killers in the nineteenth century were respiratory and not waterborne. It is
unclear whether simple crowding had much to do with the process, since
some parts of our cities are quite as crowded as they were in the 1850s. As
far as we can tell, the decrease in death rates from the infectious killers of
the nineteenth century is a consequence of the general improvement in
nutrition and is related to an increase in the real wage. In countries like
Brazil today, infant mortality rises and falls with decreases and increases in
the minimum wage. The immense betterment of nutrition also explains the
drop in the higher rate of tuberculosis among women than among men. In
the nineteenth century, and even long into the twentieth in Britain, working
men were far better nourished than homebound women. Often if meat could
be afforded for the table in an urban working-class family in Britain, it was
saved for the man. So there have been complex social changes, resulting in
increases in the real earnings of the great mass of people, reflected in part in
their far better nutrition, that really lie at the basis of our increased longevity
and our decreased death rate from infectious disease. Although one may say
that the tubercle bacillus causes tuberculosis, we are much closer to the truth
when we say that it was the conditions of unregulated nineteenth-century
competitive capitalism, unmodulated by the demands of labor unions and
the state, that was the cause of tuberculosis. But social causes are not in the
ambit of biological science, so medical students continue to be taught that
the cause of tuberculosis is a bacillus.
In the past 20 years, precisely because of the decline in infectious disease as
an important cause of ill health, other single causes have been raised as the