Were our grandparents really healthier than us?
By Tegan Taylor
Updated 5 July 2018 at 1:04 pm
First posted 5 July 2018 at 8:07 am in
ABC Health & Wellbeing
Our grandparents were raised on "real" food and played in the dirt, whereas we eat junk and sit in front of screens all day, or so the story goes. So who was healthier?
Ah, the good old days. When kids played outside in the dirt until the dinner bell rang, veggies came from the back garden instead of wrapped in plastic, and a tablet was something you took if you were sick.
It's a common refrain that our grandparents were raised in simpler, more natural times, before processed foods and ubiquitous screens gave us all sorts of lifestyle diseases.
But how true is that assumption? Were our grandparents really healthier than us? Or are we just romanticising a bygone era?
Your days are numbered
If we're trying to work out which generation was healthier, perhaps a good place to start is life expectancy.
This has risen in Australia pretty steadily since the turn of the 20th century.
Life expectancy in Australia has risen steadily since 1890.
(Australian Bureau of Statistics)
Let's say the average ABC reader's grandparents were born roughly 100 years ago. Your grandfathers, born in about 1918, would have had a life expectancy of less than 60, and your grandmothers a little more than 60.
By contrast, you would have been born expecting to live at least another 10 years more than that, and someone born today is expected to live beyond 80.
Having said that, life expectancy tables can be deceiving. Things like high rates of infant mortality can skew the numbers down, and if we're talking specifically about our grandparents' health, then we're assuming they lived long enough to reach adulthood and have a family.
And yes, a big contributor to our improved life expectancy over the past century has been a reduction in infant deaths. At the beginning of the 20th century, for every 1,000 babies born alive, 105 died.
Today, that death rate is down to just over 3 deaths per 1,000 live births.
But the life expectancy for older people has also increased. The increase in life expectancy for people over 65 has actually accelerated over the past 20 years. The ABS attributes this to an ageing population and improvements in social, economic and living standards.
Compared to a century ago, older people today are much more likely to die from a chronic disease than an infectious disease.
So on the life expectancy metric, we're healthier than our grandparents were.
But living for a long time isn't exactly the same as having a healthy life, is it? So let's look at some things we know are associated with good health overall, and see how they compare to our grandparents' generation and now.
What's on your plate, grandpa?
Sweetened tea and sugary biscuits and cakes were very popular.
(NSW State Archives: NRS 15051 School photograph collection)
What we eat has changed over the past century, but so has where we eat and where we shop, according to Jan O'Connell, whose book A Timeline of Australian Food: From Mutton to Masterchef looks at Australian food over the past 150 years.
While many families may have had a backyard vegetable garden, and a much larger proportion of the population lived on the land and raised their own meat, O'Connell said people in the 1920s and 30s ate a fair amount of foods we would consider unhealthy today.
"Heaps of sugar, heaps of meat, lots of tea [with sugar] and bread and butter. Nobody thought of saturated fat being bad for you," she said.
In fact, during the Depression and World War II, when meat rationing came into place, "there were people writing in the newspaper saying poor people were going to be restricted to having meat just once a day instead of sausages for breakfast, meat sandwiches for lunch and meat for dinner", she said.
The early decades of the 20th century was also the era when sweets like Aeroplane jelly, Darrell Lea chocolates, Jaffas, Minties and Cherry Ripes were launched, and sugar featured heavily in cakes and biscuit recipes. But O'Connell said bought confectionery would have been a rare treat for most children.
Towns had hotels and pubs but most families would have eaten out very rarely.
(Supplied: Brian Hooper)
In terms of eating out, options for families were limited. There weren't many fast food possibilities other than pies or fish and chips, and going out for an evening meal wasn't common.
"Only the moneyed classes and mostly men would have their lunch in a cafe," O'Connell said.
"But people didn't go out in the evening to restaurants anywhere near the way that they do now. There just weren't the smaller neighbourhood restaurants, so the temptation to go out and eat big meals just wasn't there."
O'Connell said a shift in the way we shop also had an effect on the amount of processed foods in our diets today compared to our grandparents'.
"You used to have to go to the grocer — and this would have been the case in the 1920s up until the 60s really — they either went and stood at the counter while the grocer weighed out the biscuits and the flour or they left the grocery list and the grocer's boy would deliver it home," she said.
"But it was a considered purchase, there was no impulse buying."
(Supplied)
People in the pre-World War II period were leaner than today — University of Sydney medical historian Peter Hobbins said recruitment records of young men joining the armed forces showed their weights were relatively low for their height — but that doesn't mean they had a better quality diet.
By the 1950s, a lot of people were dying from heart disease.
"The amount of fat and meat they were eating had a huge effect on people's life spans, especially men," Dr Hobbins said. "These days we have a lot more information about eating well, even if we don't eat well."
Nutrient deficiencies were another problem. For example, goitre was widespread in certain areas, which is caused by iodine deficiency and can cause mental problems in babies whose mothers are deficient in pregnancy.
Iodised table salt was introduced in the 1920s, but food fortification programs didn't really come into effect in Australia until about the 50s and 60s.
On the diet metric, there's no clear winner. While we may have more processed food and may be eating more energy-rich food than we need these days, we're also better educated about healthy food choices than our grandparents were.
The way you move
(Museums Victoria: Kathleen Margaret Gawler)
It's hard to overestimate just how different the amount of movement required to get through daily life was when our grandparents were young compared to today.
At work, around the home and how we travel have all become much less active, according to David Dunstan from the Baker Heart and Diabetes Institute — and studies show more incidental movement throughout the day is linked to a reduced risk of heart disease and early death.
(State Library of South Australia B 46457: D Darian Smith)
"The advent of computers has really obviated the need to move too much whilst at work," Professor Dunstan said.
"In the past people were having to go down to the archives, find files, etc. Office clerks would be continually up and moving around; nowadays it's connected to a computer screen."
Even modern jobs that we would consider to be relatively active would have involved a lot more exertion in the 1930s and 40s. These days, a single crane operator can sit in a cab and do the work that may have taken a gang of workers a century ago.
"Occupational health and safety has come a long way but it creates an environment that's highly inducive to long periods of low energy expenditure," Professor Dunstan said.
Similarly in the home, labour saving devices like washing machines, dryers, kitchen appliances and even central heating mean we don't have to physically work as hard as our grandparents did to keep ourselves clean, well fed and warm.
(Supplied: The Foundling Archive)
Then there's transport. Where people in the first half of the 20th century tended to rely on public transport, walking or cycling, transport today centres on the car.
"Neighbourhoods nowadays are really tailored towards the automobile," Professor Dunstan said, pointing to knock-on effects like busy roads making it less safe to cycle or walk.
"Coming with that is progressive urban sprawl. There are some people here [in Melbourne] that are commuting more than an hour one way a day.
"The accumulation of sedentary sitting time in cars is substantial nowadays on a daily basis."
So on the physical activity metric, while cars, computers and household appliances have made our lives more efficient, they've also removed a lot of the health-protective movements our grandparents' generation would have done without thinking.
Our grandparents win this one.
Medicines and medical care
(Museums Victoria: H V McKay Factory Medical Centre)
Perhaps the biggest shift in terms of health over the past 100 years has been changes in medicine and Australia's health system.
By 1920, vaccinations were already being taken up, with children being immunised against smallpox, diptheria and whooping cough, said medical historian Dr Hobbins.
The infant mortality rate had already been declining in the few decades leading up to the time our grandparents were born.
But the vaccination program has expanded even more in the decades since, with smallpox being eradicated globally and protection against diseases like polio that had a devastating effect before.
The industrialisation of penicillin in the 1940s also transformed medicine, Dr Hobbins said.
"That had a dramatic impact on the treatment of a lot of bacterial infections," he said.
"People who had major burns that might be susceptible to dying from a skin infection were much more likely to survive. It also meant there was much more scope for serious surgery … like abdominal surgery or brain surgery which previously would have been a death sentence."
Other medicines that have been developed since our grandparents' time, such as pain relief, antiviral and cholesterol drugs, not only save lives but improve quality of life in general.
Not only has medicine advanced, but our access to healthcare is also vastly different than it was in the 1920s and 1930s, Dr Hobbins said.
"There was no sense [back then] that Australians had a right to being healthy and well," he said.
"It wasn't part of the mindset and it certainly wasn't part of the mindset that was the responsibility of the government."
Some people might pay into a health fund or what was called a friendly society that could be used to pay a doctor, but that wasn't actually very common either, Dr Hobbins said.
And in 1920 the majority of hospitals were not owned by the government, but were created and owned either by communities or by religious organisations.
It wasn't until the late 30s and into the 40s and wartime that the idea that the state should take responsibility for health care started to grow.
We also have access to a much broader range of allied health options that have improved our overall health and wellbeing: "allied health professions beyond doctors and nurses who also help us live better as well as helping us not die as early ," Dr Hobbins said.
Treatments for psychiatric illness and conditions such as epilepsy, which was at that time considered a mental illness, have progressed considerably.
"If you had major depression or bipolar disorder or a psychotic disorder like schizophrenia, your chance of recovery and returning to the community was basically nil," Dr Hobbins said.
(Supplied: F. Oswald Barnett Collection, State Library of Victoria)
Another factor that influenced the health of our ancestors was cigarette smoking.
Lung cancer deaths became prominent in the post-war period. According to the ABS, the lung cancer death rate rose for both sexes throughout the 1950s,1960s and 1970s until a peak was reached for males in 1982.
These days we smoke far less, which can only be good for our health.
Yet another shift that has improved general safety and wellbeing is the improvement of building codes and other public safety measures, Dr Hobbins said.
"It was really taking off in the 1890s and was in full swing by about the 1920s," he said, giving the examples of clean plumbed water, proper sewage systems and food inspectors to make sure people weren't eating tainted produce.
Other small changes since, like rules around doors opening directly onto stairs to reduce the risk of falls, all add up to a safer environment, Dr Hobbins said.
In terms of medicine and access to medical care, we have it better than our grandparents did.
The verdict
Looking at diet, the claim that our grandparents had healthier lives than us seems a little dubious, and we're definitely able to access better health care and preventative medicine than they had access to. But they were probably healthier in terms of the amount of physical activity they did throughout the day.
It's also worth mentioning that this discussion has looked at a fairly specific group of people — people born in Australia in the 1920s, who were more likely to be average, middle-class people of British descent.
Minority and marginalised groups — people from non-white backgrounds, Indigenous Australians, people with disabilities, LGBTI people, and those in remote areas — have probably seen an even bigger change in their overall health and wellbeing over the past century.
Type-2 Diabetes controlled totally by DIET without drugs
Country wise CHD table
Fake doctor kills the patient.
