| Book Review | The American Historical Review, 107.5

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| Book Review | The American Historical Review, 107.5 | The History Cooperative

Book Review

Comparative/World

James C. Riley. Rising Life Expectancy: A Global History. New York: Cambridge University Press. 2001. Pp. xii, 243. Cloth $49.95, paper $16.95.

The decline of mortality that accompanies social and economic development has long attracted the attention of historians and epidemiologists. In 1971, Abdel Omran described it as an "epidemiological transition," the fundamental feature of which was a shift in the distribution of causes of death away from infectious diseases in favor of cancer and cardiovascular diseases. Although geographically wide-ranging, Omran's model was concerned largely with how declines in specific causes of death impinged on human mortality experience. A few years later, Thomas McKeown presented the final version of his account of why mortality from infectious diseases fell in historical Europe. In McKeown's account, improved nutrition consequent on a rising standard of living was accorded the lion's share of the credit, whereas advances in medicine were regarded as relatively insignificant. 1

Since the 1970s, research into the improvement in mortality has increasingly recognized that the ways human beings manage their lives, at both individual and societal levels, are crucial in determining the chance that those lives will be long and healthy. The decline in mortality is viewed as a health transition, in which, as James C. Riley says, "the key factor . . . is not disease but the actions that diminish it, reducing mortality or morbidity" (p. 26). Riley's book is the first general survey of the mortality decline (in the tradition of Omran and McKeown) to adopt this perspective. . . .

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