To Live and Die in America: Labor in the Time of Cholera and Cancer

A popular explanation of the epidemiological transition is that the germs that caused infectious disease mortality were defeated by the “magic bullets” of mainstream medicine over the course of the 20th century, permitting the population to get old enough to get the chronic diseases of heart disease and cancer. This explanation is false. The most important causes of infectious disease were the political and economic structures that favored capital at the expense of labor so blatantly that it left a large portion of the working population virtually at death's door. This was remedied only when resistance by labor created a more livable workday, child labor laws, and a higher wage, resulting in improvements in nutrition and housing. Chronic disease increased as firms transformed the production process by introducing more mechanized and chemically intensive production processes. This has transformed our food, water, air, and work processes in unprecedented ways and created a historically unique chronic disease pattern.