Future Ready

4Below the Surface

On June 15, 1849, former U.S. President James Polk died at his home from cholera, just three months after leaving the White House. Though he had been a well-off, healthy 53-year-old when he left the presidency, Polk's death from simple waterborne bacteria was not considered particularly unusual. Cholera spreads through feces-infected water and, at the time, much of the world—including most of the United States—had no modern infrastructure for providing clean drinking water. As a result, waves of infection regularly swept through every country on Earth in the 1800s, killing hundreds of thousands of people annually.

Today, Europe, North America, and other wealthier nations have comprehensive water and wastewater infrastructures, and, as a result, virtually no cases of cholera or any of the other deadly diseases caused by contaminated water. In fact, the modern ubiquity of water infrastructures and other basic sanitation measures in wealthier nations has meant their significant historic impact is often underestimated—or ignored altogether. Between 1860 and 2020, life expectancy in the United States doubled, with similar gains being made in rapidly developing European countries. Today, many people assume this amazing, historically unequaled expansion of human longevity to be most directly attributable to rapid advancements in medical practices. However, the single largest jump in life expectancy in the United States, an extra 22 years, coincided with the 60 years ...