Manners maketh men, and women too

礼貌造就男人，女人也一样

Not all of the improvement in health can be attributed to improvements in sanitation and hygiene. Over the course of the 20th century, economists have debated the relative importance of other factors such as improved medical techniques (in midwifery, in particular) and better nutrition associated with rising incomes. Indeed, nutritional gains do seem to have played a meaningful role in reducing mortality. But the contribution from better diets is difficult to assess, given the fact that the bodies of people who grow up in disease-ridden environments are less able to retain nutrients from the food they eat.

健康状况的所有改善都不能归因于环境卫生和个人卫生的改善。在整个20世纪，经济学家一直在争论其他因素的相对重要性，比如与收入增长相关的医疗技术的改进(尤其是在助产方面)和更好的营养。事实上，营养的增加似乎在降低死亡率方面发挥了有意义的作用。但是，更好的饮食习惯的作用很难评估，因为在疾病肆虐的环境中长大的人，其身体从所吃食物中保留营养的能力较低。

词汇

Midwifery/产科学，助产学

Similarly, while some research suggests that municipal investments in public-health measures can explain most or nearly all of the decline in mortality in the late 19th century, it is difficult to be certain. Cities in which public support for sanitary investments was high, for example, might have been more aware of public-health information generally, and more inclined to practise good personal hygiene.

同样，尽管一些研究表明，市政部门在公共卫生措施方面的投资可以解释19世纪末死亡率下降的大部分或几乎全部原因，但这很难确定。例如，公共卫生投资支持度高的城市，可能对公共卫生信息有更广泛的了解，也更倾向于养成良好的个人卫生习惯。

词汇

Municipal/市政的，市的；地方自治的

The effects of declining urban-mortality rates were profound. Healthier cities accelerated the process of urbanisation by boosting the natural rate of increase (births less deaths) within cities. The cap on urban population share placed by high mortality in cities was removed; by the end of the 19th century nearly 80% of the British population lived in towns and cities.

城市死亡率下降的影响是深远的。更健康的城市通过提高城市内部的自然增长率(出生率低于死亡率)加快了城市化进程。取消了城市高死亡率对城市人口比例的限制;到19世纪末，将近80%的英国人口居住在城镇。

Perhaps more dramatic, however, was the effect of the decline in mortality on the skill level of the workforce. Falling mortality rates, in cities especially, began a process known in the social sciences as the “demographic transition”. The pace of population growth and urbanisation both accelerated. As more children survived to adulthood, families began having fewer of them. Meanwhile industrial economies’ increasing demand for skilled workers raised the return to education. Families began to invest more heavily in the schooling of each child; longer lifespans meant the pay-off to investments in education grew.

然而，死亡率下降对劳动力技能水平的影响或许更引人注目。死亡率下降，特别是在城市，开始了社会科学中称为“人口过渡”的过程。人口增长和城市化的步伐都在加快。随着更多的孩子活到成年，他们的家庭也开始减少(生）子女数目。与此同时，工业经济体对技术工人日益增长的需求，提高了对教育的回报。家庭开始对每个孩子的教育投入更多;人的寿命延长意味着教育投资的回报增加。

词汇

Demographic/人口结构的；人口统计的

The cycle of increasing technological sophistication and increased educational attainment lifted incomes across the economy. So did the effect of slower population growth, which allowed for faster growth in levels of capital per worker. It was the fall in urban mortality in the 19th century that finally launched the world into an era in which brains dominated brawn.

科技水平不断提高和受教育程度不断提高的循环，提高了整个经济的收入。人口增长放缓的影响也是如此，这使得人均资本水平增长更快。正是由于19世纪城市死亡率的下降，世界才最终进入了大脑支配肌肉的时代。

词汇

Sophistication/复杂；有教养

Brawn/发达的肌肉

By the end of the 19th century, the bacteria responsible for many endemic infectious diseases had been identified. The first half of the 20th century brought about the discovery of antibiotics and the development of vaccines against a host of viral scourges. Over the course of the century, matters of public health once again shifted in the direction of personal responsibility: toward diet, fitness and lower consumption of alcohol, drugs and the like. Hygiene, meanwhile, became a matter first and foremost of fashion and class, in the rich world at least. For well-heeled metropolitan types, personal care—the juice cleanses, pilates sessions, skin treatments and so forth—is a matter of vanity and identity as much as an effort to prolong life or contribute to the broader public health.

到19世纪末，引起许多地方性传染病的细菌已经被发现。20世纪上半叶，人们发现了抗生素，并研制出了预防大量病毒疾病的疫苗。在这一世纪的进程中，公共卫生问题再次转向个人责任的方向:转向饮食、健康和降低酒精、（）等消费。与此同时，卫生成为时尚和阶级的首要问题，至少在富裕国家是这样。对于生活在大都市的有钱人来说，个人护理——果汁排毒、【这个不懂】、皮肤护理等等——既是一种虚荣心和身份认同的问题，也是一种延长寿命或对更广泛的公众健康做出贡献的努力。

词汇

Endemic/地方性的

well-heeled/富有的

metropolitan/大城市人

Yet recent history illustrates once more that public health is often a matter of collective action. In the 1980s and 1990s the HIV/AIDS epidemic shook a world accustomed to thinking of deadly disease outbreaks as a thing of the past. It contributed to new public-health campaigns built on the idea that changes in personal behaviour were an important part of keeping both individuals and society healthy.

然而，最近的历史再次表明，公共卫生往往是一个集体行动的问题。20世纪80年代和90年代，艾滋病毒/艾滋病的流行震动了习惯于认为致命疾病爆发已成为过去的世界。它促进了基于改变个人行为是保持个人和社会健康的重要组成部分这一观念的新的公共卫生运动。

More recently a backlash against vaccination has put hard-fought gains against diseases like measles at risk. This trend has reinforced the idea that maintaining collective support for public health, and shifting social norms, is an ongoing battle for policymakers to take seriously. So, too, have the recurring pandemic threats of the 21st century, from SARS to covid-19.

最近，对疫苗接种的强烈反对【应该也就西方那块有:D】使防治麻疹等疾病取得的来之不易的成果面临风险。这一趋势强化了这样一种观念，即维持对公共卫生的集体支持，改变社会规范，是决策者需要认真对待的一场持续的战斗。21世纪反复出现的大流行威胁，从SARS到covid-19，也是如此。

Prosperity now, as ever, relies on human connections within great cities. A world more populous and integrated than ever before will continue to face a serious risk of pandemic disease. What is not yet clear is how many accommodations are needed. What new public investments must be made to prevent contagion from shutting down the world economy? What behavioural changes will persist in the years after this pandemic? Which invisible walls of affects will be erected to reconcile our need to be social with our desire for good health? As sophisticated and modern as we perceive ourselves to be, our clumsy efforts to manage the health risks of a growing global economy might well strike the healthier, richer people of the future as depressingly Dickensian.

与以往一样，如今的繁荣依赖于大城市内部的人际关系。一个人口比以往任何时候都多、一体化程度更高的世界将继续面临大流行病的严重风险。目前尚不清楚的是需要多少调整。必须进行哪些新的公共投资，才能防止危机蔓延导致世界经济停滞?在这次大流行之后的几年内，将会出现哪些行为上的变化?在我们对社交的需求和对健康的渴望之间，会竖起哪一面无形的情感之墙呢?随着全球经济不断增长，我们管理健康风险的笨拙努力，可能会让未来更健康、或者让更富有的人变得和狄更斯主义者一样沮丧，尽管我们自认为自己既shi'gu又现代。