ealth care is currently undergoing important changes characterised by waning confidence in the biomedical
Historic Causes of DeathOne indicator of medicine's likely level of success in promoting health in contemporary populations is its success (or otherwise) in promoting the health of past generations. It is a fact that in the Western world average life expectancy, an index of overall population health, has generally increased progressively over the past few centuries. In the popular press, and in some sections of the medical literature, these apparently generalised and progressive improvements in health are heralded as evidence of the achievements of biomedical science. Closer examination, however, has shown that the major improvements in population health over the recent past have been coincidental with, but not causally related to, developments in curative medicine (McKeown, 1979).