Manners maketh men, and women too

禮貌造就男人，女人也一樣

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.

健康狀況的所有改善都不能歸因于環(huán)境衛(wèi)生和個(gè)人衛(wèi)生的改善。在整個(gè)20世紀(jì)，經(jīng)濟(jì)學(xué)家一直在爭(zhēng)論其他因素的相對(duì)重要性，比如與收入增長(zhǎng)相關(guān)的醫(yī)療技術(shù)的改進(jìn)(尤其是在助產(chǎn)方面)和更好的營(yíng)養(yǎng)。事實(shí)上，營(yíng)養(yǎng)的增加似乎在降低死亡率方面發(fā)揮了有意義的作用。但是，更好的飲食習(xí)慣的作用很難評(píng)估，因?yàn)樵诩膊∷僚暗沫h(huán)境中長(zhǎng)大的人，其身體從所吃食物中保留營(yíng)養(yǎng)的能力較低。

詞匯

Midwifery/產(chǎn)科學(xué)，助產(chǎn)學(xué)

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.

同樣，盡管一些研究表明，市政部門(mén)在公共衛(wèi)生措施方面的投資可以解釋19世紀(jì)末死亡率下降的大部分或幾乎全部原因，但這很難確定。例如，公共衛(wèi)生投資支持度高的城市，可能對(duì)公共衛(wèi)生信息有更廣泛的了解，也更傾向于養(yǎng)成良好的個(gè)人衛(wèi)生習(xí)慣。

詞匯

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響是深遠(yuǎn)的。更健康的城市通過(guò)提高城市內(nèi)部的自然增長(zhǎng)率(出生率低于死亡率)加快了城市化進(jìn)程。取消了城市高死亡率對(duì)城市人口比例的限制;到19世紀(jì)末，將近80%的英國(guó)人口居住在城鎮(zhèn)。

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，死亡率下降對(duì)勞動(dòng)力技能水平的影響或許更引人注目。死亡率下降，特別是在城市，開(kāi)始了社會(huì)科學(xué)中稱(chēng)為“人口過(guò)渡”的過(guò)程。人口增長(zhǎng)和城市化的步伐都在加快。隨著更多的孩子活到成年，他們的家庭也開(kāi)始減少(生）子女?dāng)?shù)目。與此同時(shí)，工業(yè)經(jīng)濟(jì)體對(duì)技術(shù)工人日益增長(zhǎng)的需求，提高了對(duì)教育的回報(bào)。家庭開(kāi)始對(duì)每個(gè)孩子的教育投入更多;人的壽命延長(zhǎng)意味著教育投資的回報(bào)增加。

詞匯

Demographic/人口結(jié)構(gòu)的；人口統(tǒng)計(jì)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.

科技水平不斷提高和受教育程度不斷提高的循環(huán)，提高了整個(gè)經(jīng)濟(jì)的收入。人口增長(zhǎng)放緩的影響也是如此，這使得人均資本水平增長(zhǎng)更快。正是由于19世紀(jì)城市死亡率的下降，世界才最終進(jìn)入了大腦支配肌肉的時(shí)代。

詞匯

Sophistication/復(fù)雜；有教養(yǎng)

Brawn/發(fā)達(dá)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世紀(jì)末，引起許多地方性傳染病的細(xì)菌已經(jīng)被發(fā)現(xiàn)。20世紀(jì)上半葉，人們發(fā)現(xiàn)了抗生素，并研制出了預(yù)防大量病毒疾病的疫苗。在這一世紀(jì)的進(jìn)程中，公共衛(wèi)生問(wèn)題再次轉(zhuǎn)向個(gè)人責(zé)任的方向:轉(zhuǎn)向飲食、健康和降低酒精、（）等消費(fèi)。與此同時(shí)，衛(wèi)生成為時(shí)尚和階級(jí)的首要問(wèn)題，至少在富裕國(guó)家是這樣。對(duì)于生活在大都市的有錢(qián)人來(lái)說(shuō)，個(gè)人護(hù)理——果汁排毒、【這個(gè)不懂】、皮膚護(hù)理等等——既是一種虛榮心和身份認(rèn)同的問(wèn)題，也是一種延長(zhǎng)壽命或?qū)Ω鼜V泛的公眾健康做出貢獻(xiàn)的努力。

詞匯

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，最近的歷史再次表明，公共衛(wèi)生往往是一個(gè)集體行動(dòng)的問(wèn)題。20世紀(jì)80年代和90年代，艾滋病毒/艾滋病的流行震動(dòng)了習(xí)慣于認(rèn)為致命疾病爆發(fā)已成為過(guò)去的世界。它促進(jìn)了基于改變個(gè)人行為是保持個(gè)人和社會(huì)健康的重要組成部分這一觀念的新的公共衛(wèi)生運(yùn)動(dòng)。

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，對(duì)疫苗接種的強(qiáng)烈反對(duì)【應(yīng)該也就西方那塊有:D】使防治麻疹等疾病取得的來(lái)之不易的成果面臨風(fēng)險(xiǎn)。這一趨勢(shì)強(qiáng)化了這樣一種觀念，即維持對(duì)公共衛(wèi)生的集體支持，改變社會(huì)規(guī)范，是決策者需要認(rèn)真對(duì)待的一場(chǎng)持續(xù)的戰(zhàn)斗。21世紀(jì)反復(fù)出現(xiàn)的大流行威脅，從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.

與以往一樣，如今的繁榮依賴(lài)于大城市內(nèi)部的人際關(guān)系。一個(gè)人口比以往任何時(shí)候都多、一體化程度更高的世界將繼續(xù)面臨大流行病的嚴(yán)重風(fēng)險(xiǎn)。目前尚不清楚的是需要多少調(diào)整。必須進(jìn)行哪些新的公共投資，才能防止危機(jī)蔓延導(dǎo)致世界經(jīng)濟(jì)停滯?在這次大流行之后的幾年內(nèi)，將會(huì)出現(xiàn)哪些行為上的變化?在我們對(duì)社交的需求和對(duì)健康的渴望之間，會(huì)豎起哪一面無(wú)形的情感之墻呢?隨著全球經(jīng)濟(jì)不斷增長(zhǎng)，我們管理健康風(fēng)險(xiǎn)的笨拙努力，可能會(huì)讓未來(lái)更健康、或者讓更富有的人變得和狄更斯主義者一樣沮喪，盡管我們自認(rèn)為自己既shi'gu又現(xiàn)代。