The (Still) Limited Contribution of Medical Measures to Declines in Mortality

“Medical measures appear to have contributed little to the overall decline in mortality in the United States since about 1900.” Readers might assume that this statement is from a recent research article or policy report featuring the social determinants of health. But no, it is from the 1977 seminal Milbank Quarterly article by John and Sonja McKinlay titled “The Questionable Contribution of Medical Measures to the Decline of Mortality in the United States in the Twentieth Century.” John McKinlay is a medical sociologist and epidemiologist, and Sonja is a mathematical statistician. They both ended their full‐time careers leading the New England Research Institutes. The McKinlays asked the question “if they [medical measures] were not primarily responsible for it [the decline in mortality], then how is it to be explained?”