Our received wisdom tells us that over time advances in medicine, or at least in hygiene, have allowed people to live longer, healthier lives. Without the benefit of this progress, people in the past seemed lucky if they lived even into what we would now consider middle age. Like so much received wisdom, though, it has little real evidence to support it. The truth tells a very different and more complex story.

Throughout human evolution we can see a trend towards greater longevity, with a significant increase in the Upper Paleolithic. (Caspari & Lee, 2003) As per the “Grandmother Hypothesis” that George Williams first suggested in 1957, such elders could invest their time and energy into existing offspring, meaning that they could pass on skills, knowledge, and traditions. (Caspari, 2011) Archaeologists once referred to a “Creative Explosion” in the Upper Paleolithic, when we find some of the earliest cave paintings, tools, and sophisticated hunting techniques. We’ve since found older roots for many of these individual elements, but they come together in the Upper Paleolithic to form for the first time the sort of complexity and depth we see in all human societies today. Traditional societies revere elders as the source of wisdom and knowledge. Caspari’s work reinforces that with archaeological evidence, suggesting that the emergence of elders led to the first blossoming of human social complexity.

While human lifespan began increasing significantly in the Upper Paleolithic, it did not continue increasing steadily. The Agricultural Revolution had a massive impact on the health and lives of those who joined it. Hunter-gatherers certainly eat cereal grains from time to time, but it never formed a staple for them as it does for agriculturalists. That shift in diet caused health effects ranging from greater tooth decay to stunted growth. Hunter-gatherers can go hungry sometimes in lean seasons, particularly in the desolate environments where they survive today, but they do not rely on the tiny number of closely related species that agrarian societies do, so famine only became a common problem for agriculturalists. (Berbesque et al, 2015) Overall, the dawn of agriculture had an absolutely catastrophic impact on human health:

“During the transition to agriculture of the Neolithic and Late Neolithic periods, the longevity for both men and women decreased significantly to 33.1 years for men and 29.2 years for women. More strikingly, the measures of health decrease dramatically. Male height drops from nearly five foot ten in the Paleolithic to approximately five-three in the Late Neolithic, and the pelvic index drops by 22%. People were not only dying younger, they were dying sicker. Similar patterns were seen in the Americas during the transition period. Overall, the data shows that the transition to an agricultural lifestyle made people less healthy.” (Wells, 2011)

Few places illustrate this as starkly as Dickson’s Mounds. The burials there represent every known era of Native American history in Illinois, including a very fast transition to a mixed economy of foraging and maize agriculture in 1050-1175 CE. This site allowed archaeologists to compare the remains of hunter-gatherers with their agricultural grandchildren, helping to eliminate many of the variables that complicate the question of agriculture’s impact on human health. The agricultural population showed significant increases in enamel defects, iron-deficiency anemia, bone lesions, and degenerative spinal conditions. Life expectancy at birth dropped from 26 to 19. (Goodman & Armelagos, 1985)

In her effort to debunk the idea that the past has anything worthwhile to offer us, Marlene Zuk (2014) pointed out that while, yes, the dawn of agriculture did bring with it a catastrophic drop in health and longevity, those populations began to get healthier and longer-lived over the ensuing generations. However, she exaggerates the improvement and ignores the fact that sometimes it became even worse. Average life expectancy in ancient Rome, for example, sat at just nineteen or twenty years, a full decade less than that found at the Neolithic city of Çatal Hüyük in Turkey. (Wright, 2005)

Archaeologists often use height as a proxy to indicate health because malnutrition and other health problems have an enormous impact on it. In the Upper Paleolithic, European males had an average height of about 5’10”, but the height for males in the Neolithic Linear Band Pottery Culture dropped five inches, to just 5’5”. Perhaps most importantly, average male height remained in the range from 5’5”-5’7” through the end of the nineteenth century. (Hermanussen, 2003) While of course agricultural populations struggled to recover from the catastrophic impact that the Agricultural Revolution had on their health, only in the twentieth century — with the sort of breakthroughs that fossil fuels could provide — could Europeans finally close the gap and reach the sort of health and longevity enjoyed by their hunter-gatherer ancestors.

Even that leaves some very important caveats unmentioned, though. Hunter-gatherers show remarkably low incidence of the “diseases of civilization” that plague the inhabitants of WEIRD (Western, educated, industrialized, rich, and democratic) countries today — conditions like obesity, coronary heart disease, and type 2 diabetes. This disparity has caused a good deal of interest in the “Paleo Diet” in the hopes that emulating a hunter-gatherer diet might confer some of those benefits.

Since the Agricultural Revolution, however, elites have generally enjoyed far greater health and longevity than the majority of the population. In the modern world, these divisions have become, at least in part, geographical. The world’s elites no longer exist as a globally-distributed upper class, but now exist primarily in WEIRD countries like those in North America and western Europe. While the past century has afforded the inhabitants of these countries lives as long and (almost) as healthy as their hunter-gatherer ancestors, most people do not live in WEIRD countries. For the rest of the world, the catastrophic impact of the Agricultural Revolution on health and longevity remains an every-day reality. When we say that modern populations have regained much of what we lost in the Agricultural Revolution, we must note that we mean only the global elite, leaving out most of the human race.

When we look at the average life expectancy of hunter-gatherers today, however, we do see frighteningly low numbers — numbers low enough to suggest that perhaps they really don’t live very long lives. What seems like a fairly straightforward, quantitative comparison, however, quickly sinks into a morass of cultural assumptions and projections.

Hunter-gatherer populations do tend to have very high infant mortality rates, which pulls down their average life expectancy significantly. In a study of Hiwi hunter-gatherers, congenital problems accounted for 30% of all infant deaths. This included babies born premature or for some reason especially small or weak, trauma suffered during childbirth, or cases where the mother could not produce milk. (Hill et al, 2007) Western medicine may well have had an impact on cases like these, though modern hospitals also see newborn children die under these very same circumstances every day.

Infanticide accounted for another 30% of infant deaths in the same study. (Hill et al, 2007) People from WEIRD countries often react with shock and horror when they learn that hunter-gatherers consider infanticide an acceptable, even if generally tragic, option. Before we condemn hunter-gatherers too harshly, though, we should remember that WEIRD countries have their own debates on this subject, specifically around abortion. Some WEIRD countries will not report babies born only 22 or 23 weeks into a pregnancy as live births, while other countries do. This can have a significant impact on the infant mortality rate that these countries report, making them difficult to really compare. (Kaplan, 2014) As we can see just by comparisons between WEIRD countries, calculating life expectancy lays bare many assumptions. Among hunter-gatherers, infanticide plays a role similar to that of abortion in WEIRD countries. The shock we might feel about that does not differ very much in kind from the revulsion anti-abortion activists feel about abortion. That we include these deaths when calculating infant mortality among hunter-gatherers tells us more about our own cultural values and assumptions than it does about hunter-gatherer life.

Even so, infant mortality certainly marks the biggest difference between the mortality of hunter-gatherers and those who live in WEIRD countries. In an extensive review of demographic data from extant hunter-gatherers, Michael Gurven and Hillard Kaplan wrote:

“Infant mortality is over 30 times greater among hunter-gatherers, and early child mortality is over 100 times greater than encountered in the United States. Even late childhood mortality is about 80 times greater among hunter-gatherers. Not until the late teens does the relationship flatten, with over a tenfold difference in mortality. This difference is only fivefold by age 50, fourfold by age 60, and threefold by age 70.” (Gurven & Kaplan, 2007)

While this does show that after childhood the difference in mortality between hunter-gatherers and people living in WEIRD countries becomes much smaller, mortality rates three, four, or five times that found in the United States even among older adults would certainly seem to support the idea that they must surely live much shorter lives. Again, though, other factors cloud what seems a very simple, quantifiable comparison on the surface.

Gurven and Kaplan studied the demography of extant hunter-gatherers, but hunter-gatherers survive today only in the most marginal environments: places like the Kalahari Desert, the Amazon rainforest, or near the Arctic Circle. They survive there because no one else can make a living there at all. While the lifespan of a !Kung hunter-gatherer does not compare favorably to that enjoyed by someone from the United States, it does compare quite favorably to that of other Namibians. If they can live such long lives in the Kalahari Desert, how long could they live if they could inhabit productive environments today?

Illness accounted for more than half of all deaths in all but one group that Gurven and Kaplan studied (the Ache), yet “most infectious diseases are absent in newly contacted groups, because small, mobile populations cannot support these contagious vectors.” (2007) Hunter-gatherers have always had to deal with disease, of course, but most epidemic diseases fall under the heading of zoonotic diseases: diseases that come from animal populations, usually introduced to humans by domestication. Even with diseases that did not arise from domestication, hunter-gatherers lack the population density to keep many epidemic diseases alive, so many of the illnesses they die from actually come from their agricultural or pastoral neighbors. When you consider also how many hunter-gatherers find themselves hunted by those same neighbors for sport, the leading cause of death for hunter-gatherers seems like living near people who don’t hunt and gather.

Gurven and Kaplan concluded from their study that hunter-gatherers, in fact, live reasonably long lives, even under their current conditions. “The data show that modal adult life span is 68–78 years, and that it was not uncommon for individuals to reach these ages, suggesting that inferences based on paleodemographic reconstruction are unreliable.” (Gurven & Kaplan, 2007) They noted that past 70 years, the quality of life begins to deteriorate, as senescence sets in. This does not differ very much from the pattern of life still seen in WEIRD countries; while they have made significant improvements in overall longevity over the past century, the quality of life in those additional years has not always kept pace.

Today, thanks to the efforts of a nineteenth century white supremacist named John Crawfurd and his crusade to turn anthropology into a force for imperialism and colonialism, we tend to use the term “noble savage” to warn against romanticizing indigenous people. As Crawfurd intended, we use it to dismiss any suggestion that any fragment of humanity outside the modern WEIRD countries ever had or developed anything of value. (Ellingson, 2001) The term first developed to mean something altogether different, though. Noting how Native Americans could hunt game freely, a right reserved for the nobility in his native France, Marc Lescarbot titled a chapter in Histoire de la Nouvelle-France, “The Savages are Truly Noble.” It referred not to their moral character, but to the rights they enjoyed, matched in Europe only by the aristocracy.

In this original sense, the term “noble savage” provides an excellent way to understand the history of human health and longevity. The lifespan and health enjoyed by all hunter-gatherers as a group seems comparable to that found among the most wealthy and powerful elites that agricultural societies have ever produced. If you happen to count yourself among civilization’s elites, then hunter-gatherers might not have much of an advantage over you in terms of health or life span, though they don’t lag very far behind you, either. Compared to most of the human race, though, “the savages are truly noble.”