This lecture focuses on the changes in patterns of morbidity (ill-health) and mortality (death) from the middle of the 19th to the middle of the 20th Centuries, and how these changes have come about. The evidence that this lecture presents is well established, but not very popular, because it suggests that most of the benefits in terms of health gains, such as reduced morbidity and mortality have occurred as a result of changes in how people live their lives, rather than the technology of medical science. Drugs and technology have played a quite minor role in the improved life expectancy that has occurred.

In contrast to this, most of the budget for health care is now spent not on the area that has been shown to be most important in determining health and well-being, but on the technological side of the health care industry, such as hospitals and attempts at curative approaches to the predominant degenerative diseases that we face today.