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187 " However we decide to apportion the credit for our improved life spans, the bottom line is that nearly all of us are better able today to resist the contagions and afflictions that commonly sickened our great-grandparents, while having massively better medical care to call on when we need it. In short, we have never had it so good. Or at least we have never had it so good if we are reasonably well-off. If there is one thing that should alarm and concern us today, it is how unequally the benefits of the last century have been shared. British life expectancies might have soared overall, but as John Lanchester noted in an essay in the London Review of Books in 2017, males in the East End of Glasgow today have a life expectancy of just fifty-four years—nine years less than a man in India. In exactly the same way, a thirty-year-old black male in Harlem, New York, is at much greater risk of dying than a thirty-year-old male Bangladeshi from stroke, heart disease, cancer, or diabetes. Climb aboard a bus or subway train in almost any large city in the Western world and you can experience similar vast disparities with a short journey. In Paris, travel five stops on the Metro’s B line from Port-Royal to La Plaine—Stade de France and you will find yourself among people who have an 82 percent greater chance of dying in a given year than those just down the line. In London, life expectancy drops reliably by one year for every two stops traveled eastward from Westminster on the District Line of the Underground. In St. Louis, Missouri, make a twenty-minute drive from prosperous Clayton to the inner-city Jeff-Vander-Lou neighborhood and life expectancy drops by one year for every minute of the journey, a little over two years for every mile. Two things can be said with confidence about life expectancy in the world today. One is that it is really helpful to be rich. If you are middle-aged, exceptionally well-off, and from almost any high-income nation, the chances are excellent that you will live into your late eighties. Someone who is otherwise identical to you but poor—exercises as devotedly, sleeps as many hours, eats a similarly healthy diet, but just has less money in the bank—can expect to die between ten and fifteen years sooner. That’s a lot of difference for an equivalent lifestyle, and no one is sure how to account for it. "

Bill Bryson , The Body: A Guide for Occupants