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Marler Blog Providing Commentary on Food Poisoning Outbreaks & Litigation

Taking a Whack at Raw Milk – Again

RawMilk.jpgI must admit that I am a bit perplexed by the proponents of raw milk. On average it seems that they spend a disproportionate amount of time twittering on Twitter and posting angry comments on blogs – mine in particular – about “Food Nazis” – of which I am apparently one, along with a long list of people not raw milk drinkers (the enemy or persecutors).

Perhaps its just me, but you would think that they would spend that time figuring out how they can make their magic elixir safe, or as safe as possible, and instead of breaking laws, working to change them. 

So, when given the chance for a bit of payback by Frederik Joelving of Reuters – “Beware E. coli when drinking raw milk: study” – I frankly could not help myself:

“There has been a movement away from highly processed foods to organic foods,” said Bill Marler, a Seattle-based lawyer who represented three of the sickened people in Connecticut. He recently settled the cases with the Simsbury farm that made the milk and the grocery store that sold it, but would not give the amount of the settlement.

“There are so many internet sites out there that talk about raw milk as if it cured everything from autism to erectile dysfunction,” said Marler.

“You can absolutely do the best you can in producing raw milk, but because of the location of the cow’s anus to the cow’s udder, it makes it really difficult for the bacteria not to get into the milk,” said Marler. “You can’t tell a cow not to poop when it gets milked.”

Raw milk sale between states has been banned for decades, but 10 states currently allow retail sale, according to Marler. He recommends that consumers visit www.realrawmilkfacts.com, a website developed by university and government scientists, for more information.

“A lot of states do have a variety of requirements, but it is a real hodgepodge of rules and regulations,” he said. “There are really no particular standards or testing protocols.”

He said raw cow milk usually costs at least twice as much as pasteurized milk in the store, while raw goat milk may run as high as 18 dollars per gallon.

“People are even touting raw goat milk as an alternative to mother’s milk,” he said. “It’s a real concern.”

Here is the Connecticut study.

And, me keeping track of just the 2010 Milk and Cheese recalls and outbreaks.

  • John Munsell

    Tobacco and alcohol are harmless to us, yet their use is legal, and optional for use for those of us so inclined to consume. Production and consumption of raw milk should be likewise legal. User beware. Risks are involved, including legal liability.
    Prior to pasteurization of milk, a cacophany of criticism of pasteurization filled our airwaves and printed media warning consumers of the alleged “dangers” of “unnatural” pasteurization. We know better now. Likewise, the current concept of irradiated meat, including whole carcass pasteurization (which does not use radioactive material), is being described by many as unsafe and unwholesome. While irradiation of meat and whole carcass pasteurization is not a panacea, they nevertheless are valuable food safety tools which must be allowed as an efficacious and optional tool in our food safety arsennal. They cannot be used to REPLACE current interventions, but must be IN ADDITION TO technology in use. Food emanating from irradiation and/or whole carcass pasteurization must be labeled in some form enabling consumers to make educated choices. I for one would pay more for meat which has benefitted from this additional processing aid.
    John Munsell

  • Mark Calhoun

    In response to the first comment by John Munsell, I am hoping that the statement “tobacco and alcohol are harmless” is in error. Their use is not harmless for more reasons than can be outlined in this short paragraph and the use of both may present serious health risks to the consumer. They are legal only in the sense that they may be purchased by a person over a certain age. Once past this age of consent we believe that those who choose to purchase and consume these products are emotionally mature enough to handle the responsibility of their actions. The age restriction attempts to prevent children from using these potentially risky products and protect them from incurring health risks that they might not comprehend.

    For decades we have used pasteurized milk to supply calcium and vitamins in a pleasing form to our children and so provide the requirements for stronger bones and teeth, to borrow a phrase. It is undisputed that millions of Americans, entire generations in fact, have grown up healthier from the benefits of pasteurized milk. To discard this reality for the pseudo-scientific rhetoric of raw milk advocates is beyond ignorance.

    The problem with any argument in favor of raw milk is that milk is still a product that is wholly designed for and targeted towards children. There are numerous outbreaks associated with raw milk or raw milk products every year. Children are particularly susceptible in these outbreaks and the evidence speaks for itself. Not that it should be equated on the same level as tobacco and alcohol, but as a potential health risk perhaps a greater standard of care should be applied or more stringent restrictions on its sale and use.

    To adopt risky behaviors or habits beyond the age of consent is to assume one’s legal responsibility. To accept this risk on behalf of your children, to provide them with a raw milk product when there is a sufficient alternative, especially one that is so readily available and has demonstrated its effectiveness throughout much of the last century is not only ignorant but contemptable. User beware is not a concept that should be applied to this situation. Find a way to make it safe, let the science bear that out then sell it to the public. Until then, if you care about them, don’t give it to your kids.

  • John Munsell

    Egads Mark, you are precisely correct that the word I meant to use was “harmful”, not harmless. So solly for the gaffe. Must have had turkey and dressing on my mind.
    John Munsell

  • Michael Bulger

    So, raw milk proponents who complain of persecution would be better served spending their time trying to change the laws. Shouldn’t those concerned about the current hodgepodge of regulations and the consistent outbreaks caused by raw milk spend some time trying to develop policy to better protect the public?
    I’m sure everyone has ideas, but short of making raw milk illegal, what might they be?
    It’d be nice to trust the raw milk industry to make safe food, yet observing the disproportionate amount of people sickened by their product, one gets the feeling that they need some help bringing all there members in line.

  • Bill Anderson

    Bill Marler,
    It was not that we “scared people away” from legalizing raw milk in Wisconsin. Quite the contrary — after the raw milk legislation was vetoed, the Dept. of Agriculture showed up for an armed raid of one of the farms which was a known supplier of raw milk. The subsequent news coverage of the raid created such a public outcry (even from many people who said they would never consume raw milk) that it forced the chief of the division of food safety to resign.
    The farm that was raided had never made anyone sick. It had nothing to do with food safety.
    The reason that the WI raw milk bill was vetoed by the governor (after being passed overwhelmingly by the senate and assembly) was because the dairy processing industry mobolized all of their resources to lobby the governor to veto it.
    The governor, btw, has been in the pocket of big business since he was elected. Nothing new or special here. That is how politics works in America, regardless of political party. It is called fascism — the merger of state and corporate power.
    If you want, I can send you a list of all the corporate agri-business organizations that lobbied the governor to veto the Wisconsin raw milk bill, along with the letters they signed.
    We worked hard to try and change the law, but the powers that be showed that there was no comprimise with their iron-fisted corporate control. Today, because of the public outrage following the farm raid, there is a panel of agri-business representatives assembled by the Dept. of Agriculture who are drafting a policy to legalize raw milk in Wisconsin. The regulatory burden it proposes is approximately the same as California’s regulations for the sale of raw milk. The differences are that:
    1) It will allow on-farm sales only. (As I’m sure you know, in CA, certified raw milk can be sold on the retail shelf and served at resteraunts.)
    2) It is only for cow’s milk, and only for fluid milk. It explicitly excludes goat and sheep milk, and explicitly excludes any cultured products such as butter, yogurt, cream, or unaged cheese.
    3) It fails to establish a definition of raw milk. For example, milk which is thermally treated or which has gone through ultra-filtration rendering it essentially sterile is not the same thing as REAL raw milk. Yet both of these types of milk processing would fall under the regulatory system being proposed by agri-business, for the sale of unpasteurized milk.
    I am all for food safety, Bill Marler. I just don’t understand what those regulations have to do with food safety. They only have to do with protecting agribusiness. Yes, create the rigorous testing and hygene standards for certified legal raw milk. But define it, protect it as a standard of identify (like other dairy products are protected) and allow it to be sold and turned into cultured products (such as cheese, butter, yogurt, etc…) as any other dairy product is.
    After all, culturing only makes it safer. The drop in pH (increase in acidity), and loss of moisture in the case of cheese and butter, all tend to make the product safer by inhibiting the growth of pathogens.
    The whole ordeal shows that none of this debate about raw milk really has to do with food safety. We already have the tools neccessary to test and verify the safety of raw milk and products made from raw milk.
    The dairy processing industry just doesn’t want people to know the truth, that REAL milk from pasture-grazed heritage breeds of cows tastes better and is better for you than commercial milk and milk products. The more you process the milk, the worse it tastes and the worse it is for you. We are talking about putting an entire industry out of business here. Of course they are going to hide behind the noble rhetoric of “food safety” for as long as they can. Their actions, however, speak much louder.
    Thanks for giving these guys more ammunition. Its not doing anything to make raw milk safer. Its just creating more public animosity towards the existing “food safety” authorities.

  • Bill,
    You would support regular testing of raw milk and milk products? Would you also support the government prohibiting dairies from selling products when testing shows contamination?

  • Yes and yes. Frankly, I am not in favor of retail sales at all.

  • I’m not surprised, Bill. I would think that a number of people in States where it is already legal would take issue with a policy such as that. That is why I stopped short.
    I also would be curious as to an answer from Bill Anderson or a raw dairy producer.
    Thank you.

  • Bill Anderson

    I support testing ALL dairy, regardless of whether it is raw or pastuerized. Currently, pastuerized milk and milk products do not need to be tested for human pathogens. It is just assumed, without any scientific basis, that the current legal standards for pasteurization kill all disease causing organisms.
    In fact, there is one pathogen I am aware of, which is probably present in most of the commercial milk supply, which is known to be able to survive pastuerization temperatures — Johnes disease, which is the bovine version of Crohns, and is believed to be linked to human Crohns.
    I don’t know how you intend to define “contamination” of milk. In my opinion, most of the milk produced in America is contaminated with artificial growth horomones, chemical sanitizers, Johnes disease, and poor cow nutrition. I believe that the majority of commercial milk is unsafe for human consumption and should be removed from the retail shelves.
    I do not understand why Bill Marler is opposed to retail sales of certified raw milk. Bill, why don’t you go pick on deli meats instead? They are far more dangerous than certified raw milk, yet you can get deli meats at virtually every grocery store in America.
    Oh that’s right, because this has nothing to do with food safety, it has to do with protecting the dairy processing and CAFO big-ag racket. I forgot…

  • Michael Bulger

    First of all, pasteurization is highly effective in log reduction of pathogens. That is just a simple fact. It would have to have a unusually high bacteria load for the heat not to eliminate the pathogens.
    There are studies upon studies that show this to be fact. These studies are public and easily found in university libraries (at least mine). I’m sure you can also find some online.
    I would define contamination has having above a certain amount of pathogenic bacteria. It many cases (if not all), the level would be zero as bacteria can grow during transport, storage, etc. This goes for all food products, raw or otherwise.
    So when a known pathogen, proven to be dangerous (such as E. Coli O157:H7), is detected in a product then that product would be considered contaminated. This would not be raw milk specific.
    If deli meat testing reveals a product contaminated with O157:H7, it would be prohibited from entering the market. The same would have to apply to raw milk, am I right?

  • I looked at the link between Johnes and Crohns and could not find what I felt would be legal causation that would support a claim. I have read all the literature that is out there. The problem is proving a causal link between drinking milk and Crohns. Similar issues arise in dealing with Mad Cow and GMO’s and human illnesses.
    Re: Raw Milk – I set out my position with respect to Raw Milk here:
    http://www.foodsafetynews.com/2009/11/what-id-recommend-raw-vs-pasteurized-milk/
    Here was a short summary of my suggestions:
    In lieu of banning raw milk products, some states have adopted regulations that attempt to protect public health and allow for consumer choice. This is an approach I would suggest the following:
    1. Raw milk should be sold only on farms that are certified by the state and inspected and tested regularly. Make ambiguous black market milk/cheese sales and “pet food sales” meant for human consumption clearly illegal;
    2. Raw milk should not be sold in grocery stores or across state lines–the risks of mass production and transportation are too great; the risk of a casual purchase by someone misunderstanding the risks is too great, as well;
    3. Farms should be required to have insurance coverage sufficient to cover reasonable damages to their customers;
    4. Practices such as outsourcing (buying raw milk from farms not licensed for raw milk production) should be illegal;
    5. Colostrum should be regulated as a dairy product, not a nutritional supplement;
    6. Warning signs on the bottles and at point-of-purchase should be mandatory. An example: “WARNING: This product has not been pasteurized and may contain harmful bacteria (not limited to E. coli O157:H7, Campylobacter, Listeria and Salmonella). Pregnant women, infants, children, the elderly and persons with lowered resistance to disease (immune compromised) have the highest risk of harm, which includes Diarrhea, Vomiting, Fever, Dehydration, Hemolytic Uremic Syndrome, Guillain-Barre Syndrome, Reactive Arthritis, Irritable Bowel Syndrome, Miscarriage, or Death, from use of this product.”

  • Michael Bulger

    Thanks, Bill. I had been playing around with the insurance idea in my head, but had never seen your opinion. My thought is that insurance could be privately bought, or it could be offered by the government (USDA). The government plan would be inexpensive, but would come with stringent safety requirements. HACCP plans, records of sales, regular submission of test results, warning labels, and regular inspections would all come with the USDA policy.
    There would be griping of course, but it would ultimately protect their businesses. If an actor failed to produce safe milk within the new system, they would have insurance to protect their business. Hopefully, that would lessen the instances of people having dramatic standoffs with the FDA over contaminated product. This might ease the entire sector’s relationship with inspection and food safety, thereby promoting cooperation in food safety.
    Ultimately, the improved safeguards on production and diminished financial risk for the producer would generate a better environment for the consumer.

  • Bill Anderson

    Michael-
    Pasteurization is highly effective at making pathogenic organisms undectable by current standard methods.
    It does not mean that the disease causing agents are not present, or that they are not causing disease in humans. It simply means that the people who fund the science and set the standards for the detection of disease causing agents do not want to fund studies or technologies that would find disease causing agents in pasteurized commercial milk.
    On the other hand, they have strong incentives to find disease causing agents in raw milk (despite the superior health benefits of certified raw milk, might I add) because of the political and economic implications of compulsary pasteurization for big agri-business.
    This fact underlies the entire debate about raw milk. It is not about true food safety.
    In fact, as one gentleman well-versed in micro-biological techniques, who goes by the screen-name “miguel” on David Gumpert’s blog points out:
    http://www.thecompletepatient.com/journal/2010/10/26/in-nations-drama-capital-a-falling-out-at-rawesome-a-form-of.html?currentPage=2
    As an explanation of why L. momocytogenes would disappear when milk is pasteurized and then reappear after a period of time,I would suggest that pasteurization(heat shock) does NOT eliminate the listeria.It simply induces it to change form into a cell wall deficient listeria.In this form it can still cause disease and in fact can enter white blood cells where it can cause even more problems because it is able to hide from the immune system.The myth that pasteurization can solve any problems associated listeria is just a myth.Actually for those of us who have competent immune systems,pasteurization makes milk contaminated with listeria more dangerous than if it was consumed unpasteurized.The pasteurization induced L-form is able to elude a competent immune system while the listeria with it’s cell wall intact is not.
    http://www.sage-hindawi.com/journals/iji/2010/704321.html
    “7. Listeria monocytogenes L-Forms
    L-forms are protoplast-like variants of bacteria that lost their ability to maintain a rigid cell wall. They have been first described at the beginning of the last century and were reported for many bacterial species. After their discovery, they have been intensively studied using numerous approaches [108]. However, due to the fastidious nature of L-form bacteria and experimental difficulties using old-fashioned techniques, these studies mainly focused on morphology and physiology of L-form cells and often led to inconclusive data. This was also the case for L-forms of L. monocytogenes [109]. It was only recently that L-form research experienced a renaissance, due to new experimental systems and the application of molecular biology and state-of-the-art imaging techniques [110–112]. In a recent study, it was demonstrated that stable L-forms of L. monocytogenes are viable bacteria that are not only able to survive, but also able to replicate and multiply using a unique, previously unknown mechanism [110]. Thus, L-forms are unlikely to be just artifacts found under laboratory conditions, but seem to represent a pre-programmed, alternative phenotype of bacterial life. Of particular interest is the observation that L. monocytogenes L-forms are able to persist within macrophages, suggesting that they retain at least a part of their pathogenetic traits (Schnell et al., unpublished data). Previous results from tissue culture studies already suggested that L-forms may be able to persist within eukaryotic cells for various time periods [113, 114]. Clinical case reports about the isolation of cell wall-deficient variants in cases of persistent and recurrent bacterial infection also suggested that L-forms may serve as cryptic agents of disease in a variety of human infectious diseases [114–118]. Subsequent reversion to parental forms may lead to a damage of the host cells. In the case of L-forms, when the bacteria have completely shed their cell walls, several proteins that represent important markers for the human immune system are also lost. Therefore, the immune system may no longer be able to discern and recognize these bacteria cells. Lack of the cell wall as an important target for antibiotic treatment represents a further threat, due to the ineffectiveness of cell-wall active drugs such as β-lactams and cephalosporins on L-form cells [110, 119].”
    My question for Lykke or anyone else is: If pasteurization cannot eliminate listeria,what can we do to make food safe from this bacteria? If pasteurization cannot eliminate listeria and cooking does not eliminate listeria,what should our approach to food safety be?

  • Michael Bulger

    Interesting study, Bill. I read through it and no where does it say that the L. forms are created by pasteurization.
    Pasteurization does indeed rupture cell walls and cause the “guts” of the bacteria to spill. It also denatures the cell’s enzymes which ends the cells ability to function. Out spills the nonfunctioning guts of the cell.
    You are citing a study who’s introduction contains this:
    “Because the bacteria are readily inactivated at pasteurization temperature, the main source of infection represents contaminated raw food that is subjected to minimal further processing, such as soft cheeses, frankfurters, paˆte ́s, vegetables and postprocessed contaminated milk products.”
    Apparently, pasteurization does eliminate listeria. Remember, you chose the study.
    Regardless, it would be difficult to impossible to test enough to halt listeria today. I think those who forego pasteurization would do well to address the avenues of initial contamination. That would be a start.

  • I am not aware of a study that has shown adequate pasteurization not killing off Listeria. I have had a few cases involving cheese and milk that likely became contaminated with Listeria AFTER pasteurization. Both caused deaths, a fetus and an elderly man.

  • Doc Mudd

    “Pasteurization is highly effective at making pathogenic organisms undectable by current standard methods…It does not mean that the disease causing agents are not present, or that they are not causing disease in humans.”
    Yep, pasteurization magically makes ’em invisible! Bumps ’em over into a parallel dimension where they take on new super powers! This is all so very, very obvious – no need for geeky scientists, right?
    This will have serious repercussions when terrorists figure out to boil & pasteurize one another so they can move about completely undetected! They may be doing it already!! We must run, Goosey Loosey, we must run and tell the King!!!
    The whackadoodle Kool-Aid is flowing freely. Not pasteurized, most likely.

  • Debra C

    Psychrotrophics produce enzymes that survive the pasteurization process, making pasteurized milk sometimes taste bitter, unclean, oily, chalky, metallic or medicinal .
    This is One Reason pasteurized milk doesn’t taste as good as raw milk from the farm is because of “holding over” milk. The milk is placed in large “milk silos” until ready for processing. It may remain for days. This favors the growth of bacteria called psychrotrophic. These bacteria, such as Listeria monocytogenes grow at the refrigeration temperatures of the silos used for storage.

  • Debra C

    Psychrotrophics produce enzymes that survive the pasteurization process, making pasteurized milk sometimes taste bitter, unclean, oily, chalky, metallic or medicinal .
    This is One Reason pasteurized milk doesn’t taste as good as raw milk from the farm is because of “holding over” milk. The milk is placed in large “milk silos” until ready for processing. It may remain for days. This favors the growth of bacteria called psychrotrophic. These bacteria, such as Listeria monocytogenes grow at the refrigeration temperatures of the silos used for storage.
    And besides all that, we live in the 21 century. Most Fresh Milk is produced by machinery just as well as pasturization, Raw Milk doesn’t come through hand milking the cows and dirty barns. And besides that part, Raw Milk is Safer than Pasteurized milk., for the reason pasturized destroys all the good bacteria
    . Until 1950, raw milk commonly contained bacterial counts of 3 million ml and 200 ml pathogens, compared to 10,000 ml and 10 ml pathogens now, and there were no epidemics that proved to be caused by raw milk, proving that raw milk is not harmful when containing many pathogens even when used as a preservative for raw meat . Before 1950’s Raw milk produced under gross conditions has not been proved to be the cause of an epidemic. No one been maimed by drinking raw milk. Many people now , that are 70 and 80 year olds, claim that’s all they had was raw milk to drink..

  • Curious George

    It’s always interesting when people think that no one died from a disease or bacteria, simply because the connection was not well known at the time, and therefore not reported.
    Do you think anybody died from cancer in the 18th and 19th centuries, prior to modern scientific methods? What do you suppose those deaths were attributed to at that time?
    Similarly, do you think it’s possible that people died from drinking raw milk in the 1950’s, and it is because of modern detection techniques that we now know raw milk is dangerous?
    By the way, why Do you Capitalize certain Words?

  • Michael Bulger

    I believe that is copied and pasted from another website. Obviously, one that doesn’t want people to know of the actual outbreaks associated with their products.

  • L. E. Peterson

    Some of the comments here literally astound me with the complete utter denial of fact regarding pastuerization and the introduction of Listeria post-pastuerization. The meat regulations regarding Listeria deal specifically with contamination of post-lethality exposed RTE meat products. Listeria in pastuerized milk is there for the same dang reason–it was contaminated post-pastuerization! Is it so far beyond the stretch of your imagination that possibly Listeria is present in the holding tanks leading to the contamination of pastuerized milk?

    It’s like dealing with my bipolar friend who’s currently off his meds and very unstable. The lights are on, but the elevator isn’t quite making it to the top and it’s obvious no one is home. You can slap him in the face with reality but he’ll still insist the opposite is true because his delusions are so real to him. He’s at least agreed to get some treatment because he’s still lucid enough to understand he’s a threat to himself and possibly to others due to his lack of coherent thought and good judgement.

    In my friend’s case, his disease is to blame. What is the excuse for raw milk producers that don’t give a shit about their consumers and producing a clean, safe product?

  • Dog Doctor

    To Curious George, humans have prescribed causes to death for a number of reasons when we don’t know or examine from mystic forces to old age. Up until the 19th century, many people believed it was an imbalance of bodily fluids (humours) which was proposed by Hippocrates which is why bleeding was a popular treatment .The belief in the humours generated such terms as melancholy, and sanguine which is still part of our language today.
    In the 19th century there were terms like consumption for TB, undulant fever for brucellosis were used until the infectious agents for these diseases were discovered. If you want to see the leading cause of death from 1900 to 1998, CDC has a publication at http://www.cdc.gov/nchs/data/dvs/lead1900_98.pdf.
    If the tables will transfer you will see in 1998 Heart disease was number 1, follow by cancer, and stroke. In 1900, number was pneumonia, TB, and diarrheal diseases were the number 1, 2, and 3 killers in the US. Poor water and food sanitation were linked to diarrheal diseases. If you don’t want to believe the CDC since they are paid off by big Ag and dairy can be found at http://www.uky.edu/Classes/PHI/350/cod.htm which is a philosophy course taught at the University of Kentucky which discusses causes of death through the last 600 years.
    Another site is at http://www.publicagenda.org/charts/leading-causes-death-1900-and-2004 which is summarizing information from National Vital Statistics fast A to Z October 2006 edition again dates from the CDC. You will note that average life expectancy was 49.2 years in 1900 and 77.8 years in 2004.
    In reading the pro raw milk blogs, there is indication that none of this information is believed and considered to be fictitious. Of note is comments from one raw milk dairy producer in California who often states that people who get sick from raw milk are not worthy of its benefits.
    But, this information from these government sources is what it is, if you were born at the turn century you had a 30% chance of dying before your 1st birthday as opposed in 1997 where there was only a 5% chance of death before your first birthday. I have tried to copy a graph of infant mortality from an article at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm4838a2.htm
    You can research the material for yourself and make your own conclusions on what has occurred in the last century in the United States and why these numbers have changed. Being in public health, I associate these improvements in infant mortality and life expectancy to the advances that have been achieved such as water treatment and standards, food safety standards, vaccination, and other improvements in sanitation. Doing inspections on small farms to large corporate plants, the majority of managers and employees want to product safe, wholesome food and are proud of what they accomplish. It is rare exceptions that do not from the small dairy farm where I stood almost hip dip in manure on the owner’s dry lot with his herd of 60 cows to a large poultry processor who fought every USDA regulation even if it was easier and cheaper for him to follow the regulation. Fortunately both of these individuals are out of business due to their own decisions not government regulations. They fought inspectors until they sold their businesses.

  • Curious George

    And people used to contribute the miasma theory, or “bad air,” to the spread of cholera in the 19th century. It wasn’t until one of our fathers of epidemiology, John Snow, investigated the Broad Street Pump and realized the disease was caused by a contaminated water source.
    Life expectancy figures can often be misleading though, because there are a lot of confounding factors that are difficult to control for. In the past 100 years, we have had several wars, social policy changes, and cultural shifts. As a result, while I would agree that public health has improved, I would be reluctant to put a number on it, or even attribute the change to a handful of advancements.
    I would be interested in looking at deaths throughout history and trying to figure out if there were other contributing factors. Even though one cause of death is usually listed, there can often be several health complications at the time.
    I think a lot of people foolishly believe that life was like what they see in classic films. They probably also believe that parents slept in separate beds too.