Enlightenment Now: The Case for Reason, Science, Humanism, and Progress

Today we don’t worry about babies getting eaten by sows, but other hazards are still with us. After car crashes, the likeliest cause of accidental death consists of falls, followed by drownings and fires, followed by poisonings. We know this because epidemiologists and safety engineers tabulate accidental deaths with almost plane-wreckage attention to detail, classifying and sub-classifying them to determine which kill the most people and how the risks may be reduced. (The International Classification of Diseases, tenth revision, has codes for 153 kinds of falls alone, together with 39 exclusions.) As their advisories are translated into laws, building codes, inspection regimes, and best practices, the world becomes safer. Since the 1930s, the chance that Americans will fall to their deaths has declined by 72 percent, because they have been protected by railings, signage, window guards, grab bars, worker harnesses, safer flooring and ladders, and inspections. (Most of the remaining deaths are of frail, elderly people.) Figure 12-6 shows the fall of falling,⁵⁰ together with the trajectories of the other major risks of accidental death since 1903.

Figure 12-6: Deaths from falls, fire, drowning, and poison, US, 1903–2014

Source: National Safety Council 2016. Data for Fire, Drowning, and Poison (solid or liquid) are aggregated over 1903–1998 and 1999–2014 datasets. For 1999–2014, data for Poison (solid or liquid) include poisonings by gas or vapor. Data for Falls extend only to 1992 because of reporting artifacts in subsequent years (see note 50 for details).

The slopes for the liturgical categories of dying by fire and dying by water are almost identical, and the number of victims of each has declined by more than 90 percent. Fewer Americans drown today, thanks to lifejackets, lifeguards, fences around pools, instruction in swimming and lifesaving, and increased awareness of the vulnerability of small children, who can drown in bathtubs, toilets, even buckets.

Fewer are overcome by flames and smoke. In the 19th century, professional brigades were established to extinguish fires before they turned into conflagrations that could raze entire cities. In the middle of the 20th century, fire departments turned from just fighting fires to preventing them. The campaign was prompted by horrific blazes such as the 1942 Cocoanut Grove nightclub fire in Boston, which left 492 dead, and it was publicized with the help of heart-wrenching photos of firefighters carrying the lifeless bodies of small children out of smoldering houses. Fire was designated a nationwide moral emergency in reports from presidential commissions with titles like America Burning.⁵¹ The campaign led to the now-ubiquitous sprinklers, smoke detectors, fire doors, fire escapes, fire drills, fire extinguishers, fire-retardant materials, and fire safety education mascots like Smokey the Bear and Sparky the Fire Dog. As a result, fire departments are putting themselves out of business. About 96 percent of their calls are for cardiac arrests and other medical emergencies, and most of the remainder are for small fires. (Contrary to a charming image, they don’t rescue kittens from trees.) A typical firefighter will see just one burning building every other year.⁵²

Fewer Americans are accidentally gassing themselves to death. One advance was a transition starting in the 1940s from toxic coal gas to nontoxic natural gas in household cooking and heating. Another was better design and maintenance of gas stoves and heaters so they wouldn’t burn their fuel incompletely and spew carbon monoxide into the house. Starting in the 1970s, cars were equipped with catalytic converters, which had been designed to reduce air pollution but which also prevented them from becoming mobile gas chambers. And throughout the century people were increasingly reminded that it’s a bad idea to run cars, generators, charcoal grills, and combustion heaters indoors or beneath windows.