When we talk about the key shifts of the twentieth century—those involving politics, trade, consumption, art—we leave out what is surely the most astonishing physical change in all of human history, one that has happened mostly during the last century: the doubling of the human life span in much of the world (alas, not all). In North America, this has meant an increase in longevity from around forty years to eighty years.

In genealogies of modernity, too little has been said about this remarkable extension of life. This is a grave oversight. The very recent change in the life span has brought with it a host of social and personal practices that have become the focal points of cultural struggle, as well as theological and ecclesial dispute. We are astonished by rapid changes in moral norms, especially those related to procreation and family, because, like the doubling of life spans, they are unlike anything previously known in history. Only one hundred years ago, for nearly everyone it was unimaginable that women would choose to delay childbirth until their late thirties, even early forties, almost as unimaginable as men marrying men. The same is true of today’s widespread assumption that death at sixty-five is “early.”

The study of increased life expectancy and its causes is very recent, and still undeveloped. Only in the past few decades have pioneers in this discipline begun to address the topic synthetically. James C. Riley describes the enormous shift that has taken place in one century as a great “health transition.” Causes for high mortality before the twentieth century are still debated by historians and public health researchers. Malnutrition ranks high (affected by crop production, economic policies, climate, war, and child-rearing practices). Important, too, were disease, plagues, infections. Sanitation and public water distribution were crucial factors.

We often tell a story of progress that begins with the Renaissance, highlights the origins of modern science, and continues through the Enlightenment and onward to the present. Yet this story of progress obscures the fact that when it came to life and death—a matter of profound existential concern—from the sixteenth century until the end of the nineteenth, it made no difference if you were rich or poor: Your life expectancy was similarly low (and sometimes lower if you were rich). Mortality was fastened to existence from birth onward. Death colored every relationship at every point in a person’s existence—siblings, parents, relatives, friends, neighbors, self. To grow old was exceptional. Death was all around and all the time.

The doubling of life expectancy in the last one hundred years, first in the West and now bit by bit around the world, is explained by the resolution of factors contributing to early mortality. As longevity has increased, fertility rates have fallen, the ranks of the elderly have swollen, and the economics of labor, retirement, health care, and schooling have been upended.

Our political debates recognize these effects of increased life expectancy. Politicians and policy experts are talking about how to sustain entitlements for the elderly. Economists speculate on the correlations between population growth and economic expansion. Immigration debates are haunted by worries about low birth rates in developed countries. We give less attention, however, to the ways in which increased life expectancy shapes our cultural debates.

Our complacent expectation of life’s longer duration breaks the body’s bridge to eternity. We know that we will die, but our awareness of longevity shifts it from a present reality to a distant horizon. We push death to the margins. It comes “at the end.” Life’s duration becomes something we imagine to be valuable for its own sake.

Everything we struggle against culturally flows from this. For if we can stage-manage death, we can do the same with any feature of our bodily existence. The sexual revolution? We tend to see profound change of that sort as deriving from the invention and application of new techniques, in this instance the Pill and other reliable methods of birth control. These new techniques and technologies, however, proceed to transform our culture because they veil our common life from the realities of existence. The most fundamental reality is the simple fact that we are gathered before the judgment seat of Christ, having honed our character through a few short years of toil and generativity. With this forgotten, the imposing presence of the dead upon the living disappears. The saintliness that comes from sustaining the proper threshold and commerce between the two shrivels, and God’s giving and saving of mortal flesh cease to astonish and shape our deepest commitments.

The new longevity affects the shape of the family and relationships within it. Our presumption that death remains remote influences how large families are; how old parents are when children are born; and now, given technological interventions, whether the parents you live with are biologically your own or not. The lengthening of the life span has dramatically changed our assumptions about maturation. We have revised the stages of life and their number, as well as their length and significance. This includes what we mean by childhood, adolescence, and young adulthood (which now includes living in our parents’ home well beyond teenage years). We have transformed our attitudes toward work and parenthood and old age.

These changes have, in turn, altered gender roles. Who works, and how should we educate and prepare men and women for it? With mortality at a distance from our consciousness, we adjust the ideal age for childbearing and marriage. Adult singleness takes on a very different meaning.

All of this has affected women the most, obviously. But these changes have also altered the function and self-perception of men: as workers, generative beings, fathers, protectors, and sources of wisdom. For both women and men, longer lives have meant that the nature of work itself becomes an open question. Freed from the immediate need to sustain life against the mortal threats of want, what is labor for? How is it related to spouses, children, larger family, and even the self?

Most fundamentally of all, the Great Health Transition and its doubling of the life span have profoundly changed the way we think about our bodies. It is no longer clear what bodies are “for” or how they are to be used. We argue over the role of sensual pleasure in our own and other people’s bodies. We have lost any place for physical pain as a positive, if difficult, component of existence. With longer and healthier lives, we locate death among the elderly, whose status is now disconnected from younger people. Only in the last two generations have forty-year-olds gone to gyms to exercise rather than accepting physical decline as a part of mortality’s never-distant claim upon us.

There is a procreative imperative lodged within mortality. The nearness of death gives urgency to our capacity to bring forth new life. Yet, with the sudden reality of extended life spans, men and women are easily disoriented. Every relationship gets wrenched from its historical, generational flow. Human contacts are handed back to individuals for re-evaluation. The web of relations ordered around the human need to fend off death’s early arrival becomes the possession of individual choice. Faced with expanded life expectancy, we no longer see ourselves as instruments of nature’s drive to repopulate the human family. Instead, we see ourselves seeking other meanings across life’s longer duration, striving to populate our individual lives with richer experiences.

A comparison of pre-1900 Anglican Book of Common Prayer matrimonial rites and twentieth-century revisions of the marriage service illustrates this clearly. The sixteenth-century marriage liturgies place matrimony between a man and woman within the state of “innocencie” in paradise. They bind its form and meaning to the “mistical” union of Christ and his Church, humanly embodied in Cana’s wedding. This common life, informed by the fear of God in the face of creative mystery, is divinely ordered to procreation, to the restraint of concupiscence, and to mutual aid in the face of the assaults of mortality, including sickness and death. The marriage service is filled with prayers that link the married couple to the providential life of Israel’s patriarchs and matriarchs whose fruitful unions produced progeny, a line that carries forward God’s life-giving inheritance.

In this way, the Old Testament’s “begetting,” fused to the ongoing practice of Christian marriage, sustains the hope given in the redemptive promise of the second Adam. As Katherine Sonderegger has put it in discussing justification in the Book of Common Prayer, the second Adam is not simply an over-and-against response to the first Adam. Jesus “occupies our death,” so that our own mortality becomes the vessel of a divine grace “from within.” The sixteenth-century marriage service can speak of the marriage of Adam and Eve as a “blessyng.” This blessing comes not because matrimony escapes death. Rather, our mortal flesh is shaped by marriage into a natural fruitfulness, and this life-giving hope within our mortal frame is taken over by Christ, the Bridegroom whose marriage feast celebrates death’s defeat.

It was not until the twentieth century that this framework for marriage was dismantled. In contemporary revisions, procreation is downplayed; in some it is not mentioned at all. The challenges of history and genealogy—both are always shadowed by mortality’s threat to bring things to an “end”—have disappeared, as has the entire Old Testament narrative that enveloped them. Illness and death have been muted in the vows, and sometimes silenced altogether. In place of all this rise up the determining categories of “love,” “support,” “forgiveness,” and (as the New Zealand Prayer Book puts it) “cheer.” These elements are important, but their mortal context has dissolved. Taken on their own, twentieth-century approaches to marriage do not open up the hope of a procreative, familial existence among the living and the dead.

Within Anglicanism, the shift took place after 1920. It is linked to changes in teaching on contraception and divorce associated with the Lambeth Conferences. At the time, the bishops who made these decisions were mostly Westerners, and hence in the midst of the Great Health Transition itself. By the late 1970s and 1980s, however, the rapid increase in the number of bishops from places where the transition had not taken hold—Africa especially—recast the Lambeth dynamics.

The experience of these non-Western bishops was shaped by their specific societies in ways that were often related to health and war. By the 1990s, the stark resurgence of mortal demands imposed by the AIDS pandemic had become central. Mortality was now itself an object of debate, although often in unconscious or confused ways. Westerners and non-Westerners construed the place of death differently, especially as related to sexual existence. In the West, mortality was assumed to be bound to diseases that could be managed and eliminated—that is our cultural habit of mind. In Africa, mortality was seen as part of the overall form of human existence, not so much to be mastered by science and technology as struggled with on the basis of the Gospel.

Although the Great Health Transition has revolutionized human relations, in certain ways, nothing much has changed. As St. Peter writes quoting Isaiah, “All flesh is like grass and all its glory like the flower of grass. The grass withers, and the flower falls” (1 Pet. 1:24). Whether it takes forty years or eighty years, the withering is inevitable and, from a physical point of view, final. What is less certain, even denied outright in our cultural era, is the contrast Peter then draws: “The word of the Lord remains forever. And this word is the good news that was preached to you.” It is on the basis of this contrast between created, finite flesh and the divine, eternal Word that mortality becomes the central vessel of moral purpose. These days, we do not deny death itself; instead, we drain it of meaning, unable to imagine that our mortality serves as an instrumental grace in our common life. From Ernest Becker’s pessimistic therapies that rid us of religious illusions to Raymond Kurzweil’s transhumanist vision of immortal minds without bodies, the Bible’s conjunction of divine purpose with mortal limitations is modernity’s enemy—or perhaps its forgotten grace.

The contemporary theological landscape reflects this. One popular version of modernity sees it as the gradual triumph of Enlightenment values. This is probably still the main view, held unconsciously by most Westerners and their university epigones elsewhere in the world. More leftist views add forms of economic development to the process. They interpret capitalism and “late capitalism” as forces of cultural change that derive from and eclipse key Enlightenment values such as “bourgeois” concerns about individual rights. On the right, we have another variant of modernity that highlights the dangers of liberal individualism.

Western theologians often reflect these conceptions. We organize our apologetics, polemics, and systems around similar assumptions about modernity. Some pen Enlightenment defenses against old cognitive fundamentalisms, as if a Thomist or even nineteenth-century Baptist vision of human existence as a mortal pilgrimage under God were intrinsically oppressive. Others adopt leftist critiques, which often involve reworking traditional Christian claims on the basis of new liberative frameworks, often sounding like eschatology à la Bernie Sanders. Still others pursue conservative reappropriations of tradition, arguing that we need thick communal identities as defenses against the atomizing effects of liberal individualism.

All these are but Sisyphean responses to the transition’s grip. No doubt new questions and theories about traditional Christian claims were arising with growing energy over the course of the nineteenth century. One might even see modernity as a series of botched attempts over several hundred years to replace a failed religion. Certainly, the sense that secular entities, such as the nation-state, seemed to have donned the garments of salvation is not without some plausibility. Still, the Great Health Transition marks a deeper fissure. Religion, explicitly the Christian religion of the West, was hardly wilted lettuce among the populace as Europe marched into the twentieth century. More recent study of popular religiosity and practice, in England as much as in North America, indicates that the deeper shifts in belief, shifts toward a secular mentality, did not really occur until the twentieth century, long after the birth of natural science, the establishment of liberal democracies, and rise of historical consciousness, milestones often touted as integral to the rise of a distinctively modern Western culture. Before 1900, the Bible was still read deeply, catechesis was widespread and traditional, and the claims of a mortal existence bound up with genealogical moral purpose ordered toward eternity were firm. Something else seems to have happened to shrink the power of religion in contemporary times.

The Health Transition, however, was not straightforward. In Britain—and elsewhere, too—the advent of the transition coincided with the most imposing reign of death in centuries, extending from World War I through World War II. In Europe, the transition merged with nihilistic reactions to collective horror. The stark contrast of economic, medical, and public health advances that quickly and dramatically extended life expectancy to death’s violent imposition in spasms of warfare and genocide created a revolutionary reaction. After World War II, Europeans seem to have come to the conclusion that death is simply not our business any longer. The Cold War delayed, perhaps, the American participation in this new sensibility, but eventually we caught up. It is as if we say, collectively, to hell with death, and to the demands it makes on our individual moral conscience and collective self-ordering. Human rights prohibit death. Modern prosperity and technology delay it. And if death is not our business, then the forms of life that, for all of human history, have engaged it are not our business, either. Sex, childbearing, even gender identity: Why should we allow our intimate lives to be shaped by our mortal frame?

More than anything else, this reordering is the cultural shape of modernity. It is recent, and it has little to do directly with economic systems or legal constructions, issues that dominate discussion of contemporary existence today.

Sex is hardly the only area turned upside down by the transition. We are largely impotent in the face of rapidly expanding legal permissions for suicide. The traditional Christian claims of “if for this life only,” or “fear not,” or “eternal life” are now adopted by the proponents of suicide and hurled back at Christians as sufficient grounds to silence religious scruples. “You taught us that death is nothing, and now we are acting on it!” Given the widespread assumptions of autonomy and self-possession (my life is my own to do with as I please), Christian opponents are hard pressed to offer counterarguments that have public traction. What has been missing, of course, is the deep conviction that, because we are creatures, “death is our business.” It is our business in the sense that we have a calling to cherish our mortality in specific ways. We are in fact “not our own,” as Thomas Aquinas insisted in his third point against suicide: “Life is God’s gift to man, and is subject to His power, Who kills and makes to live. . . . For it belongs to God alone to pronounce sentence of death and life.”

My late brother-in-law, a general surgeon in a small city, was a committed Marxist and atheist. He once told the story of a patient, a young mother in the hospital dying of cancer. He was touched by the way she engaged her children with openness, honesty, and hope, despite her pain and approaching death. “I have tried to teach my children how to live well; but I must also teach them how to die well.” This witness impressed my brother-in-law, yet also confused him. For “to die well” is to locate what is good somewhere outside our control—in the God who gives and receives our lives. It is also to allow that alien goodness, the goodness of God’s transcendent superintendence over life and its temporal duration, to inform the very meaning of our vulnerability to illness, suffering, and death.

The Church’s call is to unravel this confusion as far as possible. Obviously, we all remain mortal. Modernity has not so much denied this as it has rendered death of limited importance. It has become the remote horizon. The only meaningful moral project in reference to death is to make it still more remote. In relation to death, the deepest meaning of life simply is to extend it. With that demotion and diminution of death’s moral import has come the veiling of creaturehood, among Christians as much as anybody. But because mortality isn’t going away, the demotion and the veiling are in fact lies, no more and no less.

We must restore the truth of creaturehood, and we can do so in three areas.

First, we need to remember that life span continues to frame life. Whether it is forty years, as it was for many Westerners in 1900, or eighty years on the average today is irrelevant to the fundamental character of temporal constraint upon human identity. Genesis opens with a list of lengthy antediluvian life spans, but the Gospels end with a human life on a cross whose breadth has dwindled to three decades. The whole passage of mortal history is assumed by God’s own Son, narrowing its range of meaning to just this divinely incarnated life span, at least in terms of worldly purpose. There is a “treasure” of glory, but carried in “earthen vessels.”

Second, and out of this, genealogy is intrinsic to human purpose. Procreative multiplication binds together the mortal passage from the first Adam to Christ, the second Adam. Having sex and making babies are bound up with what one might term “filiation.” The generations branch out across history, establishing a web in which every one of us finds himself. This is what founds human existence. First enacted in the Garden, in “the time of innocency,” genealogy is itself the human experience of the way God orders creaturely mortality through history. The limited life span continues a greater genealogical purpose and action. Thus begins the entire ethical theater of human life. All the toil of conception and survival, nurture and struggle, love and its enemies, the self and its fallen and yearning neighbors—these are “edges” of moral life. They are also thresholds of divine grace, as we see so often in the agonies of mortal life in the Old Testament.

Third, all this makes mortality the vessel of grace: “For we must all appear before the judgment seat of Christ, so that each one may receive good or evil, according to what he has done in the body” (2 Cor. 5:10). How we order our embodied life in the course of time, how we inhabit our allotted span, determines the shape of our passage into eternity.

Although our culture wars create an atmosphere of contestation, these claims don’t really need to be argued for, which is good news for the Gospel’s articulation. They do, however, need to be lived in a commendable fashion. Ivan Illich famously called the medical establishment back from a secular devotion to techniques of bodily healing. Instead, it must contribute to the “craft of suffering well,” a craft related to the long-standing craft of dying well, the ars moriendi that flourished into the nineteenth century. The development and implementation of such arts are singularly ecclesial tasks for Christians.

They are tasks that involve theological reflection and debate. Should we not, for instance, be critical of contemporary claims to an eschatology that sets aside the redemptive shape of mortality, both in its primordial goodness and in its form as a divinely purposed vessel? The eschatology of modern liberalism can be seen as a project of this-worldly life pushing death as far to the margins as possible. The opposite holds for apocalyptically focused assertions of completely other-impinging power into our historical order. Both visions of history tend to erase creation’s role as a passageway of grace, whatever the depredations of sin. Each sidelining of mortality’s fruitful role is born of the Great Transition’s veiling of mortality. At our most serious, even our impoverished exegesis is a reflection of modernity’s reformulation of the created body as infinitely curable, and if not, disposable or a matter of spiritual indifference. Thus, the Church’s witness to creaturehood is indeed bound up with restoring a range of traditional theological claims.

Because the character of mortality as a divine vessel of grace is a given, the Church need only offer words that describe rather than argue. Rolling back modernity’s falsehoods requires the reassertion of who we actually are. That reassertion is inevitable. Mortal creaturehood is by definition vulnerable, fragile, and limited. The significant Russian decline in life expectancy in the 1990s seems to have followed social disruption and psychic loss of confidence, leading to alcoholism and other pathologies. The Great Health Transition is hardly static. Perhaps it has simply thrust us into a vicious circle of increased life expectancy and decreased meaning, which in turn will decrease life spans. That seems to be happening among poorer white Americans, who are now more and more likely to die of drug overdoses, suicide, adult onset diabetes, and other health problems. Articulating the divine truths bound up with our small frame of existence will never lack resonance, for such speech indicates that to which our bodies tend.

In 1981, when I first went to work in Burundi, Africa, the average life span was around forty-seven years. In 1960, it had been close to forty-one. Today, it has reached sixty, far below the Western world’s eighty years. The figures tell a story of minimal health care, faltering economics, and civil war. They also shape the ways Africans see their lives. In 1981, it was polite to ask a Burundian woman how many children she had. And she might answer, “Eight, four living.” The proportions might vary, but the two-fold character of her progeny was almost always stated. Her identity was not only informed by life; it was also informed by death. Her mortal flesh—both her generative power and her vulnerability to the grave’s power—bound her to the living and the dead. She could speak of life’s gift and death’s blows in a single breath.

As every mother knows, whether in America or Africa, children born, whether dead or alive, are nonetheless children. They are enlivened by their very giftedness from God. The mortal edges of temporal existence upon which our efforts at love are made, well or poorly, show us this. The great communion of saints is informed by mortality’s gathering horde and its rumble. So the Church listens and speaks.

Ephraim Radner is professor of historical theology at Wycliffe College. His most recent book is A Time to Keep: Theology, Morality, and the Shape of a Human Life.