This compelling account charts the relentless trajectory of humankind, and its changing survival and disease patterns, across place and time from when our ancient ancestors roamed the African Savannah to today’s populous, industrialised, globalising world. This expansion of human frontiers - geographic, climatic, cultural and technological - has encountered frequent setbacks from disease, famine and dwindling resources. The social and environmental transformations wrought by agrarianism, industrialisation, fertility control, social modernisation, urbanisation and mass consumption have profoundly affected patterns of health and disease. Today, as life expectancies rise, the planet’s ecosystems are being damaged by the combined weight of population size and intensive economic activity. Global warming, stratospheric ozone depletion and loss of biodiversity pose large-scale hazards to human health and survival. Recognising this, can we achieve a transition to sustainability? This and other profound questions underlie this chronicle of expansive human activity, social change, environmental impact and their health consequences.