We examine the long-term trends observed in the living standard of the Colombian population over more than 180 years. We construct a Historical Index of Human Development (HIHD) for Colombia for the nineteenth and twentieth centuries and find modest advances in the index during the nineteenth century, life expectancy being the dimension that contributed most to the Colombian Human Development Index in that century. In contrast, all HIHD components exhibited significant advances during the twentieth century. In particular, social dimensions were the main contributors to a growing Human Development Index in Colombia, and life expectancy was the main driver for both men and women. These achievements are mainly explained by the role of public policies aimed at the improvement of education and health. Next, since life expectancy was the dimension that most contributed to human development in the long run, we empirically examine the role of improvements in the provision of public utilities in the significant reduction of mortality. Our hypothesis is that the reduction of mortality was largely brought about by improvements in the provision of aqueducts and sewerage. To this end, we construct a new dataset using statistics reported by the Colombian government, which included annual information on the main diseases and causes of mortality during the 1916–2014 period disaggregated by departments. Econometric results show that the decline in mortality rates, especially those related to some waterborne diseases, was significantly related to the expansion of aqueducts and sewerage services in the country.