It was good to read a post-apocalyptic novel that didn't dwell on violence and murder (though it acknowledged those things), but rather told of how people went about surviving, preserving family and building community.

The study of the slow decomposition of the body of modern culture was interesting.
Stewart's presentation of xenophobia arising from a hygienic fear of disease and cultural contamination was plausible and sadly relevant.

I expected there to be outdated attitudes to race and women, which were there but ameliorated to some degree by the interracial marriage of Ish and Em, and the strength of will and cohesive force shown by Em, and even if this was presented in a stereotypical "Earth Mother" non-intellectual way, the community would have failed without her.

The outdated attitudes I found most disturbing were ableism and eugenic "purity", the consequences of which might perhaps have been apparent to Stewart at the time he was writing, in the immediate aftermath of the nazi "Final Solution", though the resurgence of both xenophobia and state control of reproductive rights shows that these abhorrent ideas are tenacious.

Getting off my soap box, this was a slow-paced, thoughtful book that took me a while to get into, but which I found rewarding. The last section about the Last American was an especially poignant picture of old age and end of life. 

Finally, I'm possibly unduly influenced by having recently read the Elder Edda, but rather than the cliché Adam and Eve, the nicknames of Ish and Em were suggestive to me of Ask and Embla, "Ash and Elm", the first man and woman of Norse myth, the roots of the family tree, the Father and Mother of Nations. I've no idea if this was intended, but I do like the idea.