"I kept wondering why, if we're in a fantasy 80s and 90s in which organ donation is dealt with in this very futuristic, dysptopian way, the world this took place in didn't in fact look more futuristic, rather than set back decades. Very odd decision on the part of the designers."
As it's all set in an alternate world (at least from 1952 onward) fashions are bound to have taken a different course. Not necessarily progressive. The cultural influences that defined the decades in our own universe - Elvis, the Beatles, Woodstock - may not have taken off in the world Kathy H grew up in. Instead, it was the likes of Judy Bridgewater with her song "Never Let Me Go". For all we know, the first man on the moon may not have been Neil Armstrong, but a Russian. (Assuming anyone even has been on the moon in Kathy H's world.)
In the movie of 1984 (Michael Radford's version), the hairstyles are reminiscent of 1948, because cultural development froze at a certain point some time in the 1950s. The only technological developments that caught on in 1984 were things relevant to warfare and espionage: telescreens, rocket bombs, floating fortresses, etc. Everything else looked dingy, squalid and decaying.
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