Diseases and cities: a brief history lesson

Modernity has created its own health crises--and cities have been at the center of those crises. Diseases such as COVID-19 and environmental disasters have caused tremendous damage and loss of life. Joel Kotkin puts 2020 and 2021 into perspective in City Journal.

Frederich Engels speaks powerfully in “The Conditions of the Working Class in England” of the squalid conditions endured by Britain's mid-nineteenth century urban poor.  Mortality rates in London were three times higher than in the surround’sing countryside, making the city dependent on constant demographic infusions from the hinterlands and Ireland.  The urban proletariat suffered stunted lives not only in terms of economics but also regarding their physical stature and longevity. Epidemics of infectious diseases such as cholera, typhoid, typhus, smallpox, and tuberculosis were widespread, and crowded conditions, alcoholism, and mass prostitution contributed to a public health nightmare.

Such maladies also became commonplace in America. Pollution of air and water was rampant—observers speak of the Ohio River in Cincinnati turning red with “rivers of blood” from slaughtered pigs. Residents of industrial cities like Pittsburgh suffered high rates of lung infection. Smog in Southern California in the past created an environment so toxic that young children often had to be warned not to play outside.

Today, we see these conditions most commonly in fast-growing cities of the developing world. The massive slums of Dhakarta, Cairo, Kinshasa, Karachi, and New Delhi are extraordinarily unhealthful places. Coronary diseases, according to one study, have grown as Asian populations have urbanized, often in stressful conditions. The average Mumbaikar lives to 55—seven years less than the general population which is still largely rural.

Read the whole thing here.

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