Tag Archives: health

Why Austerity Kills

I think COVID-19 has made all of us realise just how deadly austerity is, but The Body Economic by David Stuckler and Sanjay Basu should be required reading for its death-dealing potential outside of pandemic conditions.

Please, can we not go backwards after this.

I am often nervous about anything that draws parallels too strongly between society and body, policy and medicine. But I think they do it really well here.

Austerity is medicine intended to reduce symptoms of debts and deficits, and to cure recessions. It cuts governmnet spending on healthcare coverage, assistance to the unemployed and housing support. At the start of the trial, its potential side-effects were not well understood (ix).

There is a wealth of work on the social determinants of health such as Marmot‘s review — there is nothing so new here but yet it can’t be repeated enough it seems.

Good health doesn’t start in hospitals and clinics; it starts in our homes and our neighbourhoods, in the food we eat, the air we breathe, and the safety of our streets. Indeed, a top predictor of your life expectancy is your zip code. (xi)

They study the impact of the economy on health and find that it is not recession but austerity that impacts it most negatively. ‘Recessions can hurt,’ they write, ‘but austerity kills (xx)’. Even the IMF has recognized this, reversing previous policy, writing that ‘austerity slows down economies, worsens unemployment, and hampers investor confidence.’ Yet how little has changed.

This book consists of chapter after chapter of evidence pulled from around the world (I love this scope around the world…) where divergent paths can be seen and tested to some degree, starting with the Great Depression in the US. States implemented the New Deal very differently, states taking fullest advantage of government supports and providing social services showing mortality rates far below those states which did not. They move on the the post-communist mortality crisis–which I am humbled to say I had never heard of. The authors show that the huge rise in mortality in men — the awful, heartrending rise in mortality — took place wherever in the former Soviet Union they pushed Shock Therapy, ‘a radical package of market reforms’ designed to push the transition to capitalism as quickly as possible. Primarily Harvard economists were behind this: Andrei Shleifer, Stanley Fischer, Lawrence Summers and Jeffrey Sachs. Russia, Kazakhstan, Kyrgyzstan followed this advice. Stiglitz was on the other side of this argument, pushing for gradual reform, Belarus, Poland and the Czech Republic followed this path.

The austerity imposed through shock therapy did not just cause a spike in mortality, it also significantly slowed economic recovery — even by its own justification (if there could be such a thing causing so many deaths), it failed. Milton Friedman himself admitted Stiglitz was right.

Another chapter on East Asia, again showcasing the deaths caused by IMF imposed austerity in Thailand, South Korea and Indonesia, as compared to Malaysia where austerity was resisted. Heartbreaking again.

On to the ‘Great Recession’, the approach taken by Iceland prosecuting bankers rather than imposing austerity. Quicker economic recovery, fewer deaths. Compare this to Greece. Compare this to the US, where they write:

A 2009 study found that people who lack medical insurance were 40 percent more likely to die prematurely than those who had it. During the great Recession, before the PPACA came into effect, there were approximately 35,000 avoidable deaths due to the lack of healthcare insurance (99).

People were dying, and at the same time

Profits of health insurance companies soared…In 2009 the top five US health insurance companies reported $12.2 billion in profits, a staggering increase of 56% over the figures for 2008. In 2009, a year that saw 2.9 million people lose coverage, insurance companies’ profits rose by 56 percent (101).

I haven’t read Kenneth Arrow, Nobel prize-winning economist, but he wrote in a 1963 paper that markets ‘often fail to deliver affordable, high-quality healthcare‘ (101). What they do instead, is make some people a whole lot of money.

Stuckler and Basu move on to Italy, the protests of the vidove bianche, or white widows of the increasing numbers of men committing suicide after losing employment. This opens a chapter on suicide and its connections to work, the ever increasing numbers of primarily men killing themselves after the imposition of austerity around the world. The way that governments, as they have done here in the UK, averaging out the numbers of deaths erase the spikes that demand attention.

From work to housing… They look at the unprecedented rise of the West Nile Virus during droughts, ultimately it was discovered that this had been caused by the foreclosure of homes and the breeding of mosquitoes in neglected pools. As an aside, West Nile Virus is a pretty terrifying disease.

This is not the only cost to health from the housing and foreclosure crisis. Housing is a precondition for good health — to be without it is to be among the most vulnerable groups.

People without homes tend to die forty years earlier than those with a roof over their heads. They often suffer from a raft of health problems and lack adequate access to healthcare. In addition, the homeless are at high risk of contracting infectious diseases like TB, which can then spread to the rest of the population. Poor health and homelessness are so closely linked that it is difficult to ascertain which came first, but the public health outcome is the same: a huge increase in the risk of death and avoidable suffering (127).

They describe people skipping medicines to be able to pay mortgages, a rise in hospitalisation leading to increased medical debt leading to increased likelihood of foreclosure. They write that the rise in foreclosures in communities strongly correlated to a rates of emergency room visits.


Ultimately austerity has failed because it is unsupported by sound logic or data. It is an economic ideology. It stems from the belief that small government and free markets are always better than state interventions. It is a socially constructed myth–a convenient belief among politicians taken advantage of by those who have a vested interest in shrinking the role of the state, in privatizing social welfare systems for personal gain. It does great harm–punishing the most vulnerable, rather than those who caused this recession (140).

Well said. These are their recommendations:

To break the cycle of radical austerity programs, we need a New New Deal…To work, it must follow three key principles:

1. “First, do no harm” is the ancient higher law of the healing professions. Because social and economic policies have collateral effects on health and sickness, the doctors’ mantra should become a requirement for all such policies.

2. Help people return to work: In hard times, having a stable job is often the best medicine. Unemployment and the fear of unemployment are among the most significant drivers of poor health that people face in an economic crisis (143).

3. Invest in Public Health (144)

Stuckler, David and Sanjay Basu (2013) The Body Economic: Why Austerity Klls. Recessions, Budget Battles, and the Politics of Life and Death. NY: Basic Books.

Storytelling in a time of plague: Boccaccio’s Decameron

In the face of its onrush, all the wisdom and ingenuity of man were unavailing…numerous instructions were issued for safeguarding the people’s health, but all to no avail. (4)

Boccaccio describes the Black plague then, the swellings in the groin or armpit, the spread of swelling, the blotches and bruises. From the time of the first sign of swelling you knew you would die.

I can’t imagine it. All that we know now of science and medicine and so this bubble we find ourselves in and the ambulances to take people away and the clean white antiseptic of hospitals and experts and antibiotics and you can still die and it is still terrifying…but not like then.

Against these maladies, it seemed that all the advice of physicians and all the power of medicine were profitless and unavailing (5)

But what made this pestilence even more severe was that wherever those suffering from it mixed with people who were all unaffected, it would rush upon those with the speed of a fire racing through dry or oily substances…

It did not just do so through direct touch, but through clothes and other objects handled by others. Some became more sober and abstemious and god-fearing, others hedonistic, satisfying all cravings. Laws broke down. Servants died or fled, breaking down some of the distinctions between people, women were no longer able to gather and mourn the dead. The bodies were left lying outside of the door of the home for collection to be buried in mass graves.

…it is reliably thought that over a hundred thousand human lives were extinguished within the walls of the city of Florence…Yet before this lethal catastrophe fell upon the city, it is doubtful whether anyone would have guessed it contained so many inhabitants.

Ah, how great a number of splendid palaces, fine houses, and noble dwellings, once filled with retainers, with lords and with ladies, were left bereft of all who had lived there… (13)

Thus the circumstances that lead seven young ladies to gather at a church. Pampinea says:

Here we linger for no other purpose, or so it seems to me, than to count the number of corpses being taken to burial, or to hear whether the friars of the church, very few of whom are left, chant and their offices at the appropriate hours, or to exhibit the quality and quantity of our sorrows, by means of the clothes we are wearing, to all those whom we meet in this place. And if we go outside, we shall see the dead and the sick being carried hither and thither, or we shall see people, once condemned to exile by the courts for their misdeeds, careering wildly about the streets in open defiance of the law, well knowing that those appointed to enforce it are either dead or dying; or else we shall find ourselves at the mercy of the scum of our city who, having scented our blood, call themselves sextons and go prancing and bustling all over the place, singing bawdy songs that add insult to our injuries. Moreover, all we ever hear is “So-and-so’s dead” and “So-and-so’s dying”; and if there were anyone left to mourn, the whole place would be filled with sounds of weeping and wailing.

And if we return to our homes, what happens? I know not whether your own experience is similar to mine, but my house was once full of servants, and now that there is no one left apart from my maid and myself, I am filled with foreboding and feel as if every hair of my head is standing on end. Wherever I go in the house, wherever I pause to rest, I seem to be haunted by the shades of the departed, whose faces no longer appear as I remember them but with strange and horribly twisted expressions that frighten me out of my senses. (13-14)

Our coronavirus is not quite like this. It is strange to know that it is all around us, to watch the numbers of the dead climb, to mourn. To hear accounts of places like New York where a friend of mine describes constant sirens, fear, a life more at risk for Asian features as attacks spread. To see the strange attacks here in the UK on G5 masts, this mad conspiracy theory but yet its components not mad at all in marking out the collusion of government and industry for profit without caring about human cost. I can’t look too hard at what is happening around us to be honest.

We have been in a bubble, my partner and I, still allowed to go outside though as of yesterday lockdown extended three more weeks. It will be more, how could it not be more?

And today my grief sits hot and unbearable in my chest, it is not the covid but the cancer, taking my aunt and there is nothing to do. No way to go. Impossible to travel to be present to say goodbye to grieve with family. I am not the first by any stretch to note the horror of this epidemic is the way it keeps us apart from one another, though if we are lucky we can drive by family homes, speak to them from the drive, press our hands against their windows. But not when they are an ocean away.

To travel such distance, always a privilege. It requires money or credit cards, the right to travel with a legal status and passport that permit exit, entrance, return. This should belong to all of us. The cost of its absence immeasurable.

I take refuge, as my family always does, in some level of dark humour. This is from the introduction to the Decameron:

…the sombre and frightening prelude which medieval rhetoricians regarded as an essential component of the genre of comedy to which the Decameron, like Dante’s great poem, was intended to belong. Both works, in fact, despite their obvious differences in form and subject-matter, respect the definition of comedy formulated for instance by Uguccione da Pisa in his Derivationes: ‘a principio horribilis et fetidus, in fine prosperis desiderablis et gratus’ (foul and horrible at the beginning, in the end felicitous, desirable and pleasing’). (xlii)

You don’t even need a translation for that. I rather love this idea of comedy, always have, but it seems even more necessary now. It makes me think of Stewart Lee, though he rarely gets around to the felicitous, desirable and pleasing. I love him for it.

Titmuss on the Welfare state

In 1950 Richard Titmuss (1907-1973) took up the first Chair of Social Administration at LSE, where he remained for the rest of his career.[1]  Superficially this was a surprising appointment since he had no formal educational qualifications. But three factors explain his coming to the School. First, Titmuss was, and remained, extremely good at networking. In the 1930s, for instance, he had joined the Eugenics Society where he rubbed shoulders with prominent social scientists and academic leaders such as William Beveridge (LSE Director 1919-37) and Alexander Carr-Saunders (LSE Director 1937-57).  Second, in the late 1930s, although employed by an insurance company, Titmuss was nonetheless carrying out independent, and well-regarded, research. His particular interests were in what he saw as the threat to Britain’s future population growth and structure and the state of the population’s health. Third, in the early 1940s he was commissioned to write one of the official histories of the British experience on the ‘Home Front’ during the Second World War, Problems of Social Policy. This volume, which appeared in 1950, remains an invaluable source of data about the wartime social services while also setting out what Titmuss argued must be achieved by post-war social reconstruction. For him, this should be based on the British people’s wartime social solidarity and social cohesion. [LSE history blog]

I don’t even know what to do with that biography. I’m one of those as thinks the right kind of experience in a field is generally equal to educational qualifications. But kicking it with Beveridge in the Eugenics Society? Just one of those unsurprising surprises that always seems to lurk in the closets of this empire.

So this is just going to focus on what I found interesting about what he saw and documented about the Welfare State, which is as useful in some ways as the Beveridge Report damn it. Considered a classic, these essays published in book form in 1958 contain another unsurprising surprise about just how far back current debates go. This is a collection of talks really, covering quite a lot of ground and looking at the many different aspects of poverty and working class demographics impacting on costs and policies of the welfare state. Not all them were useful to what I’m working on, but give such a good sense of how things began, which explains so much about how we have ended up where we are.

The titles give a great sense of the wealth of historical data and discussion to be found here.

Social Administration in a Changing Society

First, just a brief excerpt on this new department of the LSE, and the drive behind its founding — the expected appearance of the Fabian Webbs, the unexpected appearance of funding from Tata and the welcome transition from a moral inquiry into symptoms to a depper inquiry into causes:

This department for the study of social administration was founded at a time when fundamental moral and social issues were being debated with vigor and a new sense of purpose. It was a product of the ferment of inquiry to which the Webbs, Charles Booth and many others contributed so much. Poverty, on the one hand, and moral condemnation of the poor on the other, were being questioned. Inquiry was moving from the question ‘why are they poor?’ Professor Tawney, aware, as he has repeatedly taught us, that the most important thing about a man is what he takes for granted, was in his element when he gave his inaugural lecture as Director of the Ratan Tata Foundation… (17) it was a period when social policies were being shaped by diagnoses which took account of the presenting symptoms rather than of the causes of contemporary social ills. (18)

The Social Division of Welfare

So here we have the principal contemporary critiques of the Welfare State:

‘The Welfare State’ was ‘established’ too quickly and on too broad a scale. the consequences, it is argued, have been harmful to the economic health of the national and its ‘moral fibre’.

Ah, the old moral fibre. That’s one they keep coming back to.

Against this background, compounded of uneasiness and complacency, criticism has mainly focused on the supposedly equalitarian aims or effects of the social services. it is said that the relief of poverty or the maintenance of a national minimum as an objective of social policy should not mean the pursuit of equality…The error of welfare state policies since 1948 has been, according to this diagnosis, to confuse ends and means, and to pursue equalitarian aims with the result that the ‘burden’ of redistribution from rich to poor has been pushed too far… (35)

We can’t all be equal is another. Not that a bit of redistribution is the same thing.

Titmuss notes that the widespread nature of these criticisms have

produce[d] in the public eye something akin to a stereotype or image of an all-pervasive Welfare State for the Working Classes. Such is the tyranny of stereotypes today that this idea of a welfare society, born as a reaction against the social discrimination against the poor law may, paradoxically, widen rather than narrow class relationships. As Gerth and Mills have pointed out ‘… if the upper classes monopolize the means of communication and fill the several mass media with the idea that all those at the bottom are there because they are lazy, unintelligent, and in general inferior, then these appraisals may be taken over by the poor and used in the building of an image of their selves’. That is one danger…a second emanates form the vague but often powerful fears that calamity will follow the relaxation of discipline and the mitigation of hardship…(37)

I just…again, the more things change the more they stay the same. Turns out the upper classes did monopolize the media, did (further) propagate the idea that poverty was caused by being lazy and inferior. Our prime minister and cabinet are still spouting these things today like a stream of poisoned water out of a Flint water fountain.

What the welfare state was meant to achieve on the other hand? I rather like this, it feels a short rather conservation definition of the welfare state, yet one that takes as a starting place that the residents of the country form a whole, and that they are all part of one society:

All collectively provided services are deliberately designed to meet certain socially recognised ‘needs’; they are manifestations, first, of society’s will to survive as an organic whole and, secondly, of the expressed wish of all the people to assist the survival of some people. ‘Needs’ may therefore be thought of as ‘social’ and ‘individual’; as inter-dependent, mutually related essentials for the continued existence of the parts and the whole. No complete division between the two is conceptually possible…(39)

Pension Systems and Population Change

This is a talk about pensions and the impact of a changing population, the ‘long-term shift from an ‘abnormally’ youthful population in the nineteenth century to a more ‘normal’ age structure… (60) Are we really STILL having that same conversation? Yet at the same time it really brings home the horrors of working class life and early death before the welfare state was put in place. Also the fact that it was believed possible after the war, how much more should it be possible now?

All the adjustments involved in changing over to a different population structure can only be made with the minimum of social friction if the redistributive effects are equitably shouldered. They are as much a national affair as war or mass unemployment. It thus behooves us to take account of the total complex apparatus of social policy in relation to old age…(61)

It’s hard to believe this was written at a time when equality was growing, even if slowly…

The outlines of a dangerous social schism are clear, and they are enlarging. The direction in which the forces of social and fiscal policy are moving raises fundamental issues of justice and equality; not simply issues of justice between taxpayers as a separate class, or between contributors as a separate class, but between all citizens. Already it is possible to see two nations in old age; greater inequalities in living standards after work than in work; two contrasting social services for distinct groups based on different principles, and operating in isolation of each other as separate, autonomous, social instruments of change. (74)

Those days are long since gone, and it is steadily widening again. People still are worried about those pensions penciling out though.

War and Social Policy

Ah, another issue that remains an issue. Yet WWII moved everything in a new direction even as every war since seems to have been part of the pendulum swing back. On the Education Act 1944, Beveridge Report 1942, National Insurance, Family Allowances, National Health Service Acts:

All these measures of social policy were in part an expression of the needs of war-time strategy to fuse and unify the conditions of life of civilians and non-civilians alike. In practice, as we have seen, this involved the whole community in accepting an enlargement of obligations–an extension of social discipline–to attend to the primary needs of all citizens… as war has followed war in an ascending order of intensity, so have the dependent needs of wives and children been increasingly recognized. The more, in fact, that the waging of war has come to require a total effort by the nation the more have the dependent needs of the family been recognized and accepted as a social responsibility. (84)

‘The Position of Women’

A whole essay! On women! Amazing! Not particularly deep or insightful, why am I even excited, but it exists. Titmuss writes:

Few have been concerned with the working-class woman, and particularly with the conditions of life of the working class mother. (88)

He’s not wrong either. Shocking given the next fact:

At the beginning of this century, the expectation of life of a woman aged twenty was forty-six years. (91)

You really need to look at work done by people like Pember-Reeves and Harkness and Higgs to understand just how much hardship is contained in such statistics, but I am curious about the changes he notes here around marriage — not least because I had always assumed Victorians married younger and were more likely to marry period. Wrong.

No doubt the political and legal emancipation of women has contributed to these changes in what is expected from marriage. A more socially equal relationship was foreseen by the leaders of the Women’s Movement but what they could hardly have envisaged is the rise in the popularity of marriage since about 1911. (99)

Married life has been lengthened not only by declining mortality but by earlier marriage…In 1911 24 per cent of all girls aged twenty to twenty-four were married; by 1954 this proportion had risen to 52 percent. … There are now fewer unmarried women aged fifteen to thirty-five in the country than at any time since 1881… (101)

Industrialization and the Family

Not only does Titmuss give thought and space to the particular circumstances and hardships faced by women, but also of the family (perhaps following Engels here):

Industrialization demanded the breakdown of the mutual relationships of the extended family; paradoxically, the poor law struggle–though ineffectually–to maintain them… Authoritarian patterns of behaviour, sanctioned in the factory, were carried into the home. (110)

This is curious, were families less authoritarian really before factories? I wonder. He also tries to tackle the meaning of unemployment, citing Bakke’s Citizens Without Work on the idea ‘that a man’s job was not simply something that brought him money; it was an activity that gave him a place in the social world and in large measure gave meaning to his life‘. (113)

This of course is one of the underpinnings of Labour’s goal of full employment which in turn supports the welfare state economically.

The Hospital and Its Patients

He spends most time on the NHS here, full of facts and figures that I confess made me nod off just a little. The juicy bits were in the next section

The National Health Service in England

Like this one:

Among all the ideas of the 1930s and 1940s which led to the creation of the Health Service the one which increasingly dominated the mind of the public and the profession alike was the idea of prevention; the prevention of ill-health and incapacity. (140)

And what the hell happened to this idea of territorial justice?

‘Perhaps the most important argument in the planning approach [to the NHS] was the need for ‘territorial justice’–more equality of access to medical care services for people living in different parts of the country. In other words, a geographically comprehensive hospital service could not, it was thought, be provided under the aegis of some 2,000 separate, independent and often competing hospitals. (143)

But always fighting the everpresent argument that costs were spiraling out of control. In 1950 the BMJ’s headline went:

The National Health Service is heading for the bankruptcy court…and we are facing bankruptcy because of the Utopian Finances of the Welfare State. (2 December, 1950 — 148)

But this was from the time doctors hated everything about the NHS.

The other point of interest comes when Titmuss emphasizes the importance of practitioners spending time with patients…ah, imagine those days. How did we ever come to the 10 minute rule? Absurd. But that happened long after his time.

The Irresponsible Society

This was the most interesting piece I thought, from the point of view of today. Saved for last of course. He outlines some of the issues and guess what…they feel remarkably contemporary. Like this one Titmuss expected to be sorted in the 60s:

One of the most important tasks of socialists in the 1960s will be to re-define and restate the inherent illogicalities and contradictions in the managerial capitalist system as it is developing within the social structure of contemporary Britain. Much of the doctrine of Victorian Marxism is no longer applicable to a different set of fundamental illogicalities in a different age. (215)

and this?

In highly complex and wealthy societies like our own almost all social forces tend to encourage the growth of conformism unless checked by strong, continuing and effective movements of protest and criticism. If these do not come from socialists and if they are not stated in terms of power they will not come at all. (219)

Socialists fighting conformism! Encouraging multiple strands of criticism and protest! It’s the socialism I would have loved to see, if only that had happened!

This is just depressing:

We did not understand that government by the people could mean that power in the government, the Cabinet and the City, could lie almost permanently in the hands of those educated at Eton and other public schools. (220)

And finally, words against the solution that continues to be put forward today but its remarkably prescient on housing:

These problems will not and cannot be solved by the private insurance market, by property speculators, by forcing land values to insanely prohibitive levels, or by any criteria of profits and tax-free gains. Private enterprise is only building about 1,000 new dwellings a year in the county of London, for example, and most of them are luxury flats for the rich. Nor will they be solved by growth of the ‘social welfare firm’… (229)

If only New Labour could pay attention.

Department of Social Science and Administration, 1971. Credit: LSE Library

Titmuss, Richard M. ([1958] 1976) Essays on ‘The Welfare State’ Third Edition. London: George Allen & Unwin Ltd.

Young and Willmott on Leaving the Slums for the Estate

I know they are listed as Young and Willmott but that simply is impossible to roll off the tongue, I shall try and probably once again fail to write it this way in part two on Family and Kinship in East London (1957). From the densely woven networks of family described in part 1, held together in crowded rooms and turnings by living with parents or next door to them, by every day visits, shared meals, shared chores, shared lives, to spacious new council homes built on 44 acres near Epping Forest. This is how everything changed, and as Young and Willmott write, what better way to understand the importance of residence?

From Bethnal Green to Greenleigh (Debden)

Less than twenty miles away from Bethnal Green, the automatic doors of the tube train open on to the new land of Greenleigh. On one side of the railway are cows at pasture. On the other, the new housing estate. Instead of the shops of Bethnal Green there is the shopping centre at the Parade; instead of the street barrows piled high with fruit, fish, and dresses, instead of the cries of the costermongers from Spitalfields to Old Ford, there are orderly self-service stores in the marble halls of the great combines. In place of the gaunt buildings rising above narrow streets of narrow houses, there are up-to-date semi-detached residences. Bethnal Green encases the history of three hundred years. Cottages built for the descendants of Huguenot refugees, with their wide weavers’ windows and peeling plaster, stand next to Victorian red-brick on one side and massive blocks of Edwardian charity on the other. Greenleigh belongs firmly to the aesthetics of this mid-century. Built since the war to a single plan, it is all of one piece. Though the Council has mixed different types of houses, row upon row look practically identical, each beside a concrete road, each enclosed by a fence, each with its little patch of flower garden at front and larger patch of vegetable garden at back, each with expansive front windows covered over with net curtains; all built, owned, and guarded by a single responsible landlord.

Instead of the hundred fussy, fading little pubs of the borough, there are just the neon lights and armchairs of the Merchant Venturer and the Yeoman Arms. Instead of the barrel organ in Bethnal Green Road there is an electrically amplified musical box in a mechanical ice-cream van. In place of tiny workshops squeezed into a thousand back-yards rise the first few glass and concrete factories which will soon give work to Greenleigh’s children. Instead of the sociable squash of people and houses, workshops and lorries, there are the drawn-out roads and spacious open ground of the usual low-density estate. Instead of the flat land of East London, the gentle hills of Essex.

‘When I first came,’ said Mrs Sandeman, ‘I cried for weeks, it was so lonely. It was a shock to see such a deep hill going up to the shops.’ (121-122)

That gives such a beautiful sense of the differences, albeit a very particular view of them. But the scale is quite incredible.

Between 1931 and 1955 nearly 11,000 families containing over 40,000 people were rehoused from Bethnal Green on L.C.C. estates, many of them outside the county.’ (124)

People did, many of them, choose to come of course. Part of the study was to understand just why. The reasons were many, but not, for the most part, weaker attachments to their family.

lf the migrants did not have weaker kinship attachments than other people, why did they come? The main reason is {quite simple. The attraction is the house. Our couples left two or three damp rooms built in the last century for the ‘industrious classes ‘, and were suddenly transported to a spacious modern home. Instead of the tap in the backyard, there was a bathroom with hot and cold water. Instead of the gas stove on the landing, a real kitchen with a sink and a larder. Instead of the narrow living room with stained wallpaper and shaky floorboards, a newly painted lounge heated by a modern solid-fuel grate. And instead of the street for their children to play in, fields and trees and open country. The contrast is all the sharper because the new residents had, in the main, come from Bethnal Green’s worst houses. (126)

But the council in general had much more to do with it:

But, in general, the L.C.C.’s view of who needed it most decided who went. Our informants were mostly at the top of the L.C.C.’s housing list – they were living in the most overcrowded or the most unhealthy houses in the borough – and that is why they were selected. (127)

One of the tenants told them — ‘If we could take the house with us, we’d go back like a shot.’ (127)

For many, as with so many families, it was about the generations to come, not the generations they had left behind.

‘Everything seems quieter here, more calmer,’ said Mrs Vince. ‘The fresh air hits you when you come out of the station.’ Many people value the air and fields even more for their children than for themselves. Greenleigh is generally thought ‘better for the kiddies’.

So even where they left their kin with regret, the people were not deserting family so much as acting for it, on behalf of the younger rather than the older generation. (128)

But many did not stay.

Many migrants in fact decided that they had made the wrong decision, and left the estate, most of them to return to the East End. Altogether, from the opening of the Greenleigh estate until March, 1956, 26 percent of the tenants who had come there moved away again. (129)

The Family at Greenleigh

So what changed? Any friendly community feeling did not survive the scale of changing community. Everyone found the neighbors snobbish, stand-offish. Talked about the terrible loneliness. Some got part-time jobs just to survive it — one of those said ‘If I didn’t go to work I’d get melancholic.’ Her verdict on Greenleigh — ‘It’s like being in a box to die out here.’ (133)

The study found a great sense of loss, particularly women missing mothers. Most of the men continued to work in Bethnal Green as there were no jobs out near the estate, so suddenly they become the ones maintaining family ties. What made me most sad — it wasn’t distance or time that kept women from their wider families, but the cost of transport. In times of trouble they had no support, there was no one to lend money to tide people over, help when sick or pregnant, help with kids. Visiting was not a thing that was done.

Their study of Bethnal Green showed just how much happened in public spaces, not private ones, and these were precisely the spaces missing in the new estates.

One reason people have so little to do with neighbors is the absence of places to meet them. In Bethnal Green there is one pub for every 400 people, and one shop for every 44 (or one for every 14 households). At Greenleigh there is one pub for 5,000 people, and one shop for 300.

They had no cinemas, so could not congregate there either. This combination of distance and television changed things. Young & Willmott write:

The growth of television compensates for the absence of amenities outside the home, and serves to support the family in its isolation. (143)

Rents were also higher there on the council estate, often by 3 times. That in addition to fares meant people were trapped there.

Keeping Themselves to Themselves

Willmott and Young found people in Greenleigh eager to talk about their neighbours, how unfriendly they found them, and they always compared back to their community in Bethnal Green.

At Greenleigh they neither share long residence with their fellow tenants nor as a rule have kin to serve as bridges between the family and the wider community. These two vital interlocked conditions of friendship are missing, and their absence goes far to explain the attitude we have illustrated. (150)

They believed this to be partly due to the fact that everyone moving in at the same time, and there was no existing community for them to integrate into. While Willmott and Young describe their expectations that things would have improved over the few years between interviews, nothing really had changed. They blame a lack of density — a bit of catch phrase these days.

One reason it is taking so long is that the estate is so strung out — the number of people per acre at Greenleigh being only one-fifth what it is in Bethnal Green — and low density does not encourage sociability. (153)

The new big homes reinforced a feeling of what people lack, rather than all that they had. They were spending more on filling homes with objects, rather than entertainment and going out as they had before.

There is also a facsinating aside on time and space — in Bethnal Green people tended to be very informal, did ‘not need a highly-developed time sense…because it does not matter greatly whether her goes round to Mum’s at 10 o’clock or at 11. If Mum is not there someone will explain where she has gone‘ (157). This was not at all true of Greenleigh. Much of the difference lay in how close things were in Bethnal Green, with everything walking distance. In Greenleigh, life required a car and a telephone to ‘overcome geography and organize a more scattered life into a manageable whole (158)’.

The impact of this was quite profound, particularly on mental health, and particularly for women. This should not have been stuck in a footnote really:

Footnote 1, p 158: The chief psychiatrist at a local hospital told us that the loneliness of the women on this and other housing estates was the immediate, precipitating cause of so many of them coming to his department for treatment.

This lack of relationships, of knowing people, meant both a growing formality, as well as increased reliance on visual clues for judging strangers.

In a community of long-standing, status, in so far as it is determined by job and income and education, is more or less irrelevant to a person’s worth. He is judged instead, if he is judged at all, more in the round, as a person … How different is Greenleigh…Where nearly everyone is a stranger, there is no means of uncovering personality. (161-162)

They continue

Their relationships are window-to-window, not face-to-face. Their need for respect is just as strong as it ever was, but instead of  being able to find satisfaction in actual, living relationships, through the personal respect that accompanies almost any steady himan interaction, they have to turn to the other kind of respect which is awarded, by some strange sort of common understanding, for the quantity and quality of possessions which which the person surrounds himself (163-164)

They also note the lack of forward planning in the planning process for the estate itself…it has been developed as a community where people cannot age. When people’s children are grown where will they live? Nowhere for them to move close by, almost certain that enough existing units will not become vacant over the normal course of things, and it was council policy to prioritise outside people from the list rather than children. Willmott and Young note the protest that this raised among residents, a local association writing of the LCC in 1955 ‘We are in opposition to the view that people are simply units to be moved around the face of the earth in line with the impersonal schemes of some “Big Brother”...’

W&Y continue

The method by which the council has eased the housing shortage in the middle of the century is bound to create a further shortage in its last quarter. (168)

They weren’t wrong.

Movement between classes

They wanted to check and make sure that this growing sense of the importance of geography was not in fact more a function of social mobility, which leads to a rather interesting way to better understand class. Again, Willmott and Young trace sense of loss and disintegration of a sense of community it primarily back to the geography of the built environment — as people tend to seek out larger houses, they must look elsewhere. The authors write:

The East does not provide ‘middle-class’ people with ‘middle-class’ places to live, and such migration may therefore be more common than it would be in districts with more of a mixture of classes. (172)

In conclusion, though, of all of it.

…very few people wish to leave the East End. (186)

While the houses were better, Willmott and Young look at the networks of support, and find they are absent on the new estates. They have the best description of  the daughters’ new plight,  engaged in the ‘arduous…puzzling…monotonous‘ work of child rearing, while older people were cut off from remaining useful and part of the family. Willmott and Young are highly critical.

It seems that when the balance of a three-generation family is disturbed, the task of caring for dependents at both ends of life, always one of the great and indispensable functions of any society, becomes less manageable. (196)

So one key recommendation is to support these connections rather than tear them apart. Central to that there follows the need to maintain communities intact, and save as many of the existing houses as possible, updating the fabric, giving people new bathrooms, lavatories and kitchens.

I cannot help but agree with them, and wish this had been policy for the past few decades so as to build on the strengths of working class communities, rather than the opposite.

Young, Michael and Willmott, Peter ([1957] 1979) Family and Kinship in East London. Manchester: Penguin Books.

Antonovsky on Salutogenesis in Health, Stress, Coping

We’ve been doing so much work around social prescribing with Salford CVS, and salutogenesis is all over that literature. A concept developed by Aaron Antonovsky (1923-1994) for where the medical focus should lie: on how people become well, not on why they are sick. There’s some really good stuff in this sadly out-of-print book that I had to order on loan from the British Library.

It opens autobiographically — an intellectual history of Antonovsky’s work and the questions driving that work. I agree that this is the real question we need to be answering:

What are the stressors in the lives of poor people that underlie the brute fact that, with regard to everything related to health, illness, and patienthood, the poor are screwed? (3)

Given that, and all that follows, I can’t say it doesn’t trouble me greatly that Antonovsky moved from NY (and his work around studies of poverty and labour) to Israel, where it does not seem as though he undertook a study of mass Palestinian displacement into refugee camps or poverty or access to health care. Of course for him, understanding the echoes of the Holocaust in survivor’s health is clearly a driving question in his research, and this is where the example that he felt was foundational to his later theorising emerged from: In studying those camp survivors, he found that as a whole the group was unable to adapt as well as other groups to menopause. However, there were women within that group that adapted as well as anyone — so the question became to turn research around and ask why those women had adapted, and why they did so well despite their experiences? This led to what Antonovsky later came to call salutogenesis. Why people are ‘healthy’ not why they are sick. He makes the point that honestly, given how shit the world is, we should all be sick all of the time, so the real question becomes what is stopping that from happening?

It’s interesting, though, that the central concept of the book isn’t really this term salutogenesis, but what leads to it and ultimately what is at the foundation of health — what Antonovsky calls a ‘sense of coherence’:

a global orientation that expresses the extent to which one has a pervasive, enduring though dynamic feeling of confidence that one’s internal and external environments are predictable and that there is a high probability that things will work out as well as can reasonably be expected. (10)

This is what determines how well you deal with the daily bombardment of illness and disease. He also emphasizes that this is NOT the same as a feeling that ‘I am in control’. But more on that later.

I sit with this though. If this is true, then how thoroughly do we have to remake this world for health? Far beyond the policies I have seen Antonovsky quoted as a supporting reference for. For me, this becomes a new framework not only for the loss of my dad and many other people I have loved and lost to poverty and its many ills, but also for the millions of people now in hopelessness, precarity and movement across the planet.

Chapter One: Studying Health Instead of Disease

The problem of salutogenesis is one of the most mysterious, intriguing, and meaningful challenges for philosophy and the biological and social sciences… Pathogenesis–the origins of disease X, disease Y, disease Z–has preoccupied us … here, as in all of science, how one poses the question is crucial to the direction one takes in looking for the answers, (12)

We have looked for the origins of disease X, Y and Z and found them. He talks about the exogenous and endogenous bugs, the sets of agents that cause disease: ‘viruses, mutant cells, pollutants, or agents of physical trauma such as guns, knives, and motor vehicles, that pose a constant threat of damage…’ wait for it though, here it really comes:

And finally, there are those bugs variously called psychosocial stressors, presses, strains: alienation, rapid social change, identity crises, ends-means gaps, discrimination, anxiety, frustration. (14)

These are not, of course, considered working within a pathogenic model.

Our dominant ideological paradigm, which shapes our society’s clinical practice and scientific research, focuses on and responds to a particular disease or clinical entity. (15)

Near the end of the chapter, he gives three reasons why ‘the focus on pathogenesis is likely to handicap us in grappling with both the scientific problem of understanding why illness is far from deviant and the human problem of somewhat reducing pain… (my bullets, his words in what follows)

  1. the pathogenic approach pressures us to focus on the disease, on the illness, on the alteration of body fluids or structures, and to disregard the sickness… it blinds us to the subjective interpretation of the state of affairs of the person who is ill (36).
  2. thinking in pathogenic terms is most comfortable with the “magic-bullet” approach–one disease, one cure–which explains the resistance of many to the concept of multiple causation. … the assumption is that we are cleverer than the bugs and can eradicate them one by one (37)
  3. pathogenesis by definition is a model that postulates a state of disease that is qualitatively and dichotomously different from a state of nondisease…

And I’m going to separate this last bit of the paragraph out, because it better explains salutogenesis:

such dichotomization blinds us to a conceptualization made possible by a salutogenic model, namely, a multidimensional health-illness continuum between two poles that are useful only as heuristic devices and are never found in reality: absolute health and absolute illness. (38)

Chapter 2: Measuring Health on a Continuum

This returns to all the problems of thinking of health and illness as a dichotomy when the real question for Antanovsky is ‘Given the ubiquity of bugs, why does anyone ever stay alive and reasonably healthy?’ (39)

On epidemiology — I know it shouldn’t surprise me that the field of medicine is siloed within as much as without, and epidemiology is only one of those silos, and yet it does–he writes:

epidemiology is one of the major scientific disciplines that have developed in the service of the health care institution. There is no doubt in my mind that the epidemiological conceptualization of the health-illness phenomenon, the model or paradigm used by epidemiologists, is powerful and, for some purposes, far more powerful that the clinical model we have been discussing.

And continues, with bullets that are again my own

  1. epidemiologists are aware of the iceberg phenomenon. They assume, with adequate evidence, that for every case of a disease that has been brought to clinical attention…there are additional cases below the surface… (45)
  2. …they are kept in check by methodological sophistication and compulsiveness… [for clinicians] intuition, art and clinical skills are necessarily acceptable in arriving at a conclusion. The epidemiologist has the luxury of rejecting such subjectivism. (46)
  3. the sine qua non of the epidemiologist’s professional activity is to go beyond description and enter the field of analysis, to deal with causation. As such, it rounds out, complements, the field of laboratory and clinical research. But its core and strength are its understanding of causation as based on teh study of group rather than individual differences. (46)

Thus he gives the public health model higher marks than the clinical model (and I just read a splendid book about social epidemiology, but more on that later), yet it still suffers from this dichotomy of health and illness.

I was curious to find Antonovsky critiquing the WHO definition of health, not its utopian aspects but the way that it can’t be operationalized. He argues that this renders it harmless, and he might be right. He prefers Dubos’ definition of health (I am looking forward to reading Dubos) ‘a modus vivendi enabling imperfect men to achieve a rewarding and not too painful existence while they cope with an imperfect world (1968, p67).

Awesome definition, but I can see that not everyone would be inspired by that. Nor is this mapping of the continuum to inspirational either perhaps, but I found it useful:

As Antonovsky writes:

by defining health as coextensive with the many other dimensions of well-being, one makes the concept of health meaningless and impossible to study … Health wellbeing must be studied separately (68)

Chapter 3: Stressors, Tension, and Stress

Stressors are omnipresent in human existence … Poor tension management leads to the stress syndrome and movement toward dis-ease on the continuum. Good tension management pushes toward health ease. (71)

Everyone alive would agree with that statement. The list of stressors he gives:

accidents and the survivors; the untoward experiences of others in our social networks; the horrors of history in which we are involved; intrapsychic, unconscious conflicts and anxieties; the fear of aggression, mutilation, and destruction; the events of history brought into our living rooms; the changes of the narrower world in which we live; phase-specific psychosocial crises; other normative life-crises–role entries and exits, inadequate socialization, underload and overload; the inherent conflicts in all social relations; and the gap between culturally inculcated goals and socially structured means. (89-90)

Quite a list.

Chapter 4: Tension Management and Resources for Resistance

In moving towards an understanding of the foundations of salutogenesis, Antonovsky develops the concept of the Generalized Resistance Resource, or GRRs as those things that help keep us towards the healthy side of the continuum.

Antonovsky p 103

The principal individual characteristics include rationality, flexibility, farsightedness, but I’m most interested in what he calls Interpersonal-Relational GRRs, more generally known as social supports. These sit in opposition to social isolation — or what in those days seemed to have been termed ‘social isolates’ or ‘social destructs’. Goddamn, imagine being thought of as a social destruct. But we are finally working our way to understanding what Antonovsky means by coherence, ‘the GRR of deep, immediate, personal roots.’ (114) I haven’t read Malinowski since undergrad, but he’s cited here:

Malinowski says that culture gives each of us our place in the world…. In Chapter Three I defined a stressor as a demand made on one for which one does not have tan automatic and readily available response capacity. From this point of view, what culture does, in giving us our place in the world, is to give us an extraordinarily wide range of answers to demands. The demands and answers are routinized: from the psychological point of view, they are internalized; from the sociological point of view, they are institutionalized. (117)

A really fascinating way to think of culture in the abstract, but I can’t help but also think of the left’s too-often sneering attitudes to ‘identity politics’ and culture and struggle, and see how really this all ties in together. And just to repeat once again”

Ready answers provided by one’s culture and its social structure are probably the most powerful GRR of all. (119)

Chapter 5: Perceiving the World as Coherent

This is the central point of the book really, and the key idea for Antonovsky:

The sense of coherence is a global orientation that expresses the extent to which one has a pervasive, enduring though dynamic feeling of confidence that one’s internal and external environments are predictable, and that there is a high probability that things will work out as well as can reasonably be expected. (123)

He doesn’t once, that I remember, quote Voltaire. It’s extraordinary. He continues:

A sense of coherence, as I trust has become clear, does not at all imply that one is in control. It does involve one as a participant in the processes shaping one’s destiny as well as one’s daily experience.

The crucial issue is not whether power to determine such outcomes lies in our own hands or elsewhere. What is important is that the location of power where it is legitimately supposed to be. This may be within oneself; it may be in the hands of the head of the family, patriarchs, leaders, formal authorities, the party, history, or a deity. The element of legitimacy assures one that issues will, in the long run, be resolved by such authority in one’s own interests. Thus a strong sense of coherence is not at all endangered by not being in control oneself. (128)

It’s all about power over your fate — and in fact by this argument participation in struggle could be as powerful and positive a health determinant as being lucky enough to be born in the upper classes. Of course, Antonovsky also describes the way that certain kinds of faith stand in as much good stead. There is so much to think about here.

He gives case histories of Norman Cousins and Freud himself as examples — you have to like that. In thinking about the conditions under which a strong sense of coherence emerges, Antonovsky notes that one line of research might be investigating  how in the case studies given, the ‘one common substantive theme … is the continuous experience of participation in shaping one’s fate‘ (152).

Chapter 6: Relation of the Sense of Coherence to Health

A long chapter that states that as the sense of coherence has not been operationalized and therefore not tested, he is simply bringing together evidence for a ‘prima facie case for the plausibility of the hypothesis‘ (161). I think he manages.

Chapter 7: the Salutogenic Model of Health

And now back to salutogenesis, along with a helpful summary:

In Chapter One, I posed the problem of salutogenesis. Chapter Two proposed a solution to the problem of the measurement of health status consonant with the salutogenic orientation. At that point, the core of the question was put as the need to explain the location of a person near the ease end of the health ease/ dis-ease continuum. Chapter Three considered–and rejected–the hypothesis that the answer could be stressor avoidance. In Chapter Four, an initial alternative answer was presented: the availability of generalized resistance resources. The initial question was also broadened to consider maintenance or improvement of one’s position on the breakdown continuum, irrespective of location at any given time. Analysis of the nature of generalized resistance resources, of why they are hypothesized to facilitate tension management and avoid stress, led to the formulation of the central construct of the book, the sense of coherence, considered at length in Chapter Five. The final building block in which I call the salutogenic model appears in Chapter Six, which presents the evidence for linking the sense of coherence and health status. (182-183)

An amazing chart here to summarise the model. I give it to you:

Antonovsky -- The Salutogenic ModelAntonovsky -- The Salutogenic ModelAnd of course, as I’ve probably failed to make clear, salutogenesis really needs to be the focus of our current age, not instead of pathogenesis but after pathogenic success.

There is, indeed, good reason for the pathogenic model to have dominated thinking about disease for most of human history. The three-pronged power of stressors…which included perhaps above all nutritional deprivation and the most primitive level of sanitation, was sufficient to overcome even substantial resistance resources. When, however, the standard of living…reaches a rough level of adequacy, differences in health level no longer are overwhelmingly determined by biochemical and physical stressors (193).

Chapter 8: Implications for an Improved Health Care System

This isn’t easy, this is no ‘guide to the perplexed‘ — Antonovsky says that twice. But he has a few suggestions. One is to think of the doctor as a GRR — each encounter between doctor and patient a way to support a patient’s sense of coherence. This is particularly important as each encounter will generally involve ‘anxiety, uncertainty, unpredictability and dependence‘ for the patient. Above all this is key after a traumatic situation, when someone finds themselves, as Antonovsky writes, as generally ‘shattered‘. However routine encounters also important. For the most part, those encounters which allow the physician to see and to treat someone as a whole with a sense of their broader self and context are the best.

Near the end of the book, Antonovsky asks: ‘Can the medical profession and the individual physician engage in activities beyond the patient-doctor encounter that affect the sense of coherence?’ Yes of course, and there are four ways this might happen: ‘making health care available to all, promoting a preventive health orientation, buttressing faith in the physician, and reaching out to persons at high risk of damage to the sense of coherence‘. (217)

One of my favourite sentences:

A society, then, that has institutionalized a health care system that expresses consensus that health care is an inalienable right of all its citizens and is to be made available to all on the universalistic ground of being  a resident of that society is a society that has taken a step forward in strengthening the sense of coherence of its members. (217)

Those blocked from this due to poverty or race or rural living distant from health care necessarily lack this sense.

Penultimate paragraph from the epilogue:

If we wish to see the present and future soberly in our world, we must use words like capitalism and totalitarianism.  The social structures in which most of humanity lives and the daily experiences to which we are exposed in these structure are far from conducive to a strong sense of coherence…Societies with a marketing mentality and fetishism of commodities, with terror and arbitrary recasting of history, with grinding poverty and starvation cannot foster a view of the world as one that provides information and music except for the fortunate few.

It would take another book and an extensive research effort to subject to serious analysis the concrete social structures and social positions that in our world foster a strong sense of coherence. Improvement in health status is contingent on such analysis and on a program of social action that could follow. This analysis is one of the crucial tasks of social epidemiological research (227).

He hopes this book is one of the tools that makes this possible, and I believe it is.

[Antonovsky, Aaron (1985) Health, Stress, and Coping. San Francisco and London: Josey-Bass Publishers.]

Bavaria’s Turn-of-the-Century Golden Rules of Health

One thing I do love about Germany — and the Czech Republic and  Poland (I think I did three posts on apothecaries after visiting Krakow?) — are the way that apothecaries are still everywhere. I know we have pharmacists, but it’s just not the same, is it? But there are also the old signs, the nods back to the glory days with dark, battered wooden shelves full of gleaming bottles and herbs drying from the ceiling, powdered minerals and bits of dried bat and crocodile. Though I do love bats, and prefer them alive. A number also harken back to the superior medical knowledge of the moors — and so I am simultaneously appreciative of that and horrified by the racism inherent in the old figures.

Still, we only saw one of them in Nuremberg. This was by far my favourite:


I loved most the rules for health from the turn of the last century:


I have copied them all for you from the website: Counsellor Eckart’s golden rules of health for a prudent lifestyle — but let me highlight my favourite:

Do not dress according to fashion, but rather in tune with the weather. Keep your feet and lower body warm. In snowy, freezing weather, thin tights and shoes are a crime against your health.

I have been thinking that to myself all winter looking at our freezing youth with their strange fashionable dislike of socks.

They are incredibly Victorian, and feel they could have as likely appeared in England or the East Coast of the US. Fresh air, cold water, not too much comfort, not too much good food, and you can imagine no whinging about all of that. I’ve been thinking about health a lot lately, and this kind of framework for how we imagine good living still seems to lurk a great deal in the background.

The golden rules of health from Carl Ludwig Ernst Eckart (1830 – 1911)

Do not burn the candle at both ends: sleep before midnight is of more worth than after sunrise.

Rest your body and nerves. This does not happen when partaking of entertainment or on the dance floor, but rather in God’s free, natural world. Keep the Sunday as a holy day, as it has been designated for our rest.

Pay attention to your daily bowel movement! It is better to eat too little than too much, and to leave the stomach time to digest. A lot of meat and strong spices make the blood heavy and hot; live on a simple and mixed diet and do not reject our natural beverage: fresh water.

Do not load up your stomach in the evening with foods which are hard to digest, and which cause restless sleep and troubled dreams. Leave yourself time to eat, so that your nutrition can be processed more efficiently.

Do not cover yourself with heavy, full bedclothes; your mattress should rather be too hard than too soft.

Do not dress according to fashion, but rather in tune with the weather. Keep your feet and lower body warm. In snowy, freezing weather, thin tights and shoes are a crime against your health.

Fresh air has never hurt anyone; therefore ventilate your rooms well and leave a window open at night. Breathe in deeply, but shut your mouth when walking in the street in windy, dusty conditions; breathing through your nose will suffice.

Get your children used to the frequent use of water. Cold water improves resilience. Keeping your mouth and teeth clean will help to prevent infections.

Always remember that our health is our most precious possession, and do not first start to live prudently when it is too late.

Municipalities start getting real: The Social History of Housing from the mid 1800s

Part 2 on John Burnett’s A Social History of Housing 1815-1985 (Part 1 is here), about that period in the middle to late 1800s when municipalities started getting  real. But not too real, you understand, these are poor people we’re talking about. It did take a while to consider that their lives might carry more weight than the property rights of a wealthier person. It’s still a battle today after all.

So we are still (almost always) in the realm of speculative building, in a world on the cusp of some planning and regulation. It came slowly and piecemeal.

Quality of Speculative Building

Burnett quotes Henry-Russell Hitchcock here:

Workers’ housing in cities flowed out of the builders’ offices–if the more modest builders ever had proper offices–without benefit of any sort of serious designing. It was therefore something of a vernacular product, like the country cottages of the Middle Ages, although the analogy is one that must not be pushed very far. (87)

Ad hoc, local materials, built as they could very much depending on the builder and with little to no thought to infrastructure. Burnett gives Wolverhampton as an example — housing was tightly packed, water was from the most part still drawn from wells, being   piped in to only 1 in 9 houses by 1850. The sewage system was only laid down between 1869-1872. Burnett writes:

Like many other industrial towns at this period, Wolverhampton suffered from a lack of civic pride, a deep-rooted objection to interference with private property rights and an unwillingness of ratepayers to invest in the social overheads required by civilized life. (92)

I wonder about this idea of civic pride here, doubt whether such a thing has ever been widespread when it came with a price tag for unseen infrastructure with no naming rights in comparison to a library or fancy hall, but perhaps. There were certainly those who worked tirelessly to change these conditions. In this (as in some other less savoury things) Liverpool was a leader.

The Liverpool Act passed in 1846 set down regulations for houses, courts, cellars, effective sewering and draining. More importantly, perhaps, it appointed the 1st medical officer of health in the country — Dr W.H. Duncan. ‘These were the real and effective beginnings of housing reform in England‘ writes Burnett, and quotes an article in the Times:

A town of manufacturers and speculators is apt to leave the poor to shift for themselves, to stew in cellars and garrets, nor are landlords and farmers apt to care much for cottages…Something of a central authority is necessary to wrestle with the selfishness of wealth.

Yet by 1850 there still existed no such central authority. Local authorities increasingly took on the role themselves, though none as yet with a thought of themselves building housing. This period also saw the beginnings of building societies, the pooling together of savings to create the capital needed to build or buy homes (94).

Meanwhile conditions in the countryside were worsening for workers, another factor in the steadily increasing population pouring into the cities and already overcrowded slums. Burnett writes:

To read through the pages of the Official Reports of the 1860s is to journey through almost unbroken misery and wretchedness, relieved only rarely by brights spots where philanthropic landowners had erected a few neat, model cottages. In general, the accounts are of crazy, dilapidated hovels, many containing only one bedroom into which large families, grandparents and even lodgers were crowded indiscriminately, of whole families ill of fever and lying in the same room with a corpse, of holes in roofs and ceilings, damp walls, saturated floors and rooms filled, not by furniture but only by smoke. (127)

From the 1870s-WWI, the loss of the laborer from the countryside became a huge topic of discussion and cause for concern. It was felt country people were fitter than the townsman, and that keeping people in the country was needed for the maintenance of the national physique (!). I hate all of this language of the time, but it was quite a shock for wealthy people I suppose, when 40% of volunteers for the Boer war were rejected on medical grounds. It was felt that country air could have prevented that, but there was little decent housing and less opportunity. I am quite fascinated by how the rural question, tied in as it was to the idea of national fitness and Empire, became part of the push to build social housing:

Already, before that war had made ‘homes fit for heroes’ a political issue, it was clear to most informed observers that the rural housing issue could not be solved without the direct involvement of the state and a major commitment to public expenditure. Almost unconsciously the problem of the rural labourer had prepared the way for a state housing policy of infinitely greater scope and implication. (139)

But building rural housing could not solve it all either.

In the England of 1850 the industrial town was still new, untypical, its future problematic: by 1914 there could be no doubt that, for better or worse, England was an urban society–indeed, ‘the’ urban society of the western world–and that solutions had to be found to the manifold problems arising from a process which was no permanent and irreversible. (140)

The growing issues in the cities were also crying out for attention.

The removal, by whatever means, of overcrowding and slum living was already being seen as the necessary cure for disease, crime, prostitution and immorality, but the medical officers of health…knew only too well that demolition without re-housing only removed the problems elsewhere…. As early as 1874 the Royal College of Physicians, in which the medical officers were active, presented a remarkable petition to the prime Minister which condemned philanthropy, laissez-faire and ‘enabling powers’ as useless. Within a few more years, they were beginning to view overcrowding and the housing problem generally in a wider context — as part of the greater problem of poverty. (146)

Cities were also home primarily to renters — it makes you realise just how much has changed, and how much discourse and policy have naturalised home ownership. In fact home-ownership was not particularly attractive in Victorian England, even to well paid workers or the middle classes. At the end of the century, there were only 14000 owner-occupiers  ‘in the whole of the metropolis‘ which I assume means London. (147)

For the vast majority of people before 1914 the payment of weekly house-rent was normal, inevitable, and the largest single fixed charge in their budget. (147)

That said, he notes that middle classes were only paying 8-10 % of their budgets on housing, despite needing a great many rooms for large families and servants. The working classes paid more, US Commissioner of Labour estimated 11.8 % (found UK to be higher than France, Germany, Belgium and Switzerland but lower than the US), Joseph Rowntree 14.9%. But still, just imagine that.

Rent took second place to food, which most estimated ‘absorbed between half and two-thirds of all earnings’ (148). Leone Levi estimated it at 71% for workers, as compared to 44% among middle classes. Many housing reformers blamed people for not devoting more of their incomes to housing, and that would allow market forces to solve the problem of scarcity. Such bastards, but it also shows the power of this idea of the market.

Burnett provides the kind of curious detail on accommodation in London that I love — half the dock laborers occupied only one room with their families, 99 % of policemen had at least two. In St George’s-in-the-East half of all families in one room, in Battersea two-thirds of all families rented 3 or more, and earned more than 25s a week (150). Many of the poor remained in the centre despite high rents to be within walking distance of work, and the corners where casual workers used to pick up work.

There also a look at how the different tenure systems prevalent in cities affected who the landlords were — coming from America where the distinction between freehold and leasehold don’t exist, I find this quite fascinating. In towns where the leasehold system prevailed, landowners tended to be small businessmen, shopkeepers, pub owners. Of course, the owners of the land itself were of a different ilk all together. Where the freehold system prevailed, landlords seem to have been a (slight) step down, and there was not the sort of last minute trading that tended to happen in the last years before the lease on a property expired. So landlords were not greatly removed from the social backgrounds of their tenants. In Liverpool, landlords of working class housing owned between 6 and 8 houses each, a pattern widely repeated.

And slowly, slowly, things began to change. Following Liverpool’s 1846 legislation, Manchester prohibited cellar dwellings by local Act in 1853, and then in 1867 regulated room sizes, window areas and every new house with small private yard. Across the country, a growing number of such regulations focused on wider streets and yards, ventilation, better lighting.

The Sanitary Law Amendment Act of 1874 allowed Local Authorities to regulate paving and drainage, and the ventilation of rooms. The Public Health Act of 1875 allowed LAs to make by-laws regulating the layout, width, and construction of new streets and buildings and sanitary provisions. Two years later model by-laws were provided, and in 1858 considerably extended. While this allowed LAs to do more if they chose to, uptake very variable, and LAs could decline invoking them altogether. Still, they were implemented enough that much of the housing built between from 1880 to 1914 became known as ‘by-law housing’, criticised for its monotony and the way in which builders were building to the lowest standard.

Burnett gives one example of a proper two up two down, from Willis Street (no longer extant) in Salford. I love these charts of old plans.

Willis Street SalfordThere are more from Little Albert Street (also no longer extant) in Easton, Bristol. There is also an early photograph…

Albert Square Albert Square


At the same time, transportation was changing. Industrial villages became possible at further distances from manufacturing and outside of the central cities. Burnett looks at development of provincial cities — Nottingham, York (Looking forward to digging into Rowntree’s research on York), but slums continued. There is an amazing quote from Robert Blatchford on Manchester:

Where are the slums of Manchester? They are everywhere. Manchester is a city of slums. (175)

What ‘affordable’ housing there was, was being built by charitable societies, arguably only affordable to the very top tier of the working classes, and critiqued in design:

Considerable evidence was presented to the Royal Commission on the unpopularity of block tenements, due partly to the regulations and absence of sheds and workshops, but mainly, reported Lord Compton, because they were regarded as ‘a sort of prison: they look upon themselves as being watched.’ (178)

This is also the period of new models of employer housing: W.H. Lever’s Port Sunlight (Liverpool), George Cadbury’s Bournville (just south of Birmingham), Rowntree’s New Earswick (North Yorkshire). I’m hoping to get to each of these at some point.

And again it is Liverpool who is the first provincial city to embark on council housing, building St Martin’s Cottages built in 1869.

Slowly other cities began following their example. In London, the LCC actually created its own Architects’ Department: W.E. Riley director, Philip Webb, W.R. Lethaby. They represent perhaps the height of this phase of council building before WWI

not only beginning to evolve another physical ‘solution’ to the problem of urban housing, but one which had a concern for non-physical factors such as the visual effect of the development and the quality of life of the inhabitants. (186)

Still, it was never enough.

[Burnett, John (1986) A Social History of Housing: 1815-1985, 2nd ed. London and New York: Routledge.]

Burnett’s A Social History of Housing: the early 1800s

I quite loved A Social History of Housing by John Burnett. I’m still trying to get my head around quite what a difference the industrial revolution made to how cities and towns worked and looked like and were lived in, which requires a slightly dfferent periodization I think, but here we start in 1815.

A time of flux, the 1800s. Professionals (see, I’m not entirely sure who they are in 1815) are moving out of the centres. The houses they leave behind are being subdivided and becoming overcrowded, the poorest quarters. Outside city centres, housing was being built up in terraces, back-to-backs and courts in very unplanned way, ‘by considerations of immediate profit‘ (11).

There were, of course, a few exceptions where one landowner regulated what happened to development — many examples are up here in the North, I have been to them (and didn’t notice I confess!). There is Ashton-under-Lyne, where the Earl of Stamford included conditions about ‘good, firm and substantial build’ in the leases. Huddersfield, where Sir John Ramsden ‘enforced wide streets and “good, straight houses”‘ and Glossop, laid out by Duke of Norfolk in regular form and regulated ‘streets, avenues, passages, drains, sewers and other conveniences‘. (11) Most other such exceptions are to be found in London.

Architects were not involved in the activities of speculative builders or any kind of planning. Possibly the first example of when this changed was the work of Norman Shaw, who in 1876 designed the middle-class suburb of Bedford Park. I found a lovely lithograph of it:

Trautschold, Adolf Manfred (1882) The Tower House, Bedford Park, London

It’s in the V&A collection, and their description is quite nice too, tying it back to William Morris:

In 1874 William Morris imagined an ideal town where ‘people lived in little communities among gardens and fields, so that they could be in the country in five minutes.’ The realisation of this idea was Bedford Park, a suburban development funded by a socially minded entrepreneur and designed by several prominent architects. This print shows the Tower House and its surrounding garden. Bedford Park had an important influence on the Garden City Movement of the following decades. [2005]

Architects mostly simply added embellishments onto houses, and put all of their energies into designing larger more public buildings or country mansions. Thus is was speculative builders who have had the most influence really, using the cheapest materials to hand and designing with one finger in the wind of popular opinion on a desirable house, but with the main eye to profit.

Part of what I love about the book is how it looks at design and materials as much as anything else. Burnett notes that while brick came to dominate the trade there were also many restrictions.

[S]uitable brick-earth deposits were not widely diffused, fuel for firing bricks was scarce in many areas, and transport of the finished product over any great distance was difficult and costly. The result was that no one building material dominated…English house before the 19th century had been built of a wide variety of locally available materials. These included stone (either ‘dressed’ or ‘rough’ and supplemented with turves, furze or any mixture of available materials), timber (for building a frame, filled in with clay, wattle and daub, lath and plaster, or weather-boarding), and in areas where neither of these was easily available, like East Anglia, clunch and flint. (27)

He’s not much of a fan of these other forms, picturesque as he admits them he describes the living conditions as generally quite terrible.It’s interesting to compare his descriptions to those of Clough-Ellis of cob and chalk — admittedly fancier houses, but proof they could be kept clean and comfortable and warm, though it seems too often they were not.

This is also a book of both city and country — I love that too. The next chapter is on the country cottage. It has to start, however, with the enclosures, with people forced out of their cottages through all sorts of means — creating intense overcrowding in those that were left. Interesting how this was driven by desire for the land (greed you know), but also later by changes in poor rates after 1795  requiring parishes to support the ‘indigent’. This gave extra inducement to tear cottages down so families could not settle (greed you know). There grew a distinction between closed parishes, controlled by one (or two) landowners, who had torn all worker accommodation down, and open parishes inhabited by multiple small proprietors where all those evicted settled as an occasional labour force for the parishes where they could not live. This was noted as a problem in the amendment act of 1834 and became one of the political questions of the 1830s and 1840s.

Burnett catalogues the ‘general hierarchy of accomodation that was available to the working classes‘ (58). They are pretty grim.


Almost always, cellar-dwellings are described as dark, damp and airless, the abodes of the most feckless, improvident and intemperate sections of the population, and the sources of much of the dirt and disease which sullied the industrial towns. Very often they are equated with the period of Irish immigration from the 1820s to the 1840s, with the implication that cellars have not been used for habitation by the english worker until his standard of living was forced down by alien influence. (58)

Good examples are in Engels descriptions of Manchester and Flora Tristan’s of Oxford Street.


Intended primarily as very temporary shelter of a minimal kind, all too often they became permanent homes for the near-destitute and near-criminal classes and almist indistinguishable from a normal tenemented house except by their gross overcrowding and promiscuity. (62)

It’s a bit later, but Mary Higgs’ firsthand experience of these was fascinating.

Tenement House

Burnett writes that the line between tenement and boarding house thin and shaky, describes the rise of the rookeries, and he gives a list:

St Giles, Saffron Hill, Ratcliffe Highway, Jacob’s Island, Berwick Street (St James’s), Pye Street, Westminster in London. Oxford Rd, Little Ireland, Parliament St, ‘Gibraltar’ in Manchetser, Boot-and-Shoe Yard in Leeds, the ‘shambles’ behind Long Row in Nottingham, and areas in Durham, Newcastle, Gateshead and Barnard Castle. (64-65)

Some were old house, some new built, but

…in general, tenements were to be found in existing, and often old, houses which had once accomodated families of substance, if not affluence, but which had now sunk to rooming-houses of an infinite variety of respectability and disreputableness. They were part of the process of town decay. (65)


Burnett writes that all of the other forms of housing were ‘not specifically designed as such: they were strictly residual, left over and adapted from their original us as family dwelling for better-off classes, and because never intended for multi-occupation, necessarily lacking in the requisite amenities’ (70). But not back to backs, those were a new thing. He quotes Chadwick (who is actually quoting a Mr Mott) on just what these were:

An immense number of the small houses occupied by the poorer classes in the suburbs of Manchester are of the most superficial character; they are built by the members of building clubs, and other individuals, and new cottages are erected with a rapidity that astonishes persons who are unacquainted with their flimsy structure. They have certainly avoided the objectionable mode of forming under-ground dwellings, but have run into the opposite extreme, having neither cellar nor foundation. The walls are only half brick thick, or what the bricklayers call “brick noggin,” and the whole of the materials are slight and unfit for the purpose. I have been told of a man who had built a row of these houses; and on visiting them one morning after a storm, found the whole of them levelled with the ground; and in another part of Manchester, a place with houses even of a better order has obtained the appellation of “Pick-pocket-row,” from the known insecure and unsubstantial nature of the buildings. I recollect a bricklayer near London complaining loudly of having to risk his credit by building a house with nine-inch walls, and declared it would be like “Jack Straw’s House,” neither “wind nor water tight:” his astonishment would have been great had he been told that thousands of houses occupied by the labouring classes are erected with walls of 4t inch thickness. The chief rents differ materially according to the situation, but are in all cases high; and thus arises the inducement to pack the houses so close. They are built back to back, without ventilation or drainage; and, like a honeycomb, every particle of space is occupied. Double rows of these houses form courts, with, perhaps, a pump at one end and a privy at the other, common to the occupants of about twenty houses.

The later work of councils would be to tear all of them down.

‘Through’ Terraced Houses

For many town workers in the first half of the century the quality hierarchy ended here. For a minority…of skilled artisans, it extended to a higher level… the ‘through’ terraced house, with two ground-floor rooms and with light and and access at both front and back: it followed that there would also be some small area of private space–garden or yard–at teh rear of teh house with entrance from a continuous alley running behind the terrace. (77)

These were the direct descendant of the Georgian town terrace, and earlier groups of rural cottages

…the residents of divided houses and interior courts set back and screened form the main roads inhabited little, private worlds in which they shared space and amenities like water and privies in a communal way: their lives were more interdependent and more public, though separated from the mainstream of ‘progress’ by warrens of narrow passages, alleys and stairways. Such places were anathema to Victorian reformers who assumed, not always correctly, that they ineviatbly bred vice and criminality as well as dirst and disease. In the terraced house, on the other hand, the front faced the public street and was exposed to teh general gaze and attention: family life was turned inwards, towards the back room and the back yard or garden, usually separated from its neighbours by high brick walls. Private territory replaced public space, and as the terraced house spread in many towns in the sceond half of the century into the typical working-class dwelling, a new type of privatized family life developed, which was to be an important part of the social transformation of the Victorian age. (79)

Workshop Houses

These were just what they sound like. So on to who was building what and how, because the design of houses themselves only gives a taste of what it was like to live in them. As important is how they sat within the city.

Cities were in fact changing quickly, and government was being forced to respond. More on this exciting phase in part 2.

[Burnett, John (1986) A Social History of Housing: 1815-1985, 2nd ed. London and New York: Routledge.]

Sachs on The Age of Sustainable Development

sachs-sustainable-developmentThe Age of Sustainable Development by Jeffrey Sachs is a good, textbook sort of volume for what I believe to be the general consensus view of the totality of what we are up against, along with potential solutions from a liberal, Keynsian perspective. It is massive, as you might imagine.

Such a simple statement from the Rio Declaration, 1992 — such a basic place to start: “development today must not threaten the needs of present and future generations.” Such a massive failing of ours. The following summits moved to a more practical approach. The 2002 UN World Summit on Sustainable Development in Johannesburg looked to accomplish: “The integration of the three components of sustainable development — economic development, social development and environmental protection — as independent and mutually reinforcing pillars (WSSD 2002, 2).” (5)

Sachs adds good governance to this list, and sees this group of four pillars as complex systems — he explains:

sustainable development is also a science of complex systems. A system is a group of interacting components that together with the rules for their interaction constitute an interconnected whole… We talk about these systems as complex because their interactions give rise to behaviors and patterns that are not easily discernible from the underlying components themselves…. Complexity scientists speak of the emergent properties of a complex system, meaning those characteristics that emerge from the interactions of the components to produce something that is “more than the sum of its parts.” (7)

Thus the four complex interacting systems of sustainable development:

global economysocial interactions of trust, ethics, inequality and social support networks…Earth systems such as climate and ecosystems; and it studies the problems of governance… In each of these complex systems–economic, social, environmental and governance–the special properties of complex systems, such as emergent behavior and strong, nonlinear dynamic…are all too apparent. (8)

He is not one to discount the progress we have made or question capitalist foundations. I found it interesting that instead he outlines the history before and after the industrial revolution that has brought us into crisis. Before:

The world before 1750 was a world of poverty; one that could nonetheless produce beautiful treasures for human history, like the Egyptian pyramids, the Acropolis… Yet for all of those grand monuments, most people in most ages lived difficult rural lives, always on the edge of famine, disease, and early death. (73)


New technologies…were certainly vital, but many complex economic interconnections were needed as well. Rural areas needed higher food productivity to produce a surplus for the industrial workforce… Transport was needed to carry food from farms to industrial towns, and industrial goods such as linnens and apparel from the factories to the countryside. New ports and global shipping carried manufactured goods abroad as exports, to be traded for the primary commodities needed for industrial production. A worldwide supply system began to take hold. And these increasingly complex transactions required markets, insurance, finance, property rights, and other “software” and “hardware” of a modern market-based economy. (75)

This is such a curious reframing of past into a technological modernity. I honestly am amazed that anyone could argue that most inventors and scientists are in it for the money, but he does.

James Watts was after profits and the patent; his aims included intellectual property, glory, and riches. He was working in an environment in which he could succeed, because the beginnings of commercial law existed in England, as opposed to many other places on the planet where such property rights had not yet been recognized. (76)

Side note: Adam Smith published Wealth of Nations same year as Watt produced the modern steam engine — 1776.

Just to show he’s down with the left economists, if not the socialists, he quotes Marx and Engels in support of this view of historical progress.

The bourgeosie, by the rapid improvement of all instruments of production, by the immensely facilitated means of communication, draws all, even the most barbarian, nations into civilisation. The cheap prices of commodities are the heavy artillery with which it batters down all Chinese walls… (78)

He makes a distinction in this linear progression between endogenous growth and catch-up growth, unrecognised in much economic development theory:

The first is based on innovation; the second on rapid adoption and diffusion… (81)

I think political ecology has a whole lot to say about the politics of that small statement – about all of this. At least Sachs does acknowledge that most of Africa and Asia were held in stagnation by colonial powers, thus unable to even start trying to catch up. He also notes that the legacy of conflict and slavery in the Americas continues today, and the high rates of inequality around the world reflect a legacy of conquest. There is no questioning, though, of the beneficial nature of the economic growth emerging from these roots.

Modern economic growth began in the dark green temperate climate of England, and quickly spread to similar locations in North America, Australia, New Zealand, and the Southern Cone of South America (Argentina, Chile, and Uruguay)… We see that modern economic growth diffused not oly according to geographical proximity (distance from London) but also what we might call “climate proximity,” the similarity of a location to that of England. (117)

So to move on from how we got here to the crisis we face. I am happy, myself, to accept the science on the facts of climate change,  I think this is a great chart to summarise the multiple threats — what the Stockholm Resilience Centre calls planetary boundaries:


So I’ll move on to the social pillar, as I confess if the UN isn’t going to go full-on world-revolutionary-and-transformational, this is possibly as good as it gets.  So his definition of social inclusion:

aims for broad-based prosperity, for eliminating discrimination, for equal protection under the laws, for enabling everybody to meet basic needs, and for high social mobility (meaning that a child born into poverty has a reasonable chance to escape from poverty). (232-233)

Where does that exist I wonder? He continues:

… we must address the challenges of social inequality and human rights across several dimensions. Race, ethnicity, power, conquest, and individual characteristics are all determinants of inequality in society. So too are the political responses, the extent to which power is used to reduce inequality or the extent to which power is used to exacerbate inequalities. (238)

It’s got all the right words in it, you know? Sachs continues to list three of the fundamental forces behind widening inequalities in the

United States, several European countries, and many of the emerging economies around the world.

  • the rising gap in earnings between high-skilled and low-skilled workers

  • the increased use of robotics, advanced data-management systems, and other information technologies, which seem to be shifting income from labor to capital.

  • the political system, which in the United States has amplified the widening inequalities caused by market forces. (239)

He talks about deregulation, the weakening of unions, and throws in this chart on spectacular inequality:


So what is needed?

Education for All:

Yes. He describes the role for universities in:

helping society to identity and solve local problems of sustainable development … Every issue which which we are grappling — poverty, disease, climate change, new information technologies, and so on — requires locally tailored solutions, often based on sophisticated management systems. (273)

So top down. Ah well, he is an expert.

Health for all

Yes. It was way back in 1978 that World health officials adopted the Alma-Ata Declaration — universal health by the year 2000. (276)

We all know how that failed. Sachs can still celebrate the Millennium Development Goals developed that year though.

Food Security:

Yes. Achievable now, but political will? Sadly lacking.

The agricultural sector is in fact the most important sector from the point of view of human-induced environmental change. Many people imagine the automobile or perhaps coal-fired power plants to be the biggest cause of human-made environmental damage. And they are indeed major causes of global environmental unsustainability. Yet it is food production that takes the dubious prize as the most important single driver of environmental harms (SDSN 2013). (339)

Crazy. Another reason to support permaculture, or other locally based, minimal-footprint systems like Fukuoka‘s, or New Mexico’s acequia agriculture, which solve all kinds of problems while at the same time improving the planet rather than destroying it.

Another interesting chart:

greenhouse-gas-emissions-by-economic-sector-ipccAFOLU here stands for ’emmissions data from Agriculture, Forestry and Other Land Use (AFOLU)’ (342)

Instead of any minimally emitting and socially beneficial and extremely cheap systems, though, Sachs promotes more technology, more GMOs, making crops more drought resistant. Making crops more nutritious. All capital- and resource-intensive. And third, using ‘precision farming;.

Precision agriculture depends on information technologies, on detailed mapping of soil types, and often on global positioning systems that can tell a farmer exactly where that farmer is in the field and what is happening in the soil in that part of the farm. (351)

Soil mapping, testing, localized chemistry… Ugh. Nothing about environmental justice here either.

Resilient Cities

Ah, we turn to cities. Sachs gives a summary of the three major features of urban sustainability:

  • Urban productivity. Cities need to be places where individuals can find decent, productive work, and businesses can produce and trade efficiently. The basis for success is a productive infrastructure: the networks of roads, public transport, power … Infrastructure also includes “software,” like an effective court system to enforce contracts. When the urban infrastructure fails, the city is overwhelmed by congestion, crime, pollution, and broken contracts that impede business, job creation, and forward-looking investment.

Enforcing contracts? There will be no tampering with capitalism here, and cities are for business and development and trade.

  • Social inclusion. … (366) The social stability, trust, and harmony in the society (including political stability and level of violence) will be affected by the extent of social mobility. When it is low and falling, protest, unrest, and even conflict are more likely to ensue. Effective urban planning and politics can lead to cities in which people of different races, classes, and ethnicities interact productively, peacefully, and with a high degree of social mobility and trust. With ineffective planning, lack of civic participation, and neglect of social equity, cities can become deeply divided between rich neighbourhoods facing off against slums.

There is nothing here I disagree with actually, though I think a shift in the whole paradigm of effective ‘expert’ planners needs to happen before we can begin to create socially inclusive cities, never mind everything else that needs to happen.

  • environmental sustainability. … Cities need to make two kinds of environmental efforts. The first, mitigation, is to reduce their own “ecological footprint,” for example, the greenhouse gas (GHG) emissions caused by urban activities. The second, broadly speaking, is adaptation, meaning preparedness and resilience to changing environmental conditions, for example, rising temperatures and sea levels (for coastal cities). (367)

On Climate Change

Ah, the energy sector, such a money maker! 7 of the 10 largest companies in the world in 2013 as ranked by Global Fortune 500, are in the energy sector

1 – Royal Dutch Shell
3 – Exxon Mobil
4 – Sinopec Group
5 – China National Petroleum6 – BP
7 – China State Grid (396)

and then of course, 8 is Toyota, and 9 is Volkswagon — very closely related. I looked up the list for this year, not much has changed:

Fortune's Global 500 2016

The consequences of climate change are, of course, terrifying. There’s lots about that. And once again, Sachs’ solutions are more of the same — capital- and resource-intensive top down solutions that don’t really disrupt business as usual. He gives three. DESERTEC — a network of renewable energy production that links North Africa, the Middle East and Europe into a single grid (you can guess where most production happens, and where most consumption happens).


Second, to tap the wind power along the US coasts.

The third — finally destroying the Inga Falls in the DRC to build the great Inga Dam Project. Surely we can do better.

There is carbon capture, Sachs writes (and this is so damn revealing I think):

If carbon capture and sequestration (abbreviated as CCS) proves to be successful, then there is a wonderful way to reduce CO2 emissions without having to change out current technologies or energy mix! (431)

Yes! We can just keep on keeping on! That somehow really does seem to be the fatal flaw in all of this.

On to the loss of biodiversity. My heart breaks as we lose species after species. I suppose I care about the economic cost of that, but, actually, no. Not really.

So to summarise:

This chart is illuminating if nothing else…

ecosystem-services-and-wellbeing-wriIt sort of lays it all out there, at least. I will have to go to the source for a deeper critique, but I kind of hate one-way arrows.

At Rio 20+ there was a shift from MDGs (not achieved) to Sustainable Development Goals (SDGs). 10 of them proposed in 2013  by the UN Sustainable Development Solutions Network (SDSN) — there are now more.

Goal 1: End Extreme Poverty Including Hunger
Goal 2: Promote Economic Growth and Decent Jobs Within Planetary Boundaries
Goal 3: Ensure Effective Learning for All Children and Youth for Life and Livelihood
Goal 4: Achieve Gender Equality, Social Inclusion, and Human Rights for All
Goal 5: Achieve Health and Wellbeing at All Ages
Goal 6: Improve Agriculture Systems and Raise Rural Prosperity
Goal 7: Empower Inclusive, Productive, and Resilient Cities
Goal 8: Curb Human-Induced Climate Change and Ensure Sustainable Energy
Goal 9: Secure Biodiversity and Ensure Good Management of Water, Oceans, Forests and Natural Resources
Goal 10: Transform Governance and Technologies for Sustainable Development

The 17 SDGs now visible at http://www.un.org/sustainabledevelopment/sustainable-development-goals/:


He ends with a salute to Gandhi, Martin Luther King, Kennedy and the English Abolitionists. I suppose that is symbolic of this whole book given those last two were so flawed and highly problematic, yet none-the-less helped win some politically admirable goals. Some good stuff, and some not-so-good stuff all mixed together, very carefully, so as not to really shift any of the broader structures or the profits to be made from them, just share the dividends a little more equally. Until we all die as how can this really stop the environmental crisis already at hand?

[Sachs, Jeffrey D. (2015) The Age of Sustainable Development. New York: Columbia University Press.]