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.
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.
There are more from Little Albert Street (also no longer extant) in Easton, Bristol. There is also an early photograph…
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.]
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:
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. 
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)
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)
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)
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.]
The 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 economy … social 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.
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:
AFOLU 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)
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:
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…
It 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.]
The Spirit Level marshals all the evidence — for those who needed such evidence — that inequality has a huge negative impact on everyone in a society, the rich as well as the poor. But especially the poor. There is of course, a minimum level of security and income which human beings require. Many do not enjoy such a level. But for those who do, it still isn’t enough to guarantee a full and happy life:
Economic growth, for so long the great engine of progress, has, in the rich counties, largely finished its work. Not only have measures of wellbeing and happiness ceased to rise with economic growth but, as affluent societies have grown richer, there have been long-term rises in rates of anxiety, depression and numerous other social problems. (5-6)
This is good book full of evidence that it is the degree of equality in a country which leads to longer, happier lives and a stronger society.
Poverty itself is a bit of a slippery concept if you think too hard, I liked this quote from Marshall Sahlins:
Poverty is not a certain small amount of goods, nor is it just a relation between means and ends; above all it is a relation between people. Poverty is a social status . . . It has grown . . . as an invidious distinction between class . . . (Stone Age Economics, quoted p 15)
Poverty as a relationship — it makes sense that this relationship is what matters above the bare minimum required for life.
Their graphs are simple, direct — only as good as their data of course, but that is well documented…This one is from p 20 and p 174, so good they showed it twice!
The best indicator for the whole gamut of health and social problems in rich countries is not poverty, but the difference between rich and poor. Reduce inequality, and you should see marked improvements in all of them.
How Inequality Gets Under the Skin
I read this over the summer, but it’s weird going back over my notes after Trump’s victory, especially reading things like this:
The growing rates of anxiety in the U.S. are very depressing indeed, yet they correlate to more aggressive declarations of self worth.
The answer turns out to be a picture of increasing anxieties about how we are seen and what others think of us which has, in turn, produced a kind of self-promoting, insecure egotism which is easily mistaken for high self esteem (36).
I’m always a little skeptical how we ascertain how society is changing us more broadly, but this rings true. Still, it is hard to analyze the water in which you’ve grown up in. They connect these kinds of psychological anxieties with inequality, and then tend to almost conflate the two in trying to explain the correlation between inequality and many of the social ills and illnesses examined as the multiple indicators of health and wellbeing.
Part 2 — The Costs of Inequality:
So for the great list of indicators:
Mental health and drug use
One of the things they cite is Oliver James on the
‘affluenza’ virus…is a “set of values which increase out vulnerability to emotional distress”, which he believes is more common in affluent societies. It entails placing a high value on acquiring money and possessions, looking good in the eyes of others and wanting to be famous. (69)
Interesting, depressing, you can see how hard this would be to live up to.
Physical Health and life expectancy
They cite more than 40 papers on the links between health and social capital have now been published. (See M.K. Islam, J. Merlo, I Kawachi, M. Lindstrom and U.G. Gerdtham, ‘Social Capital and health: does egalitarianism matter? A literature review’, International Journal for Equity in Health (2006) 5:3.)
Increasing social capital and reducing inequality improve health across the society, just throwing more money at it doesn’t. Probably because most of that money doesn’t actually go towards health, as in the US, but towards corporate profits, but that’s another story I suppose. Looking at this chart and realising that of all these countries the US is the one that doesn’t actually provide universal healthcare despite the obscene of money going into healthcare makes some sense of the outcomes, and makes you feel sick at the same time. Sadly, there’s no cure for that other than some serious structural changes. Like all of this really.
Obesity: Wider income gaps, wider waists — correlates to inequality.
Educational performance — correlates to inequality.
Teenage births: recycling deprivation — correlates to inequality.
Violence: gaining respect — correlates to inequality.
They note that inequality is ‘structural’ violence, and statistically it matches up with…inequality. Again, they connect this inequality with the anxieties that emerge from our unequal society:
…increased inequality ups the stakes in the competition for status: status matters even more. The impact of inequality on violence is even better established and accepted than the other effects of inequality. (134)
Imprisonment and punishment — inequality
I’ve read lots about the crazy amounts of incarceration in the US, The New Jim Crow is miles and away better than this summary. But one fun fact
In California in 2004, there were 360 people serving life sentences for shoplifting. (147)
Jesus wept. And of course, there is this on p 148:
I have to note that in many of these charts I couldn’t initially find the US because it is so often alone up at the top…This chart makes me sick too.
Another brief note they make, there is so much to dig into here but it’s interesting:
In societies with greater inequality, where the social distances between people are greater, where attitudes of ‘us and them’ are more entrenched and where lack of trust and fear of crime are rife, public and policy makers alike are more willing to imprison people and adopt punitive attitudes… (155)
Social mobility: unequal opportunities — inequality
This is so geared towards statistics and policies, digging through data more than into experience, but every now and then they drop into higher theory, like Bourdieu writing about ‘the actions by which the elite maintain their distinction symbolic violence…’ (164) I had forgotten he wrote about this, this book underlined for me the very strong connection between inequality and violence, inequality as violence, and how that underpins everything else.
Part 3 — a better society
I appreciated that they ended The Spirit Level with some thoughts bringing everything back together, and from there thinking through what change is possible. There was some interesting things on the racial divides in the US, and again and again this book underlines that while the poor suffer from inequality most, really it is everyone who suffers. Maybe that will have some impact? Though it doesn’t seem to have had yet…
in the USA, state income equality is closely related to the proportion of African-Americasn in the state’s population. The states with wider income differences tende to be those with larger African American populations. The same states also tend to have worse outcomes…among both the black and the white population. The ethnic divide increases prejudice and so widens income differences. the result is that both communities suffer…
So the answer to the question as to whether what appear to be the effects of inequality may actually be the result of ethnic divisions is that the two involve most of the same processes and should not be seen a alternative explanations. The prejudice which often attaches to ethnic divisions may increase inequality and its effects. Where ethnic differences have become strongly associated with social status divisions, ethnic divisions may provide almost as good an indicator of the scale of social status differentiation as income inequality. (179)
It is interesting to look at how the numbers brought Pickett and Wilkinson to these findings that are more often found elsewhere. Again and again the message — inequality hurts the poorest most, but it negatively impacts everyone. Reducing inequality benefits everyone. Evidence also suggests it should make rich countries care more about reducing the terrible inequalities between countries — little sign of that despite how desperately — perhaps even more desperately — that is needing recognition, but the more arguments made the better. This is just a building block in working towards ensuring equality remains on the agenda.
There’s a whole section on ‘can this be done?’, can we create more equal societies, but honestly. They themselves make the point that some countries have done it already.
systems of material or economic relations are systems of social relations. (199)
So what is their solution? They look to worker owned business, cooperatives, give example of Tower Colliery, where miners successfully took over pit operation, combining redundancy money to buy the pit in 1995, for 15 years until seam was mined out. They also, in the bigger picture, argue for what they call a steadd health: does egalitarianism d by economist Herman Daly. (220) I’ll have to look more into this and always prefer to start with the source, so to just finish up with some of their final findings.
Evaluations of even some of the most important services, such as police and medical care, suggest that they are not among the most powerful determinants of crime levels or standards of population health. Other services, such as social work or drug rehabilitation, exist to treat — or process — their various client groups, rather than to diminish the prevalence of social problems. (233)
even more damning, this is my personal favourite sentence:
Rather than reducing inequality itself, the initiatives aimed at tackling health or social problems are nearly always attempts to break the links between socio-economic disadvantage and the problems it produces. The unstated hope is that people — particularly the poor — can carry on in the same circumstances, but will somehow no longer succumb to mental illness, teenage pregnancy, educational failure, obesity or drugs. (234)
So really this is an economic and a political problem, they write
The historical evidence confirms the primacy of political will. (238)
Behind this lack of political will? Multiple reasons of course, one being the decline of the trade unions — their decline in power has itself made possible a great deal of this growing inequality. There’s also the fact that many corporations have bigger economies than many a nation state. They quote the UN Conference on Trade and Development (UNCTAD):
Twenty-nine of the world’s 100 largest economic entities are transnational corporations (TNCs)… On the 200 TNCs with the highest assets abroad in 2000, Exxon is the biggest in terms of value added ($63 billion). It ranks 45th on the new list, making it comparable in economic size to the economies of Chile or Pakistan. Nigeria comes in just between DaimlerChrylser and General Electric, while Philip Morris is on a par with Tunisia, Slovakia and Guatemala. (244)
Small wonder they walk with such big sticks. Small wonder higher levels of equality should be so hard to achieve, despite the improvements it makes to everyone’s quality of life.
Part 2 on Urban Sprawl and Public Health looks at potential interventions and theories that can help reduce the impact of sprawl (read part 1 here). For authors Howard Frumkin, Lawrence Frank, and Richard Jackson, hope lies in the new strategies being put forth under the terms Smart Growth and New Urbanism, arguing for Smart Growth at least as a public health strategy. I have a lot of issues with New Urbanism and Smart Growth as they are so often removed from issues of equity and spatial justice, but it’s interesting to think of how to rebuild and rework our cities as part of a plan around improving health.
They trace a lineage of people working on the connections between health and cities — Dr. John Henry Rauch (1828-1894) in Chicago arguing for land use policies to improve public health, cemeteries at a remove from dense neighborhoods being one of them. Frederick Law Olmstead, and garden cities. Edwin Chadwick working sanitary regulations, housing standards, public water and sewage systems in the UK, Thomas McKeown at Birmingham, who
showed that many of the health advances of the nineteenth and twentieth centuries resulted not from better medical care, but from ‘upstream’ improvements such as better urban infrastructure–better housing, neighborhoods, water, food, and transport. (203)
They also name psychiatrist Leonard Duhl, who has looked at connecting mental health with urban design and community involvement. His ideas have been broadened by physician Trevor Hancock. In 1987, the World Health Organization jumped on the bandwagon, initiating a Healthy Cities Network, which I confess I had never heard of.
There are of course many who could be added to this list, and in the UK at least you have the Marmot Review among others, trying to move health care providers to think more broadly about wellness and how it connects to social and environmental factors.
So…to return to the strategies they promote, we start with Smart Growth. The Environmental Protection Agency itself formed the Smart Growth Network in 1996 together with a number of other nonprofits and governmental organizations. The Networks’ ten Smart growth principles (the whole document ‘Getting to Smart Growth: 100 Policies for Implementation’ can be found here):
1. Mix land uses
2. Take advantage of compact building design
3. Create a range of housing opportunities and choices
4. Create walkable neighborhoods
5. Foster distinctive, attractive communities with a strong sense of place
6. Preserve open space, farmland, natural beauty, and critical environmental areas
7. Strengthen and direct development towards existing communities
8. Provide a variety of transportation choices
9. Make development decisions predictable, fair and cost effective
10. Encourage community and stakeholder collaboration in development decisions
The book goes on to give a more elaborate set of principles in full…they’re interesting, so I do the same — the full text can be found here:
All planning should be in the form of complete and integrated communities containing housing, shops, work places, schools, parks and civic facilities essential to the daily life of the residents.
Community size should be designed so that housing, jobs, daily needs and other activities are within easy walking distance of each other.
As many activities as possible should be located within easy walking distance of transit stops.
A community should contain a diversity of housing types to enable citizens from a wide range of economic levels and age groups to live within its boundaries.
Businesses within the community should provide a range of job types for the community’s residents.
The location and character of the community should be consistent with a larger transit network.
The community should have a center focus that combines commercial, civic, cultural and recreational uses.
The community should contain an ample supply of specialized open space in the form of squares, greens and parks whose frequent use is encouraged through placement and design.
Public spaces should be designed to encourage the attention and presence of people at all hours of the day and night.
Each community or cluster of communities should have a well defined edge, such as agricultural greenbelts or wildlife corridors, permanently protected from development.
Streets, pedestrian paths and bike paths should contribute to a system of fully connected and interesting routes to all destinations. Their design should encourage pedestrian and bicycle use by being small and spatially defined by buildings, trees and lighting; and by discouraging high-speed traffic.
Wherever possible, the natural terrain, drainage, and vegetation of the community should be preserved with superior examples contained within parks or greenbelts.
The community design should help conserve resources and minimize waste.
Communities should provide for the efficient use of water through the use of natural drainage, drought tolerant landscaping and recycling.
The street orientation, the placement of buildings and the use of shading should contribute to the energy efficiency of the community.
The regional land use planning structure should be integrated within a larger transportation network built around transit rather than freeways.
Regions should be bounded by and provide a continuous system of greenbelt/wildlife corridors to be determined by natural conditions.
Regional institutions and services (government, stadiums, museums, etc.) should be located in the urban core.
Materials and methods of construction should be specific to the region, exhibiting continuity of history and culture and compatibility with the climate to encourage the development of local character and community identity.
The general plan should be updated to incorporate the above principles.
Rather than allowing developer-initiated, piecemeal development, local governments should take charge of the planning process. General plans should designate where new growth, infill or redevelopment will be allowed to occur.
Prior to any development, a specific plan should be prepared based on the planning principles. With the adoption of specific plans, complying projects could proceed with minimal delay.
Plans should be developed through an open process and participants in the process should be provided visual models of all planning proposals.
Of course, in years of community work around development, I have never seen anything actually work like this.
walkable neighborhoods, a range of housing choices, a mix of land uses, participatory planning, revitalization of urban neighborhoods (206)
They talk about some of the critiques. They come from wildly different directions…
the public doesn’t want it
it limits consumer choice — it’s a form of coercive social engineering
can exacerbate traffic congestion by creating greater density
smart growth projects are isolated enclaves, not integrated
encourage gentrification (213)
Then go on to look at a public health approach to Smart Growth. It’s a very different perspective though concerned with all of the same things. They begin with constructing a community health assessment — paralleling the medical assessment. One method they believe has great promise is the Health impact Assessment, as a way to measure the health benefits from a Smart Growth approach. Nor is it surprising that many of the potential indicators would be the same as for sustainability — transit ridership, percentage of population living within ten minutes of a park, incidence of asthma, extent of recycling. (217) A few useful checklists exist already that could serve, one is the Built Environment Site Survey Checklist in London (this is news to me, this BESSC).(218)
I like how numerous things are coming together — concerns for the health of individuals and communities and neighbourhoods, issues of sustainability and the health of the land and environment. I think, again, there’s a lot more to think about in terms of equity. People’s own power in the process is always the first thing to go — if it ever was on the table. The cold hard facts of development and politics are not amenable to such things, so progress has been made where it helps certain kinds of development become more marketable. But criticism to come…
Urban Sprawl and Public Health — a great book! It was amazing to see urban planning and public health brought together in this way — a solid primer on both for each, along with a plea for professionals to start working together to fix this. Because sprawl is killing us.
I myself would throw in a soupçon of sociologists and geographers and community organizers to the health and planning mix as well, because what was missing? More analysis on the nature of development and how the drive for profit drives this urban form, more analysis on the struggle of everyday people to fight for and against some of these dynamics, and the ways in which race and land have long been linked (but there is more of this second aspect than in many another book). Still, despite these critiques, I confess that few things get me going the way that talking about the city and health in the same book do.
Health & Sprawl facts:
In the last 15 years, the US has developed 25% of all the land developed in the past 225 years of its official existence. (xii)
Between 1960 and 2000, average American’s yearly driving more than doubled — 4,000 to nearly 10,000 miles per years. “rush hour” spread over seven, not 4 and a half, average driver’s time spent stuck in traffic each year: 6 to 36 hours in Dallas, 1 to 28 hours in Minneapolis, 6 to 34 in Atlanta. (xiii)
Sprawl — a term from William H. Whyte! Did I know that? He wrote an article for Fortune in January 1958, titled ‘Urban Sprawl’. There are a variety of definitions and measurements of sprawl, here they follow those that incorporate both land use and transportation as intrinsic. They focus on four main aspects — density, land use mix, automobile dependence and connectivity (or how destinations are linked through transportation systems (7). (5)
I particularly like how much they use illustrations, this is a good one:
I also liked the ‘transect’ — a look at the continuum between sprawl and compact neighbourhoods (16)
Chapter 2 looks at the origins of sprawl, and it is based almost in its entirety on Kenneth Jackson’s Crabgrass Frontier. So it summarizes the multiple factors that have lead to spraw, and it is a very long list. He heads it with the pull of the suburbs and the (European) cultural values Jackson believed underlay that pull — domesticity, privacy and isolation (28). In addition you have land ownership as a mark of wealth and status, alongside (partly driving perhaps, but I’m a cynic that this drove development rather than sales) a love of land itself and antipathy toward cities. (29) The Garden City movement feeds into this, embodied by Frederick Law Olmstead, along with the new technologies and construction methods and lots of cheap land (no mention of conquest here of course). There is a little here on the willingness of cities to spend taxes on providing infrastructure like roads and sewers — directly subsidising this kind of development as opposed to improving older neighbourhoods or public housing. The rise of the automobile and destruction of public transportation. The rise of zoning. The HOLC and the FHA, federal policy and money going towards new housing for whites (I do wish, though, that they had read Freund).
Still, I like the simplicity of their conclusions though:
Sprawl, as we know it today, appears deceptively chaotic. In fact, it is a highly ordered and predictable form of development. An edifice of public and private instruments erected over the past three-quaters of a century reinforces and extends sprawl. (42)
There is a little on financing here, and that real estate financing now works on an expectation of profits within 5-7 years — more built-in obsoleteness. I wish they had connected this to Harvey’s ‘spatial fix’ but that’s complex I guess. This is my field though, and this is a good summary.
Urban health is not my field, though I have a good deal of practical organising experience on the subject.
Frumkin et al compare the evolution of urban health with public health through ‘epidemiologic transition’ — and these titles really do inspire the SF writer side of my brain: The Age of Pestilence and Famine, The Age of Receding Pandemics, and where we are now: The Age of Degenerative and Man-Made Diseases. In cities, infectious diseases once dominated, but sanitary infrastructure ended that to a great extent. But industrialisation introduced pollution, and mental health and violence are not forgotten here, with growth in poverty, social dislocation and crime. (45)
From a public health perspective, the critical problems that grew as cities did were: garbage, commercial activity (tanning and other nasty things), sewage, water, air, and housing. (46)
An interesting aside:
In New York, Assemblyman Aaron Burr [founding father and profiteer] obtained a charter for the Manhattan Company, a private firm that was to hold a monopoly on piped water for the next quarter of a century. (51)
Privatised water is nothing new. Nor are the images from Jacob Riis in How the Other Half Lives. My family for example, hanging out with the other half in Pittsburgh, probably looked much like this, though they were never in this particular alley.
The Results: A Plethora of Infections
Their heading, not mine. I had not read of the yellow fever epidemics that swept through Washington D.C. — as President Washington fled in 1793 leaving over 5,000 dead, or over ten percent of the city’s population. (55)
The book quotes a citizen group in Philly writing:
if the fever shall become an annual visitant, our cities must be abandoned, commerce will desert our coasts, and we, the citizens of this great metropolis, shall all of us, suffer much distress, and a great proportion of us be reduced to absolute ruin. (56)
Cholera, Typhoid…Cities in these early days were ‘incubators of infectious disease’ (57)
Now this is Pittsburgh just as my great-grandparents were arriving:
But slowly this would change…
During the nineteenth and twentieth centuries, as sanitary challenges were met and as industrial pollution was managed, the toxicity of cities–the factors that most threatened residents’ health and well-being and even helped drive migration out of the cities–came overwhelmingly to revolve around social circumstances. (61)
The heading for this section is ‘The Social Pathology of City Life’. (61)
during the nineteenth and twentieth centuries, as sanitary challenges were met and as industrial pollution was managed, the toxicity of cities–the factors that most threatened residents’ health and well-being and even helped drive migration out of the cities–came overwhelmingly to revolve around social circumstances. (61)
The urban crisis — it is interesting, perhaps a little troubling how the social is here linked with the epidemiological, but I am often troubled by the public health gaze at poverty. Foucault was too, so I’m in good company. The book here notes the riots of the Red Summer of 1919 — yet it doesn’t distinguish these horrifying white killing sprees where literally hundreds of people were murdered with ‘riots’, what inhabitants themselves described as ‘uprisings’ in protest of police brutality and living condition in Watts in 1965, LA again in 1992 and etc (62).
It is interesting to consider the ‘urban health penalty’, however:
a complex of environmental conditions such as deteriorating housing, inadequate access to nutritional food, and scant medical care, and health consequences such as untreated hypertension, cardiocasvualr disease, intentionala dn unintentional injuries, and infectious diseases. (63)
Interesting to read of a 1990 article in New England Journal of Medicine showing that men in Harlem had lower life expectencies than in Bangladesh.* They write:
A literature of urban health arose, focusing on these conditions and how to provide health care to the victims. (63)
From here on to the nitty gritty.
I like this chart:
‘As the model illustrates, land use patterns affect each category of athropogenic emmissions–their location, their quantity, their dispersion in the air, and how people are exposed. (66)
And a summary of what air quality means for health:
Air pollution threatens human health in four principal ways. The two most important are by increasing mortality and by threatening respiratory health. In addition, air pollution can damage cardiovascular function and increase cancer risk. There is evidence for some other health effects as well. (80)
The ‘epidemic’ of obesity must be well known to anyone doing community work, or even who just reads the paper.
Being overweight is itself a well-established risk factor for a number of diseases. people who are overweight die at as much as 2.5 times the rate of non-obese people, and an estimated 300,000 Americans die preventable deaths each year as the result of being obese. (96)
So sprawl obviously has some share of this, creating environments where no one walks. Where it is dangerous to walk even if you wanted to, and there were somewhere to go. What features of the environment help people become more active?
Frank, Engelke and Schmid** identify three dimensions of the built environment…. land use patterns, design characteristics and transportation systems. (99)
Pikora et al*** expand on this, primarily in area of design — functional factors, safety factors, aesthetic factors and destination factors. So — a mix of different land uses, availability of sidewalks and footpaths, enjoyable scenery, the presence of other people in the space being physically active, safety.
Fucking rocket science, this is.
Injuries and Deaths from Traffic
Holy Jesus, this will make you never want to get in a car again. Over 40,000 people a year die by automobile. (110)
Water Quantity and Quality
So, you got your microbial contamination of water, your chemical contamination. You have your water scarcity. Sprawl affects all of these — thus the section titled ‘The Hydrology of Sprawl’. The rain falls, it percolates through foliage, roots and soil — cleansing itself as it does — to recharge groundwater and the water table. About half of us drink water from surface sources, and the other half from groundwater. My family drank from groundwater once, now we’re on a list, because it was contaminated. But that’s a longer story.
Forested areas are best at capturing and cleaning water, paved streets and rooftops, as you can imagine, fail completely. It all becomes chemical and pollutant-rich run-off. They give a view of what development’s effect is on this process:
The stormwater runoff from suburban development contributes to microbial contamination as it ‘includes large loads of waste from pets and wildlife and nutrients from such sources as fertilizers’. Heavy runoff also carries sediment, these can protect dangerous bacteria like giardia as they sit in filters and drains. And then you have your further suburbs using wells and their own septic systems. The final way is unexpected — the continued growth of suburbs means the focus is on building new infrastructure, not repairing and cleaning out the old, which desperately need it. So our own pipes and things are poisoning us.
The chemical contamination is more obvious I think, all the toxic things we uses every day as well as those deposited by cars and exuded by factories all get swept into the water supply as well.
this is good to see here, I think it is left off of such analyses far too often. They remind us that sprawl is partly caused by a desire to get away from the city, into nature, into all that is good for mental health. Yet this is only one aspect of the suburbs — possibly offset by highways, sameness, box stores, speed, large scales, and just the amount of time people spend driving.
There is a whole of information on just how bad for us driving is. How it increases stress, makes us angrier. Studies on road rage. All of these things could, most likely do, contribute to morbidity.
This comes from community. They define such a sense of community as a
“feeling that members have of belonging, a feeling that members matter to one another and to the group, and a shared faith that members’ needs will be met through their commitment to be together.”**** There are four aspects of this sense of community: membership, influence, integration and fulfillment of needs, and shared emotional connection. (161)
They look at the many ways community psychologists, human ecologists, and sociologists have talked about community and social capital, but much of it is based on Robert Putnam’s Bowling Alone, so I won’t go on too much more here except for the ways it affects health. I’ll be dealing with Putnam too. Everyone quotes him.
Research has focused on two broad aspects of the social environment: structural features and social support. Structurally, people look at the density of relationships and extent of social networks. Social support is described as the the amount of emotional support (and other kinds?) in times of need (166. In a nutshell: People with strong social networks live longer. Lots of studies confirm it (you can see the Marmot Review on the UK). (166) The same correlations hold true for social capital.
Sprawl, on the other hand, tends to to diminish both networks and capital in several ways:
Cars have much to do with this, the amount of time people spend driving restricts free time for civic engagement.
sprawl ‘reduces opportunities for spontaneous, informal social interactions’ (173)
‘sprawl privatizes the public realm’, people who spend all their time at home don’t value public space, green space, suburban voters almost always vote to limit government programs with social goals or for public transportation
sprawl divides people into homogenous communities.
sprawl disrupts continuity of life as people age — can’t move into smaller house in the same neighbourhood (173)
1998 report from the Transit cooperative Research program found that ‘sprawl weakens households’ connection both to their immediate neighbors and to the larger metropolitan community. (174)
But it turns out that some sprawl better than others — the built environment and design can affects this, so there is some hope. But this first post is on all that is wrong, the second on what can be made right…
Health Concerns of Special Populations
I do like that there is focused attention on how sprawl impacts different groups, acknowledging that the costs of it are not even. There is a long list…Given that women are usually doing most of daily chores and chauffeuring of kids, the burden falls disproportionately upon them.
Children breath more rapidly, have narrower airways — thus pollution has much more impact on them than on adults. The lack of physical activity affects them more — and yet when they are physically active in polluted areas, it is more dangerous for them. Part of childhood is exploration of the world and the self away from parents — yet we have built spaces where that is not safe, impacting the mental health and development of kids. They are isolated, and don’t have the wealth of networks and adults watching out for them that a health community might have.
The elderly, too, are severely impacted. Communities that aren’t walkable require cars — so people drive long past the time they should not. Elders are isolated, unable to exercise, unable to have meaningful connections that improve their health and quality of life. This is often also true for those who are disabled. How dare we create cities without sidewalks.
Then, of course, there are the poor and people of colour. A reprise here for HOLC and FHA regulations, the racism that confined people into inner cities (I don’t think they quite realise how prevalent this continues to be). The steady concentration of poverty and its related health impacts in areas of higher pollution. The disparities of race in class so visible in health and morbidity statistics.
The connections are multiple and strongly evidenced. Enraging really. I like that they don’t stop there, but include a final chapter on possibilities for changing our cities and our future. That will follow in the next post.
*McCord C., Freeman, H. Excess mortality in Harlem. New England Journal of Medicine 1990; 322: 173-179.
**Frank, Engelke and Schmid (2003) Health and Community Design: How Urban Form Impacts Physical Activity, Washington D.C.: Island Press.
*** Pikora, T et al (2003) Developing a framework for assessment of the environmental determinants of walking and cycling. Social Science and Medicine 56: 1693-1703
You had your Greeks and Romans writing about health and concocting new medicines, but I confess until Krakow’s Museum of Pharmacy I had not heard of Christ, the Heavenly Apothecary. It was quite a thing:
Yet also a rather rare and not-much-discussed thing, as I discovered to my cost trying to puzzle out the not-very-crisp photographs of these paintings which I blithely assumed I could easily find on the internet. Here it states this idea of Christ as Apothecary was first introduced into Western Art in 1610 by, I believe, Michael Herr of Wurttemberg, and 140(ish) examples are known to exist in the form of stained glass, frescoes, paintings in shrines and monasteries and more. I also found a rather lovely early article on the subject by E. Kremers from 1910, called appropriately ‘Christ the Apothecary’, at that time there were only about ten known about.
Not until reviewing my pictures did I realise quite how awesome the paintings were in the museum, and how rich in meaning and how hard it would be to find more information on the web. I was a bit overwhelmed, I think, by stoppered bottles and beautiful wood and stuffed bats and dried mummies. So I have a few shots, too few, and the descriptions are sadly hit and miss. What I wouldn’t have given for a book in English! These were two of my favourites:
These are Saints Cosmas and Damian, twin brothers who trained as physicians in Arabia, worked in Turkey and were martyred in Syria. Here (unlike elsewhere) they are portrayed as Black.
I failed signally to document the artist or title of the picture above. Below, however, are two graphite retorts for dry distillation (high temperature, no air). This were contemporary with Michał Sędziwój (Michael Sendivogius), famed Polish alchemist who published treatises on alchemy distributed across Europe. Such experiments provided the basis for many new medicines. This is a painting by Jan Matejko showing Sędziwój carrying out experiments for King Segismund III — pulling out a nugget of gold from the fire no less — he had his own room in Wawel Castle, which momentarily made me more inclined to go see it (later, the line for tickets disinclined me).
Below is a picture from a memoir (Memoir! Amazing! but I can find nothing about this) of apothecary Eglinger (1608-1675) of Basel, using a heavy mortar and pestle, it’s use made easier through the rigging up of a bow string. That woman is possibly the goddess of fortune pouring things through the horn of plenty into his concoctions. It could maybe also be his wife I’m thinking, but I’ve no basis for that.
This is one of my other favourites as its title is ‘The Death of Credit’. The character on the far right is an apothecary, sadly I would only be inventing things if I told you quite what this picture meant or who painted it or when.
Again, for the picture below I have neither title nor artist, but this is a good painting of the days when apothecaries pulled out teeth. I would not wish those days back again.
Yet another picture in which I have failed to capture the title or artist, but look, it is a very old apothecary with people in hats I associate with the Renaissance behind the counter and shelves full of bottles…
Apothecaries are also found sitting sedately on embossed metal:
Their craft immortalised in stained glass:
And in statues
I have signally failed to educate myself or you about the precise nature of these paintings or what precisely can be learned from them, however.
Again, the line between alchemist and apothecary was once very fine, and the things once used to create medicine were wondrous indeed. Many also suspicious, invented, disgusting. And far too many argued as aphrodisiacs.
Of course there were herbs, wondrous herbs. The smell in the attic of Krakow’s wondrous Pharmacy Museum was amazingly pungent and sweet.
Dragon’s Blood, sadly only a combination of powdered plants with astringent qualities:
Mandrake, not a screaming homunculus pulled from the earth, but a funny shaped root:
Herbs, roots, flowers, leaves, seeds were not the only things used in medicines, however. Clay and other minerals dug from the earth such as lazurite, orpiment, sulphus, chalcanthite, and talc were also used. Here is cinnabar for treating wounds and ‘women’s problems’, and today used for acne — I love these intensely coloured powders.
Hematite powered and used to cleanse wounds and to treat blood diseases. Copper sulfate good for scars, and for its antibacterial properties.
Skinks! Dried and ground they became a ‘panacea’ for many things, and the old aphrodisiac standby…
Powders of scorpions, snakes and lizards — powdered cockroaches, crab’s stones, powdered oysters, sea sponges, musk, earthworm oil and leeches were also of course in use:
Castor, or the powdered glands of beavers — look at that picture! A stimulant, antispasmodic, good for hysteria from sexual causes…
Spermacetti, or sperm whale oil…
‘Unicorn horn’, powdered, good as a universal antidote and of course, an aphrodisiac. Really, narwhal of course, or anything approaching powdered horn…
Powdered horn, and ivory looks just like it, tusks of walrus and hippopotamus…once believed a universal cure and aphrodisiac:
Bezoars! found in the stomachs of ruminants, they look very cool but are really just hollow spheres made up of fur and undigested plant remains. But I still love imagining them as universal cures…
Spanish flies, whose smell alerts you to their presence, who blood causes painless blisters. Crushed they were used as a diuretic, but more famously as an aphrodisiac and older form of viagra — but you had to be very very careful you didn’t get it wrong…
Human scalp made into a panacea — also collected and used were human fat, ox bile, bull’s blood, and calf’s stomach.
Dried lizards, coral and pearls:
Pharmacists were also apparently the principal makers and purveyors of candles and sealing wax until the 18th century, as wax was another key ingredient in ointments and plasters. I loved this way of making them:
And of everything, perhaps this was the most incredible…Multiple use laxative pills of antimony. Crikey. You had to swallow — retrieve — clean — repeat.
Suddenly I realised it is not just the rows of bottles and jars, the mysterious names in Latin, but also the colours, smells, madness of what they held within them. The dreams they represent of cures for everything, of magic in the form of a powder or oil or pill. The intellectual endeavour they also represent, to explore the world and uncover what within it can ease our way through life and improve the days and years we are given. I owe so much to medicine as we know it, and its origins are here in these bottles and in this lore drawing on centuries of experimentation and learning.