Tag Archives: health

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:

Nuremberg

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

Nuremberg

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.

Cellar-dwellings

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.

Lodging-Houses

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)

Back-to-Backs

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)

After:

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:

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:

1239554_10151840591376668_467263772_n

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).

desertec-map_revised_vfin

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/:

screen-shot-2016-09-14-at-16-51-05

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.]

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The Spirit Level — Can we just get on with greater equality already?

The Spirit LevelThe 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!

screen-shot-2011-07-03-at-11-25-56-pm

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
p 67. reproduced at http://thestandard.org.nz/wp-content/uploads/2010/09/spirit-level-5-620x465.jpg
p 67. reproduced at http://thestandard.org.nz/wp-content/uploads/2010/09/spirit-level-5-620×465.jpg

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.

img_7485

  • 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:

homicides

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.

Another truth;

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.

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Sprawl, Health, and creating better cities through Smart Growth

Urban Sprawl and Public HealthPart 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:

Community principles

  1. 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.

  2. Community size should be designed so that housing, jobs, daily needs and other activities are within easy walking distance of each other.

  3. As many activities as possible should be located within easy walking distance of transit stops.

  4. 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.

  5. Businesses within the community should provide a range of job types for the community’s residents.

  6. The location and character of the community should be consistent with a larger transit network.

  7. The community should have a center focus that combines commercial, civic, cultural and recreational uses.

  8. 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.

  9. Public spaces should be designed to encourage the attention and presence of people at all hours of the day and night.

  10. Each community or cluster of communities should have a well defined edge, such as agricultural greenbelts or wildlife corridors, permanently protected from development.

  11. 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.

  12. Wherever possible, the natural terrain, drainage, and vegetation of the community should be preserved with superior examples contained within parks or greenbelts.

  13. The community design should help conserve resources and minimize waste.

  14. Communities should provide for the efficient use of water through the use of natural drainage, drought tolerant landscaping and recycling.

  15. The street orientation, the placement of buildings and the use of shading should contribute to the energy efficiency of the community.

Regional Principles

  1. The regional land use planning structure should be integrated within a larger transportation network built around transit rather than freeways.

  2. Regions should be bounded by and provide a continuous system of greenbelt/wildlife corridors to be determined by natural conditions.

  3. Regional institutions and services (government, stadiums, museums, etc.) should be located in the urban core.

  4. 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.

Implementation Principles

  1. The general plan should be updated to incorporate the above principles.

  2. 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.

  3. 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.

  4. 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.

The authors look at how this compares/ overlaps with New Urbanism and its principles (see the Congress for the New Urbanism for more…):

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…

  1. the public doesn’t want it
  2. it limits consumer choice — it’s a form of coercive social engineering
  3. can exacerbate traffic congestion by creating greater density
  4. smart growth projects are isolated enclaves, not integrated
  5. 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…

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Urban Sprawl and Public Health

Urban Sprawl and Public HealthUrban 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)

On Sprawl

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:

"Source:
Source: Drawing by Duany Plater Zybek as shown in F. Spielberg, ‘The Traditional neighborhood Development: How will traffic Engineers Respond?’ ITE Journal 1989 (59) 17-18

I also liked the ‘transect’ — a look at the continuum between sprawl and compact neighbourhoods (16)

Transect 03-03-03" width="1572" height="530" class="size-full wp-image-7010" /> Source: Image courtesy of Duany Plater-Zybec and Company (2003) Transect 03-03-03
Source: Image courtesy of Duany Plater-Zybec and Company (2003) Transect 03-03-03

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

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.

Bandit roost (59 Mulberry Street in New York City), Jacob Riis 1888
Bandit roost (59 Mulberry Street in New York City), Jacob Riis 1888

 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)

it continues

Cholera, Typhoid…Cities in these early days were ‘incubators of infectious disease’ (57)

Now this is Pittsburgh just as my great-grandparents were arriving:

1890s, Pittsburgh, Pennsylvania, USA --- Smokestacks from factory in Pittsburgh, Pennsylvania, belch black smoke into the atmosphere, 1890s. --- Image by © Bettmann/CORBIS
1890s, Pittsburgh, Pennsylvania, USA — Smokestacks from factory in Pittsburgh, Pennsylvania, belch black smoke into the atmosphere, 1890s. — Image by © Bettmann/CORBIS

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.

Air Quality:

I like this chart:

IMG_5598

‘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)

Physical Activity:

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:

Schematic view of water balance before and after development -- Center for Watershed Protection
Schematic view of water balance before and after development — Center for Watershed Protection

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.

Mental Health

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.

Social Capital

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:

  1. Cars have much to do with this, the amount of time people spend driving restricts free time for civic engagement.
  2. sprawl ‘reduces opportunities for spontaneous, informal social interactions’ (173)
  3. ‘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
  4. sprawl divides people into homogenous communities.
  5. sprawl disrupts continuity of life as people age — can’t move into smaller house in the same neighbourhood (173)
  6. 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

**** McMilland and Chavis
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