Such efforts were a harbinger of urban planning reforms, as cities would take on the costly job of garbage removal and create sanitation departments over the next 50 years. These measures greatly improved residents’ health in the short and long term. They also added alleyways to cities, for garbage removal.
When contaminated water brought waves of cholera sweeping through the U.S. in the 1850s, cities across the country birthed the twin agencies of public health and urban planning to make and enforce regulations. In the same period, New York City’s Board of Health made way for Central Park — the nation’s first public park — on the premise that open urban space improved human and environmental health.
The park housed a reservoir designed to deliver fresh, clean water to the burgeoning city. It received water from one of the nation’s first great aqueducts.
For the first time New York’s housing development was planned, with growth attached to funding for sewer and water lines. By 1916, this patchwork of development directives was compiled into the U.S.‘s first citywide zoning code.
Since many Cairo neighborhoods rely on a Coptic Christian group called the Zabaleen to remove waste — which they later feed to pigs — the streets soon filled with garbage. Rat populations boomed. Typhoid, cholera and other diseases resurged.
Breaking airborne disease transmission requires reducing human-to-human contact through physical distancing and business closures, for example, and wearing masks to impede infectious droplets. Shelter-in-place orders, like those in place in all but eight U.S. states, prevent travel-related disease spread.
Because lockdowns are difficult to maintain over time, policymakers are searching for longer-term solutions.
This “selection pressure” theory explains partly why rural villages were hardest hit during the 1918 Spanish flu pandemic. Per capita, more people died of Spanish flu in Alaska than anywhere else in the country.
Pandemic-related urban policy advances like ceding more terrain to pedestrians or structurally addressing homelessness take time to emerge. My research identifies some reflexive denial early in an outbreak.
But, ultimately, American cities have triumphed over infectious diseases many times before. I’m hopeful we can do it again.