Geography Reference
In-Depth Information
warmed rooms, but led to indoor pollution. Outside the buildings the emissions of
gases and particles from coal fires often created choking fogs, full of particulates,
in damp, river valley environments subject to inversions, adding to the respiratory
risks. This was related to a sixth problem, the often dangerous working conditions
in mines and industrial plants, or even in home-based industries, which led to deaths
or injuries from machinery or various industrial processes, especially those that
gave off noxious fumes or by-products. A seventh problem came from the increase
and concentrations of poor people in the cities. Their poverty was due to the limited
wages and often intermittent work, which left most with limited means to buy nutri-
tious food, warm clothing or adequate shelter. Combined with poor hygiene it made
them more prone to disease. An eighth problem came from the limited medical
knowledge and access to it at the time. This was made worse by the reluctance of
many to embrace new ideas, while the poor had too little money to even get medical
assistance, unless it was from charity provided by church organizations. The effect
of these problems on the lower class in particular was calamitous, as seen in a de-
scription by Engels of the labouring classes who were:
… For the most part, weak, thin and pale. Their weakened bodies are in no condition to
withstand illness and whatever infection is abroad, they fall victims to it. Consequently they
age prematurely and die young. (Engels 1844 , pp. 118-119)
These descriptions by Engels and the more substantial works 50 years later by
Charles Booth (Pfautz 1967 ; Davies 1978 ), who produced detailed maps of the
degree of poverty in each street in London, district measurements of the degree of
social condition in major districts (Davies 1978 ), and seventeen volumes on the
conditions of life and work-places in the metropolis, identify many of what we now
call the social determinants of health. Only a few in these slum areas were able to
escape the environment within which life was lived, which created the milieu for ur-
ban ill-health and premature mortality, although conditions were better in the more
prosperous areas of well-built and maintained houses. Hence, the physical build and
social environment in which so many of the disadvantaged lived lay at the root of
their ill-health and early mortality.
13.3.2
Changing the Built-Environment of Cities
The work of Chadwick, the descriptions of novelists and social commentators, as well
as doctors such as Snow (Frerichs n.d.), in exposing these problems eventually led to
increasing political debate about the need to improve these environments (Berridge
and Gorsky 2012 ). Some of the pressure for change came from altruism, the view that
we are all humans and that the poor should be helped, a particular belief among Chris-
tian religious organizations. Also important in supporting built-environment changes
was the realization by many in the political classes that an unfit, weakened population
needed to be improved if the country was able to assert and defend itself by healthy
effective armed men. These reasons, plus what amounted to panic from the high
spikes of mortality, especially during the cholera outbreaks, also meant the better-off
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