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The Role of Urban Planning in the Spread of Communicable Diseases

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The Role of Urban Planning in the Spread of Communicable Diseases I have seen the greatest wonder which the world can show to the astonished spirit. - Poet Heinrich Heine on London, 18271 uring the 19th century, London emerged diseases such as obesity, diabetes, and heart Das a center of commerce and industry. disease, communicable diseases – infectious As the city urbanized, the population rapidly diseases that are transmissible by direct grew from one to six million residents. contact with an affected individual, through This unprecedented growth resulted in the individual’s discharges, or by indirect London becoming an “infamously filthy”2 means, such as a vector13 – make up seven city complete with cemeteries “bursting with of the top ten causes of death in low-income stinky corpses,”3 air filled with soot, and nations.14 An increasingly globalized world streets lined with feces.4,5 These concerns has opened all nations up to the possibility were not simply aesthetic; the dirt and filth of a deadly disease outbreak, even nations that defined 19th-century London caused that previously believed these communicable serious health complications, including the diseases to be eradicated. In this paper, I The Role of Urban spread of cholera.6,7,8 expand upon the impact our increasingly urbanized and globalized world has on the Three cholera epidemics struck London spread of the flu, diarrheal diseases, and Planning in the Spread of between 1832 and 1866, killing tens of Severe Acute Respitory Syndrome (SARS). thousands.9 Cholera can induce vomiting Additionally, I discuss how land use planning and diarrhea so severe that they lead to can increase the exposure and spread of Communicable Diseases dehydration, and death can occur within Ebola Viral Disease (EVD). By highlighting hours. During the early 19th century, the the unintended health consequences prevailing theory was that cholera was an of urbanization, globalization, and land Sam Henstell airborne disease that resulted from foul use planning, I will connect the urban Dual Master of Public Health and Master of Urban and Regional Planning 2020 odors.10 Physician John Snow – familiar environment to negative health outcomes to with the effects of gases through his studies show that urban planners need to take an on anesthetics – rejected this theory, active role in working to prevent the spread of hypothesizing instead that cholera was communicable diseases. spread through invisible germs in food or water. To prove this, Snow conducted a survey ABSTRACT of an infected neighborhood by drawing a th map outlining all cholera-related deaths, URBANIZATION 19 -century urban areas were defined by rapid population growth and industrialization that finding a water pump at the center of the created filthy living conditions and poor health outcomes. Despite dramatic improvements outbreak. Snow recommended the pump be Efforts to improve “pathogenic and to living conditions, cities remain a hotbed for the spread of communicable diseases. This removed, and the outbreaks ceased.11 Later, disorderly” cities inspired the fields of paper seeks to highlight planning processes and actions – with a focus on urbanization, it was discovered that the water was being both urban planning and public health.15 globalization, and land use planning – in order to show the impact urban planners can piped from a section of the Thames River Overcrowded housing conditions and poor have on preventing the spread of diseases including cholera, the Spanish Flu of 1918, contaminated with fecal matter.12 sewage infrastructure were just some Severe Acute Respiratory Syndrome (SARS), and Ebola Viral Disease (EVD). Cities would of the health-related conditions that not exist without the people who inhabit them; therefore it is imperative that city planners While the focus in high-income countries has inspired planners to come up with new prioritize the health of residents. shifted to the prevention and treatment of visions for cities. For example, Ebenezer 26 AGORA 13 27 I have seen the greatest wonder which the world can show to the astonished spirit. - Poet Heinrich Heine on London, 18271 uring the 19th century, London emerged diseases such as obesity, diabetes, and heart Das a center of commerce and industry. disease, communicable diseases – infectious As the city urbanized, the population rapidly diseases that are transmissible by direct grew from one to six million residents. contact with an affected individual, through This unprecedented growth resulted in the individual’s discharges, or by indirect London becoming an “infamously filthy”2 means, such as a vector13 – make up seven city complete with cemeteries “bursting with of the top ten causes of death in low-income stinky corpses,”3 air filled with soot, and nations.14 An increasingly globalized world streets lined with feces.4,5 These concerns has opened all nations up to the possibility were not simply aesthetic; the dirt and filth of a deadly disease outbreak, even nations that defined 19th-century London caused that previously believed these communicable serious health complications, including the diseases to be eradicated. In this paper, I The Role of Urban spread of cholera.6,7,8 expand upon the impact our increasingly urbanized and globalized world has on the Three cholera epidemics struck London spread of the flu, diarrheal diseases, and Planning in the Spread of between 1832 and 1866, killing tens of Severe Acute Respitory Syndrome (SARS). thousands.9 Cholera can induce vomiting Additionally, I discuss how land use planning and diarrhea so severe that they lead to can increase the exposure and spread of Communicable Diseases dehydration, and death can occur within Ebola Viral Disease (EVD). By highlighting hours. During the early 19th century, the the unintended health consequences prevailing theory was that cholera was an of urbanization, globalization, and land Sam Henstell airborne disease that resulted from foul use planning, I will connect the urban Dual Master of Public Health and Master of Urban and Regional Planning 2020 odors.10 Physician John Snow – familiar environment to negative health outcomes to with the effects of gases through his studies show that urban planners need to take an on anesthetics – rejected this theory, active role in working to prevent the spread of hypothesizing instead that cholera was communicable diseases. spread through invisible germs in food or water. To prove this, Snow conducted a survey ABSTRACT of an infected neighborhood by drawing a th map outlining all cholera-related deaths, URBANIZATION 19 -century urban areas were defined by rapid population growth and industrialization that finding a water pump at the center of the created filthy living conditions and poor health outcomes. Despite dramatic improvements outbreak. Snow recommended the pump be Efforts to improve “pathogenic and to living conditions, cities remain a hotbed for the spread of communicable diseases. This removed, and the outbreaks ceased.11 Later, disorderly” cities inspired the fields of paper seeks to highlight planning processes and actions – with a focus on urbanization, it was discovered that the water was being both urban planning and public health.15 globalization, and land use planning – in order to show the impact urban planners can piped from a section of the Thames River Overcrowded housing conditions and poor have on preventing the spread of diseases including cholera, the Spanish Flu of 1918, contaminated with fecal matter.12 sewage infrastructure were just some Severe Acute Respiratory Syndrome (SARS), and Ebola Viral Disease (EVD). Cities would of the health-related conditions that not exist without the people who inhabit them; therefore it is imperative that city planners While the focus in high-income countries has inspired planners to come up with new prioritize the health of residents. shifted to the prevention and treatment of visions for cities. For example, Ebenezer 26 AGORA 13 27 HENSTELL The Role of Urban Planning in the Spread of Communicable Diseases Howard incorporated population density spread of disease while also maintaining a quarantine themselves.25 Toronto was “a to prevent the spread of these diseases. and air quality in his comparison of urban sense of routine during a time of extreme city under siege,” completely unprepared The spread of EVD in the Democratic and country living in his famous book, crisis. and ill-equipped for a disease outbreak, Republic of the Congo (DRC) as the result of Garden Cities of To-Morrow.16 Clarence which resulted in both population and deforestation and infrastructure development Perry envisioned walkable neighborhoods economic loss.26 Living in a globalized society is one example of what happens when filled with parks and green spaces in his GLOBALIZATION ensures that the threat of transmission of disease transmission is not accounted for Neighborhood Unit model.17 And the City communicable diseases no longer occurs in the planning process. The DRC is an Beautiful movement, which focused on Increased urbanization made connections only at the local level but at the international incredibly biodiverse country, which makes civic grandeur and landscape architecture, between cities common, facilitating level as well. Planners often work to find it susceptible to the emergence and spread emerged in response to the “dirt and interregional trade. Techology and innovation creative solutions to emerging problems in of zoonotic diseases, but these diseases disorder” that characterized cities.18 during the 20th century also dramatically urban areas and have a unique opportunity to only spread to humans if they are exposed increased the scale, magnitude, speed, and prioritize preventing the spread of diseases to infected animals. Of particular concern is The advantages to living in urban areas (e.g., impact of social interaction across regions.21 such as SARS in their work. the traditional practice of hunting bushmeat, higher levels of social support, potential for As a result of the process of globalization, which includes non-domesticated animals political mobilization, and increased access cities that act as economic centers of the such as bats and monkeys that often live to resources) are now well-documented.
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