Urbanism and urbanization have played key roles in creating patterns of disease and death that characterize the stages elucidated by epidemiologic transition theory. The development of sedentary life that marks the onset of urbanism, is related to the first epidemiologic transition (Barrett et al. 1998). The impact of sedentism on population growth, dietary variability, and contact with domesticated animals (both wanted and unwanted) and on other factors, changed the profile of disease and death. Later, the development of intercontinental trade between relatively small urban populations spread local diseases as pandemics. It also created a large, networked population that could initially sustain chronic infectious diseases such as leprosy, and later, when population size and speed of trade allowed, of more rapidly spreading, acute community infections as well. By 1600, the common European urban pattern involved animal reservoirs of infectious disease in homes and markets; water contaminated by organic waste, graveyards and craft production (textile dying, tanneries, etc.); inadequate sanitation; privately owned water supply; inter-urban trade that funneled pathogens into the cities; and certain customs of dining and hygiene that probably helped to spread disease. Pestilence and famine were common.
The development of the industrial city attracted a large population from rural districts and created a concentrated population whose living and working conditions, food and water supply, sanitation and hygiene were completely inadequate to human well-being and were largely unregulated by government. Infectious diseases, including tuberculosis, cholera, typhoid, typhus, diphtheria, and pneumonia, were common causes of death. By the early 20th century, many cities were affected by government regulation of food and water supply, housing, working conditions, sanitation, and the health of children in schools (Burnett 1991; Haines 1991). In America and perhaps elsewhere, the commodification of hygiene contributed also....................
