Water, Sanitation and Health in the first industrial society: Britain 1780-1930

第一个工业社会的水、卫生和健康：英国 1780-1930 年

• 批准号: ES/X00662X/1
• 负责人: Romola Jane Davenport
• 金额: $ 106.87万
• 依托单位: University of Cambridge
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2023
• 资助国家: 英国
• 起止时间: 2023 至 无数据
• 项目状态: 未结题
• 来源: https://gtr.ukri.org/projects?ref=ES%2FX00662X%2F1
• 关键词: Water; Sanitation; Health; first; industrial

Some of the greatest challenges associated with the growth of cities are the provision of safe water and the disposal of large quantities of faeces. Britain was the first society to industrialise and to achieve modern levels of urbanisation (with over half the population living in urban centres by 1851), and the slums of Victorian cities became emblematic of the health risks of rapid and unregulated urban growth. However Britain was also precocious in the development of clean water and sewerage, and the history of British reforms in public health has become a yardstick for sanitary improvements globally. While early histories of public health emphasised the importance of Edwin Chadwick's Health of Towns movement in the 1840s, more recent and influential accounts identify the 1870s as the point when towns were finally induced to provide clean water and sewage disposal, and when mortality rates from waterborne diseases fell decisively. However the available evidence (for England and Wales) suggests a much more complex picture. Falls in mortality from 'faecal-oral' diseases were not synchronised but varied markedly by disease, with the most lethal and water-dependent diseases (cholera, typhoid and dysentery) declining half a century before infant diarrhoeal mortality. Faecal-oral diseases also declined with a complex geography, falling first and fastest in the largest towns, but with similar timing and speed in other towns and in rural areas. The pattern in Scotland remains largely unexplored.This project seeks to reconceptualise the modern history of urban sanitation and health in the British context by disentangling the effects of different innovations and policies regarding water supplies and faecal disposal methods on mortality from specific faecal-oral diseases. Faecal-oral diseases differ markedly in their dependence on water, food, flies and domestic hygiene practices for transmission, and in their lethality. Much of the difficulty in understanding the uneven progress of the 'sanitary revolution' in Britain and globally has been due to a tendency to lump together different types of sanitary improvements and causes of death. Our study will analyse specific disease outcomes over a much longer period than is conventional (from 1780 to 1930) and this will make it possible to test whether industrialisation was associated with a rise in faecal-oral diseases, and whether early efforts to supply clean but unfiltered drinking water were sufficient to drive major falls in cholera and dysentery (which rely mainly on water-borne transmission), whereas improvements in infant diarrhoea had to wait for the adoption of comprehensive sewerage and in-house water supplies.Our study is novel because it takes a very long view of the history of faecal-oral diseases and water, sanitation and hygiene (WaSH) interventions; because it takes disease- and policy-specific approaches; and because it uses interdisciplinary and mixed methods. It is also the first study to take an integrated and comparative approach to developments across England, Scotland and Wales. We will use newly-created measures of public investment in specific measures (water supplies, sewage disposal and treatment) and of mortality from specific faecal-oral diseases to study how local governments responded to perceived problems, and under what circumstances their efforts were effective. Our approach combines statistical modelling with detailed case studies and archival research to understand both what happened, and why.The project will challenge the conventional narrative of the 'sanitary revolution' in Britain and replace it with a much more nuanced account of the struggles British towns faced that will provide a more realistic and informative comparator for WaSH programmes in poor populations today. The project will produce a range of economic and demographic datasets for academic use as well as school teaching materials and publicly available death rates.

与城市发展相关的一些最大挑战是提供安全饮用水和处理大量粪便。英国是第一个实现工业化并实现现代城市化水平的社会(到1851年，超过一半的人口居住在城市中心)，维多利亚时代城市的贫民窟成为快速和不受管制的城市发展带来的健康风险的象征。然而，英国在发展清洁水和排污系统方面也是早熟的，英国公共卫生改革的历史已经成为全球卫生状况改善的标尺。虽然早期的公共卫生史强调了19世纪40年代埃德温·查德威克的城镇健康运动的重要性，但更近、更有影响力的记载认为，19世纪70年代是城镇最终被诱导提供清洁水和污水处理的时间点，也是水源性疾病死亡率决定性下降的时期。然而，现有证据(针对英格兰和威尔士)显示的情况要复杂得多。“粪口”疾病死亡率的下降不是同步的，而是因疾病而明显不同，最致命和依赖水的疾病(霍乱、伤寒和痢疾)在婴儿腹泻死亡率之前半个世纪下降。粪口疾病也在下降，地理位置复杂，在最大的城镇下降最快，但在其他城镇和农村地区下降的时间和速度相似。苏格兰的模式在很大程度上仍未被探索。该项目试图通过理清有关供水和粪便处理方法的不同创新和政策对特定粪便-口腔疾病死亡率的影响，重新定义英国城市卫生和健康的现代历史。粪-口腔疾病在依赖水、食物、苍蝇和家庭卫生做法传播以及致命性方面有明显不同。人们很难理解英国和全球“卫生革命”的不均衡进展，这在很大程度上是因为人们倾向于将不同类型的卫生改进和死亡原因混为一谈。我们的研究将分析特定疾病在比常规时期(1780年至1930年)更长的时间内的结果，这将使我们能够测试工业化是否与粪口疾病的上升有关，以及早期提供清洁但未过滤的饮用水的努力是否足以导致霍乱和痢疾(主要依靠水传播)的大幅下降，而婴儿腹泻的改善必须等待采用全面的下水道和内部供水系统。我们的研究之所以新颖，是因为它着眼于粪口疾病的历史和水、卫生和卫生(洗涤)干预措施；因为它采取了针对疾病和政策的方法；因为它使用了跨学科和混合的方法。这也是第一次对英格兰、苏格兰和威尔士的发展采取综合和比较的方法的研究。我们将使用新制定的具体措施(供水、污水处理和处理)公共投资和特定粪口疾病死亡率的指标，研究地方政府如何应对感知到的问题，以及在什么情况下他们的努力是有效的。我们的方法将统计建模与详细的案例研究和档案研究相结合，以了解发生了什么，以及为什么会发生。该项目将挑战传统的英国“卫生革命”叙事，取而代之的是对英国城镇面临的斗争的更微妙的描述，这将为当今贫困人口的洗澡计划提供一个更现实、更有参考价值的比较对象。该项目将制作一系列供学术使用的经济和人口数据集，以及学校教材和公开可用的死亡率。