Debunking Suburban Neurosis and the ‘mundane trap’ of the suburban villa

(This blog post was first published on this blog’s sister site, Towards Successful Suburban Town Centres, which centres on my suburban research with colleagues at University College London)

Prompted by a blog post by the Wellcome Trust on suburban neurosis and the Peckham Experiment, I’m jotting down here my own reading on this supposed illness. In the blog post, Giulia Smith points out that the Pioneer Health Centre (developed by Dr Innes Hope Pearse and Dr George Scott Williamson) was intended to ameliorate the prevalent ‘anxieties about the ability of low-to-middle-class mothers to raise their children by themselves in the privacy of their own houses’. These ideas were based on a hypothetical illness, suburban neurosis, which would mean that ‘unhappy mothers would be unable to produce happy, healthy offspring’.

The conception of suburbs as a mundane trap were widespread amongst the cultural elite. See for example George Orwell’s excoriating ‘A line of semi-detached torture-chambers where the little five-to-ten-pound-a-weekers quake and shiver, every one of them with the boss twisting his tail and the wife riding him like the nightmare and the kids sucking his blood like leeches.’[1]

suburban villa_image from MoDa
Image courtesy Museum of Domestic Design and Architecture, Middlesex University

Simultaneous with Orwell’s novel, came supposed medical confirmation that suburbs were bad for family stability and structure, and indeed for women’s health. A doctor from the Royal Free, based his The Lancet note, ‘The Suburban Neurosis’ on his work in in hospital’s outpatient department, claiming that a new group of ‘neurotics’ had come to his notice. ‘Less poverty stricken’ but worrying about money, with few friends and not enough to do or think about.

snip from Taylor_1938_1

What wonder that the underdeveloped, relatively poor mind of the suburban woman seeks an escape in neurosis…

And as long as life offers the suburban woman so little to live for, so long will she continue at last to pluck up her courage and add to the numbers in our out-patient waiting halls…

We have, I fear, let matters go too far in the jerry-building, ribbon-development line…

If the house can be disposed of, a flat near a few friends may work wonders.[2]

snip from Taylor_1938_2

Yet, as Judy Giles points out, escaping to the suburbs from the overcrowded and unsanitary conditions of their parents’ poverty was a sign of progress in which ‘modernity means a bathroom, an indoor toilet, and an ‘up-to-date drawer space’ (p. 49).[3]. Suburban modernity was embraced rather than spurned, though this is not to say that ordinary women too did not feel the same longings as modernist male literary elites.


Young housewife Bill Brandt
Young housewife, Bethnal Green, London, 1937. Bill Brandt (copyright Focus Gallery,

The diagnosis persisted for decades more, further reinforced by a study by Margot Jeffreys of a group of relocated East Enders, who moved into an out-London housing area South Oxhey, in the 1950s. In fact, ‘Jeffreys found ‘no definite symptoms of a higher incidence of a psycho-neurotic illness than women of the same age elsewhere’.[4] One of the authors of the suburban neurosis paper actually refuted it in 1964[5] and, as Mark Clapson has pointed out, many problems were attributable to initial settling in, coupled with high numbers of ill people at top of list for allocations to the area.[6] Nevertheless, a review of the literature today will find that suburbia and the New Towns are continuing to be being blamed for female neurosis, or its analogue: New Town Blues as distinct from the general phenomenon of moving home.

The Oxhey estate near Watford, built soon after 1950 to house people from inner London, had a rate of mental illness higher than the national average, despite having a good layout, greenspace within the estate and good access to Oxhey Woods … Possibly this is an early example of the “suburban neurosis” that has been widely reported from Britain’s New Towns.[7]

The above-quoted article is in fact associating poor mental health with a lack of social contact. There is some truth in this: social isolation (or loneliness – though they are not synonymous) can be as bad for you as smoking 15 cigarettes a day,[8] but the suburbs aren’t necessarily the cause of poor health per se. My new collaboration on the Loneliness and Social Isolation in Mental Health Research Network will hopefully shed some more light on the role of the built environment in this complex issue.


[1] Orwell, G. (1939). Coming Up for Air. London, Gollancz.

[2] Taylor, S. (1938). “The Suburban Neurosis.” The Lancet 231(5978): 759-762. Intriguingly, Taylor refers to the Pioneer Health Centre at Peckham as a model (though without the health facilities) for the sort of solution he offers: to establish a sort of club that would contain, under one roof, “a swimming bath and gymnasium, a cafeteria, a day nursery, the public library and reading, smoking and games rooms.”

[3] Giles, J. (2004). The Parlour and the Suburb: Domestic Identities, Class, Femininity and Modernity. Oxford, Berg.

[4] Jeffreys, M. (1964). Londoners in Hertfordshire. London: Aspects of Change. Centre for Urban Studies and R. Glass. London, MacGibbon and Kee. 3: 207-255.

[5] We found no real evidence of what one of us (Taylor) twenty five years ago described as ‘the suburban neurosis’, nor of what has more recently been described as ‘new town blues‘”. Taylor, L. and S. Chave (1964). “Mental health and environment.” Mental Health and Environment.

[6] Clapson, M. (1999). “Working-class Women’s Experiences of Moving to New Housing Estates in England since 1919.” Twentieth Century British History 10(3): 345-365.

[7] Douglas, I. (2005). Urban greenspace and mental health. Manchester, The UK Man and the Biosphere Committee (UK-MAB).

[8] Holt-Lunstad, J., et al. (2015). “Loneliness and social isolation as risk factors for mortality: a meta-analytic review.” Perspectives on Psychological Science 10(2): 227-237.

Living with Buildings – On Housing and Health

It was interesting to listen to the latest episode of Thinking Allowed, in which Laurie Taylor interviewed Iain Sinclair about his recently published book on the relationship between housing and health (Living with Buildings: And Walking with Ghosts – On Health and Architecture). As I wrote in Mapping Society, there is a long history of buildings and urban environments being blamed for the poor health of their inhabitants.  See for example the ‘Lung-Block’, a single block in New York that was found in 1906 to be riddled with cases of tuberculosis:

copy image MoL (1)

“Infection comes not only from the room, but as well from halls and stairways. An old Italian, a hopeless victim, sits out on the steps in front all day long in the sun, while the children play around him, and all through the evening, with men and women beside him. His cough never stops. The halls behind and above are grimy, offensive, lying heavy with cobwebs, and these cobwebs are always black. The stairways in the rear house are low and narrow, uneven, and thick …”[1]

copy image MoL (2)

The programme had a reading from just three years earlier, on the state of poverty in London, with Jack London writing of the disease prevailing amongst the destitute men crowding the surroundings of Christchurch Spitalfields. In fact, there is an even more apposite section in the same book, People of the Abyss, on the situation in Frying Pan Alley[2]:

“There were seven rooms in this abomination called a house.  In six of the rooms, twenty-odd people, of both sexes and all ages, cooked, ate, slept, and worked … In the adjoining room lived a woman and six children.  In another vile hole lived a widow, with an only son of sixteen who was dying of consumption.  The woman hawked sweetmeats on the street, I was told, and more often failed than not to supply her son with the three quarts of milk he daily required … And, what of the coughing and the sweetmeats, I found another menace added to the hostile environment of the children of the slum … My sweated friend, when work was to be had, toiled with four other men in his eight-by-seven room.  In the winter a lamp burned nearly all the day and added its fumes to the over-loaded air, which was breathed, and breathed, and breathed again.”[3]

copy image MoL (3)

Well into the twentieth century – and indeed in the twenty-first century, as the programme showed, buildings and cities continued to be seen as a source for physical malaise. Descriptions of the diseased body of the city have come to represent both a symbolic and a literal state of living in poverty, yet the precise causal association between urban living and urban disease remains elusive.

[1] Huber, J.B., Consumption, its relation to man and his civilization, its prevention and cure. c. 1906, Philadelphia: Lippincott. See also my earlier post on ‘The Lung Block’, here:

[2] See also the post on the Spitalfields Life blog:

[3] London, J., The People of the Abyss (2014 edition with original photographic plates; Introduction by Iain Sinclair). 1903 London: Tangerine Press. Quote from Gutenberg edition:

The Spatial Ecology of Yellow Fever in New Orleans, 1853

City of New Orleans, Louisiana in 1872. A steel engraving from a study by Alfred Rudolph Waud, engraved by D. G. Thompson and published in Picturesque America, D. Appleton & Company, New York, New York 1872, 1:265. Scanned from the book. From

Reading the Historical Geography Research Group’s summer newsletter led me (via a piece by David Beckingham) to look at an interesting moment in the history of medical cartography: a map by Dr. Edward H. Barton that was included in his “Report upon the Sanitary Condition of New Orleans” (part of the famous Report of the Sanitary Commission of New Orleans on the Epidemic Yellow Fever of 1853).

Caption: E. H. Barton’s Sanitary Map of New Orleans (1854) depicts “various nuisances and other causes” that he associated with yellow fever, cholera, and other diseases. Via Willoughby, 2018. This image was published by the New Orleans Sanitary Commission. This work is licensed under a Creative Commons Public Domain Mark 1.0 License.

As Stevenson (1965) points out, this actually wouldn’t qualify as a spot map of disease, nor does it fulfil the claim for “presenting the localization of all the cases of yellow fever of the year”, though it does show the general locality. Indeed, he points out that this would have been a graphic challenge, given that there were nearly 30,000 cases in that year. Yet the map is important for the history of social cartography for two reasons: First, it presents an apparent association between locale and the clustering of disease, showing (in glorious detail), the location of “various Nuisances and other causes affecting the Salubrity of the City. . . . ,” such as cemeteries, slaughter houses, “vacheries,” [“nasties”] livery stables, sugar depots on the levee, factories of various kinds, open basins and unfilled lots, canals, drains, and gas works, not omitting “fever nests” and crowded boarding houses. It also shows pavements of stone, plank roads, and unsurfaced streets, as well as regions where soil had been disturbed and overturned, alongside information on the seven ships that – it was thought at the time – were the source of the disease. Second, it provides evidence of an association between topography and spatial layout.

Detail of E. H. Barton’s Sanitary Map of New Orleans (1854) depicts “various nuisances and other causes” that he associated with yellow fever, cholera, and other diseases. The dark lines “indicate disturbances of the soil, as digging for Railroads, earth thrown from Canals, Drains, or Ditches, or buildings laying down pipes for water or gas,” and the checkered lines “indicate such Nuisances as Cemeteries … Markets, Sugar depots on the levee … Fever nests, [and] Crowded boarding houses.” Via Willoughby, 2018.
Barton’s report showed how a plague spot “exists here on the river bank, because at this season (August and September) the river is low and the bank exposed, leaving an extensive surface—the common receptacle of all kinds of filth—and here, or not far distant, we find the large amount of unacclimated population; but it [the disease] first breaks out and spreads in St. Thomas and Madison streets, St. Mary street, about the Markets, at the triangle, Gormley’s Basin, &c. Sec. . . . — all filthy, crowded and badly ventilated localities.” (quoted in Stevenson, 1965, 257-258)

According to the European Centre for Disease Prevention and Control, yellow fever is spread via Aedes (Stegomyia) aegypti, commonly known as the Yellow fever mosquito. It is a known vector of several viruses including yellow fever virus, dengue virus chikungunya virus and Zika virus. It thrives in densely populated areas which lack reliable water supplies, waste management and sanitation.

In fact, as Willoughby (2018) maintains, the construction of the city 300 years ago, which entailed draining the swamps and building flood walls against the Mississippi, shaped its landscape for the long term. In addition, massive demographic change that brought about a large influx of workers, including slaves, contributed to the emergence of New Orleans and its surroundings as a zone of yellow fever. The map featured above captured the city shortly after the most devastating epidemic of the disease, that killed nearly 15% of its inhabitants.

Barton was an anticontagionist – rather than supporting the idea of disease being spread through human contact – anticontagionists believed that contagion occurred due to the locale, namely – that the environment of the locale itself was blamed for the disease. (See full explanation in Gilbert, 2002). The local stench was supposedly a sign of this, though confusingly there was the added element of incomers (“foreign elements” bringing the disease with them via the ports. This was a theory that had barely progressed from Seaman’s yellow fever maps of New York, 1799 (see image below), which had similarly showed the apparent association between “the fever” and the port. Yet, the report is significantly more sophisticated, with detailed descriptions of sanitary conditions, along with tables of statistics.

Plate II from Seaman’s “An Inquiry into the Cause of the Prevalence of the Yellow Fever in New-York,” dated March 10, 1797. Medical Repository, 1 (1800, 2nd edition): 303-323 [Rare Books Collection]. Image via Historic Maps Collection, Princeton University Library © 2012  
The spatial ecology of the disease is clear from Barton’s report. What is saddening to note is the preponderance of cases having occurred close to the water, in low-lying areas. That same spatial patterning can be seen 100 years later in the redlining map of New Orleans, pictured below, which designated the districts by the water as being most at risk for defaulting from loans. It is no coincidence that the city surveyor coloured as red, namely “hazardous” vast tracts of areas inhabited by “Negroes”, who were spatially segregated from the white inhabitants of the city due to racial zoning laws from decades earlier. It is also a sad truth to find that the devastating effects of Hurricane Katrina in 2005 also disproportionately affected the city’s African Americans, still living in the flood plain 60 years after the city’s spatial patterns of poverty had been fixed on a map.

Redline map of New Orleans, c. 1935, showing the desirability, namely the risk of loan defaults, of making bank loans to property in the city. This is part of a national programme of assessing neighbourhoods in major cities in the US. Ranking was according to four grades A to D, colour coded as green, blue, yellow and red, respectively; hence redlining (in fact, red shading would be more precise). Image via  NATIONAL ARCHIVES CATALOG


Gilbert, Pamela K. 2002. The Victorian Social Body and Urban Cartography. In Imagined Londons, edited by P. K. Gilbert: State University of New York Press.

Stevenson, Lloyd G. 1965. Putting Disease on the Map: The Early Use of Spot Maps in the Study of Yellow Fever. Journal of the History of Medicine and Allied Sciences 20 (3):226-261.

Willoughby, Urmi Engineer. 2018. The Ecology of Yellow Fever in Antebellum New Orleans: Sugar, Water Control, and Urban Development. Environment & Society Portal, Rachel Carson Center for Environment and Society Spring 2018 (1).

See also: Chapter 2. Disease: The city as organism in Vaughan, L. 2018 (IN PRESS). Mapping society: the spatial dimensions of social cartography. London: UCL Press.