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:

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“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]

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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]

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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:

Mapping Disease: Tuberculosis in Chicago, 1906

Last week we saw how a doctor in New York had sought to diagnose bad housing by mapping its morphological aetiology. Almost at the same time another doctor, this time in Chicago, made a comprehensive study of the incidence of tuberculosis in the Near West Side of Chicago. His report’s striking graphics, which show built form and land use alongside the mortality cases, were another step forward in using maps as a way to test hypotheses regarding the causes of contagious disease (Figure 1 and detail in Figure 2).

Figure 1: ‘Tuberculosis in a congested district in Chicago, Jan. 1st, 1906, to Jan. 1st, 1908, including the district represented in chart 1, population chiefly Jewish’ / by Theodore B. Sachs. Image credit: University of Chicago Map Collection


Figure 2: Detail of ‘Tuberculosis in a congested district in Chicago, Jan. 1st, 1906, to Jan. 1st, 1908, including the district represented in chart 1, population chiefly Jewish’ / by Theodore B. Sachs. Image credit: University of Chicago Map Collection


The spatial solution for disease in the ‘body’ of the city shifted over time. By the end of the nineteenth century, Charles Booth was advocating suburbanisation as the best solution to “the evils of over-crowding”, proposing a system of tramlines to provide easy commuting routes that would allow London to be broken up into suburban centres. These were to be constructed alongside a programme of widening thoroughfares, and the opening up of courts to allow for a battle to be fought against “the war with dirt, disease, and premature death.[i] At the same time in the United States, following the New York State Commission, other states picked up the issue of overcrowding, not only at building scale, but also at the scale of the lot or the block (in something of a recollection of the early Housing Acts of the city). In one example, a map of a Blind Alley in Washington and its associated report was explicitly attributing the lack of through passage as one of the causes of disease and crime in the city (see Figure 3).[ii]

Figure 3: The Blind Alley of Washington: seclusion, breeding, crime and disease


The ‘Blind Alley’ map was published in a ‘Directory of Inhabited Alleys in Washington’ from 1912, which was drawn up to allow for easy inspection of the alleys .[iii] The directory cites the death rate in the alley as exceeding the death rate in streets by a considerable degree, with the highest causes being pneumonia and tuberculosis. The solution is also outlined in the directory; it cites the relevant District Codes which will allow for the alleys and minor streets to be extended, widened or straightened for purposes of improving health. In fact, the subtle analysis of Alley Life in Washington by James Borchert refutes this argument, describing how rather than being hidden communities marked by immorality and disease’, the Black-American immigrants from the Southern states had made the most of the layout of street layouts such as these to reinforce internal communal ties, creating a reciprocal relationship of support.[iv]

Figure 4: Alley Life. Source: DC Public library via


By the end of the nineteenth century major advances in bacteriology meant that the biological causes of diseases, a long list of which includes tuberculosis, tetanus, dysentery – and the old enemy cholera – shifted  the focus from mapping disease to the new urban problem of the era: mass immigration. Not only was this seen to be intensifying poverty in urban areas, but was also coupled in the public mind with contagious disease, reaching its peak when outbreaks of yellow fever became associated with Chinese migration to major cities in Australia, the US and the UK. One striking example of how fear of contagion led to racialized mapping of San Francisco’s Chinese quarter will be look at in a later blog post. In the meantime, we will see next week the impact of race on motorcar ‘accidents’.

[i] Booth, C. Improved Means of Locomotion as a First Step Towards the Cure of the Housing Difficulties of London. Abstract of the Proceedings of Two Conferences Convened by Albert Browning Hall, Walworth. London: Macmillan, 1901, p. 23. Sources have his contemporary (General) William Booth, founder of the Salvation Army, advocating moving the poor from the filth and squalor of the slums to “a neat little cottage in the pure air of the country”

[ii] The map was published in Dr. Thomas Jesse Jones. “Directory of Inhabited Alleys of Washington.” Washington: Housing Committee Monday Evening Club,, 1912, p. 1. The scan from the directory is courtesy Jenny Schrader from her web log

[iii] Jesse Jones, 1912, p. 6.

[iv] Bochert, J. “Viewing the “Underclass” and Ghetto from the Top Down.” Journal of Urban History 25, no. 4 (May 1999 1999): 583-93, p. 2.