As cholera roared through London in 1854 and took the lives of approximately 10,000 of its residents, British physician John Snow mapped instances of the disease in one neighborhood and found a connection not to contaminated air, but to a public well contaminated by leaking sewage. That same year, Italian anatomist Filippo Pacini, isolated the bacterium that caused cholera, but it would be decades before the discovery was widely accepted. In the interim, raw sewage continued to overflow into the River Thames, and in the summer of 1858 it caused the “Great Stink,” an odor so repugnant it forced the closure of the Houses of Parliament and the construction of a modern sewer system that transported the city’s waste far enough away from London that the river’s tides took it out to sea. In addition, the muddy shorelines of the Thames were narrowed and replaced with embankments with riverside roads and gardens.Across the English Channel, Emperor Napoleon III came to power in France in 1848 amid a cholera outbreak that took the lives of approximately 19,000 Parisians. An admirer of the parks and garden squares of London, the nephew of Napoleon Bonaparte sought to remake Paris in the wake of the pandemic. “Let us open new streets, make the working class quarters, which lack air and light, more healthy, and let the beneficial sunlight reach everywhere within our walls,” he declared. Under the direction of Baron Georges-Eugène Haussmann, French authorities tore down 12,000 buildings, built tree-lined boulevards and parks, erected fountains and installed an elaborate sewage system that transformed Paris into the modern-day “City of Light.” “Haussmann’s plans were in part designed to bring fresh air and light into the dense urban grid, and were cited as such when inspiring the plans of Chicago and Washington, D.C.,” Carr says, “but it should also be noted that Haussmann’s long boulevards were also a convenient way to eliminate blighted housing, facilitate surveillance and deploy military quickly to all corners of the city.”

“His writing often references the importance of large open spaces to allow people to access fresh air and sunlight, and discusses how air could be ‘disinfected’ by sun and foliage,” Carr says. Planning for Central Park, which would be designed by Olmsted and Calvert Vaux, began in the immediate aftermath of New York’s second cholera outbreak. Thanks to the success of that project, Olmsted, whose first child had died of cholera, went on to design more than 100 public parks and recreation grounds including those in Boston, Buffalo, Chicago and Detroit.

Public health officials adhered to an idea dating back to the Middle Ages that infectious diseases were primarily caused by noxious vapors known as “miasma” emitted from rotting organic matter.

While garbage, animal manure and human waste flowed freely into drinking water sources, it was the pungent cocktail of odors they produced that many medical professionals blamed for spreading disease.

Chiefly, it drove massive infrastructural initiatives in emerging cities, such as the installation of underground wastewater systems.

This renewed integration is essential in restoring and enhancing the health and vitality of the nation's places and people.

Research has described some of the impacts of physical environments on the health and quality of life of persons with disabilities (13), residents of low-income housing projects (14), and older adults (15). In environmental health, data analysis of waterborne-disease outbreaks and extreme weather events indicates potential interaction between land-use patterns and risk for waterborne diseases (16). In an equally important area of environmental health---air quality and respiratory health---CDC staff used the unique "natural experiment" of the Atlanta Olympics to document a 42% decrease in acute asthma events among children that were attributable to reductions in automobile traffic and associated air pollution (17). Other impacts of the interdependence of urban planning and public health also have been demonstrated (Table 3).

social capital, neighborhood-level effects on health, housing and health, and clustering of fast-food establishments around schools

“There are ready-made houses and smaller buildings that can be put together like a package,” adds Woltjer.

Doing this avoids “pinch points”, a term for when lots of people are trying to use the same space and getting too close to each other in the process.

You may be able to deliver more social distancing if you pick certain streets that could be shut down,” he said.

“In 10 years, an estimated 20% of the world’s population will live in urban environments with a limited access to appropriate water, health, and sanitation infrastructures,”

therapeutic gardens

“a disorganised array of disconnected bedrooms and studios”

As these cities grew, outbreaks of typhoid and cholera became such major public health issues that they led to the construction of entire new sanitation systems: sewers.