In Boston, in 1830, 1 in 48
" 1840, 1 in 45
" 1850, 1 in 38
" 1858, 1 in 41
It is probable that the ratio for the year 1858 showed somewhat more improvement even than appears from the above figures. The proportion is based on the population as ascertained in 1855. Up to 1858, the population was somewhat, though not greatly, increased, and any increase would serve to render the proportion in 1858 more favorable to the health of the city. But it was a year in which the number of deaths was less than it had been since 1850; it was, therefore, an exceptional year; and the change in the ratio of the deaths is, we fear, not the sign of the beginning of a progressive improvement.]
But more and worse than this is the fact, that in these two cities the average duration of life (and this means the material prosperity of the people) has of late terribly decreased. While out of every hundred people more die than was the case ten, twenty, thirty years ago, those who die have lived a shorter time. Life is not now to be reckoned by its "threescore years and ten." Its average duration in Boston is little above twenty years; in New York it is less than twenty years. [Footnote: In Boston, from 1810 to 1820, the average age of all that died was 27.85 years; in 1857, leaving deaths by casualty out of the calculation, it was but 20.63 years; in 1858, it was 21.76. In New York, from 1810 to 1820, it was 26.15; for the last ten years of which the statistics are known, it was less than 20.] Is the diminution of the length of life to go on from year to year?
This needless sacrifice and shortening of life, this accumulating amount of ill health, causes an annual loss, in each of our great cities, of productive capacity to the value of millions of dollars, as well as an unnatural expense of millions more. This is no figure of speech. The community is poorer by millions of dollars each year through the waste which it allows of health and life. Leaving out of view all humane considerations, all thought of the misery, social and moral, which accompanies this physical degradation, and looking simply at its economical effects, we find that it increases our taxes, diminishes our means of paying them, creates permanent public burdens, and lessens the value of property. An outlay of a million of dollars a year to reduce and to remove the causes of these evils would be the cheapest and most profitable expenditure of the public money by the municipal government. The principal would soon be returned to the general treasury with all arrears of interest.
The main causes of this great and growing misery are patent. The remedies for them are scarcely less plain. The chief sources of that disease and death which may be prevented by the action of the community are, first, the filthy and poisonous houses into which a large part of the people are crowded; second, the imperfect ventilation of portions of the city,—its narrow and dirty streets, lanes, and yards; and, third, the want of sufficient house and street drainage and sewerage. It is important to note in relation to these sources of evil, that, while the poverty of our poor is generally not such complete destitution as that of many of the poor in foreign cities, their average condition is worse. The increase of disease and mortality is a result not so much of poverty as of condition. "The pith and burden of the whole matter is, that the great mass of the poor are compelled to live in tenements that are unfit for human beings, and under circumstances in which it is impossible to preserve health and life."
To improve the dwellings of the poor, to make them decent and wholesome, is, then, the first step to be taken in checking the causes of preventable disease and death in our cities. This work implies, if it be done thoroughly, the securing of proper ventilation, sewerage, and drainage.
Most of the houses which the poor occupy are the property of persons who receive from them a rent very large in proportion to their value. No other class of houses gives, on an average, a larger return upon the capital invested in it. The rents which the poor pay, though paid in small sums, are usually enormous in comparison with the accommodation afforded. The houses are crowded from top to bottom. Many of them are built without reference to the comfort or health of their occupants, but with the sole object of getting the largest return for the smallest outlay. They are hotbeds of disease, and exposed to constant peril from fire. Now it seems plain that here is an occasion for the interposition of municipal authority. In spite of the jealousy (proper within certain limits) with which governmental interference with private property is regarded in this country, it is a manifest dereliction of duty on the part of our city authorities not to exercise a strict supervision over these houses. The interests which are chiefly affected by their condition are not private, but public interests. There are legal means for abating nuisances; and there is no reason why houses which affect the health of whole districts should not be treated in the same way as nuisances which are more obtrusive, though less pernicious. In some of the cities of Europe, in Nuremberg, for instance, there is a public architect, to whom all plans for new buildings are submitted for approval or rejection according as they correspond or not with the style of building suitable for the city. What is done abroad to secure the beauty of a city might well be done here to secure its health. Again, by legal enactment, we have prevented the overcrowding of our emigrant ships: the same thing should be done in our cities, to prevent the overcrowding of our tenement-houses. No house should be allowed to receive more than a fixed maximum of dwellers in proportion to its size and accommodations. These are simple propositions, but, if properly carried out by enactment, they would secure an incalculable good.
[Footnote: Since writing the preceding sentences, we have been gratified to see that a bill proposing the creation of a Metropolitan Board of Health has been introduced into the Legislature of New York. If the bill becomes a law, as we trust it may, the board will be invested with power "to enact ordinances for the proper government and control of buildings erecting or to be erected, … to compel the lessees or owners of dwellings to put the same in proper order, and to provide sufficient means of egress in case of fire." The New-York Evening Post of March 23, in giving an account of this bill, says,—and there is no exaggeration in its statements,—
"The nearly one million of souls of this great city are left to take care of themselves,—to be crowded mercilessly by landlords into houses without light, air, or water, and without means of egress in case of fire; and the street filth is allowed to accumulate till the city has become as the famous Pontine Marshes, to breathe whose exhalations is certain disease. All this results, as is proved by comparison with other cities, in the unnecessary loss of five thousand to eight thousand lives annually, and of many millions of dollars expended for unnecessary sickness, and the consequent loss of time and strength,—all of which might be saved, as they are actually saved in other and larger cities, by the application of sanitary laws by intelligent and efficient officers.
"And yet our Common Council are unmoved to apply the corrective, and the Legislature postpones action upon the numerous petitions of the people upon the subject. How long these bodies will be suffered to abuse the patience of our citizens we cannot tell; but the breaking out of a pestilence which shall sweep a thousand a week into the grave, and bring this city to financial ruin, will be but a natural issue of the present neglect. The Health Bill now before the Legislature has been prepared under the auspices of the Sanitary Association. Its provisions are sweeping; but the importance of the subject, the uniform filthy condition of our streets, and the wretched and unsafe condition of our tenement-houses imperatively demand changes of the most radical nature. The general provisions of the bill seem to cover the points most requiring legislation; and while in some of its details it could probably be improved, it is difficult to imagine that the present state of sanitary regulations could be made worse, and certain that the proposed reforms, if carried out, would be of great advantage."