Illnesses in Gilded Age and Progressive Era

Through most of the nineteenth century, as American cities became more

industrialized, infectious illnesses became a legitimate concern. Industrialization spurred

urban migration from rural areas in both the United States and Europe, resulting in the growth

of towns into cities. The rising demand for low-cost housing by urban migrants resulted in the

construction of substandard dwellings that did not offer appropriate facilities for personal

hygiene. The influx of new immigrants and the expansion of big metropolitan centers during

nineteenth century facilitated the spread of illnesses that had previously been restricted to a

small geographic region and infected greater populations.

In the nineteenth century, mass immigration transformed New York Metropolis

into the biggest and most diversified city in the world. However, the city also became the

most unhygienic, since the massive increase in population made it more prone to illness.

When compared to other big metropolitan centers, such as Boston or Philadelphia, the

mortality rate attributable to illness in New York was much higher than the national average.

It was not until the twentieth century that New Yorkers began to suspect that their terrible

living circumstances were a contributing factor to the city's ill health. By the 1840s, high

rates of sickness were being attributed to the squalid conditions in which many of New

York's impoverished immigrants were forced to dwell. Between the 1870s through the 1920s,

a "new" wave of immigrants arrived in the United States. Many of these immigrants came

from countries in southern and eastern Europe, including countries such as Italy and Greece.

Others came from countries in Asia, including China, including countries such as Poland and

Russia.i

Typhoid fever was a prevalent disease in many nineteenth-century metropolitan

places, particularly in the United States. The sickness, which was caused by a bacterium that
was carried via water and food, was highly contagious and produced a ten percent mortality

rate. Cities lacking adequate water sanitation systems, such as New York, were often the

most hit by typhoid. Although most American communities had constructed water

purification facilities by the end of the nineteenth century, typhoid disease was still problem,

and public health professionals were baffled as to why. ii The explanation was that many

individuals continued to be typhoid carriers even if they were no longer experiencing

symptoms of the illness. Carriers did not display any indications of sickness themselves, but

they were hosts to the typhoid germs and were thus a potential source of disease transmission.

Even while public health interventions were generally missing in rural regions,

efforts to secure better supplies of water, create sewers, and dispose of rubbish and other

waste had started in many major cities by the nineteenth century, despite the fact that many of

these efforts were unsuccessful. Compared to 1870, when access to filtered water in urban

America was limited, by 1900, 1.86 million urban Americans had access to filtered water,

according to the Census Bureau. Other public health actions included the use of quarantine,

urban cleanliness projects, attempts to ensure the availability of safe milk, and new laws to

minimise air pollution, in addition to the provision of clean water sources and trash disposal

activities. It seems that municipal governments were responsible for public health gains in

cities, and that the timing of particular initiatives such as water chlorination was mostly

coincidental, according to the available information.iii

i
"Infectious Disease History". 2022. National Museum Of American History.
https://americanhistory.si.edu/topics/infectious-disease-history.

Brackemyre, Ted. 2022. "Immigrants, Cities, And Disease". US History Scene.

ii

https://ushistoryscene.com/article/immigrants-cities-disease/.

Eli, Shari. 2010. "Wealth Is Health: Pensions And Disease Onset In The Gilded Age".
iii

https://www.business.unsw.edu.au/About-Site/Schools-Site/Economics-Site/Documents/S.%20Eli%20-
%20Wealth%20is%20Health%20-%20%20Pensions%20and%20Disease%20Onset%20in%20the
%20Gilded%20Age.pdf.