Cities of dreams... and death


03-03-2014

The fate of migrants moving to cities in 17th- and 18th-century England demonstrates how a single pathogen could dramatically alter the risks associated with migration and migratory patterns today

Smallpox was deadly. At its height, it accounted for 10% of all burials in London and an astonishing 20% in Manchester
- Romola Davenport

Cities have always been a magnet to migrants. In 2010, a tipping point was reached for the first time when, according to the World Health Organization, the majority of the world’s population lived in cities. By 2050, seven out of 10 people will have been born in – or migrated to – a city. One hundred years ago, that figure was two out of 10.

Today, cities are generally the safest places to live. If you live in one, you’re likely to be richer than someone living in a rural environment. If you’re richer, you’re likely to live longer. If you live in a city, you have better access to hospitals and healthcare, and you’re more likely to be immunised.

But that was not always the case. In 17th- and 18th-century England, city life was lethal – disproportionately so for those migrating from the countryside.

Dr Romola Davenport is studying the effects of migration on the health of those living in London and Manchester from 1750 to 1850, with a particular focus on the lethality of smallpox – the single most deadly disease in 18th-century England. In the century before 1750, England’s population had failed to grow. Cities and towns sucked in tens of thousands of migratory men, women and children – then killed them. It’s estimated that half of the natural growth of the English population was consumed by London deaths during this period. Burials often outstripped baptisms.

In 2013, cities are no longer the death traps they once were, even accounting for the millions of migrants who live in poor, often slum-like conditions. But will cities always be better places to live? What could eliminate the ‘urban advantage’ and what might the future of our cities look like if antibiotics stop working?

By looking at the past – and trying to make sense of the sudden, vast improvement in survival rates after 1750 – Davenport and the University of Newcastle’s Professor Jeremy Boulton hope to understand more about city life and mortality.

“For modern migrants to urban areas there is no necessary trade-off of health for wealth,” said Davenport. “Historically, however, migrants often took substantial risks in moving from rural to urban areas because cities were characterised by substantially higher death rates than rural areas, and wealth appears to have conferred little survival advantage.”

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Image: Watercolour of a hand with smallpox by Robert Carswell in 1831

Credit: Wellcome Library, London


Reproduced courtesy of the University of Cambridge

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The Cambridge Institute of Public Health (CIPH) is a partnership of researchers and agencies working to improve public health, founded by the University of Cambridge, the NHS and the Medical Research Council.

Cambridge Institute of Public Health, University of Cambridge