The Problem.

Serious public health problems existed in the urban areas of the antebellum United States. Recurrent yellow fever epidemics, and major cholera epidemics in 1832 and 1849, aroused great concern. A rapidly expanding population fueled the growth of cities, but no concept of corporate social responsibility for sanitation existed. Procuring clean water and disposing of sewage and garbage were seen as individual rather than social problems. Furthermore, most people viewed dirt, disease, and poverty as inextricably linked to a common source, the immorality of the poor. The vibrant reform culture of this period attacked that trio of problems by attempting to raise public morals. Reformers believed that improved behavior would eliminate public health problems.

Changing Assumptions.

By the 1840s those assumptions were beginning to change. In 1842 British researcher Edwin Chatwick published a report of his study of the health of the British laboring...