The Transformation of the American Economy 1865-1914 by Robert Higgs

Author:Robert Higgs [Robert Higgs]
Language: eng
Format: epub
ISBN: 978-1-6101-6297-5
Publisher: Ludwig von Mises Institute
Published: 2011-11-06T16:00:00+00:00

TABLE 3.3

DEATHS PER 100,000 POPULATION IN NEW YORK, BOSTON, PHILADELPHIA, AND NEW ORLEANS

Disease Annual Average 1864–88 Annual Average 1889–1913

Tuberculosis 365 223

Stomach and Intestinal 299 196

Scarlet Fever 66 19

Typhoid and Typhus 53 25

Smallpox 40 2

Cholera 8 0

Diphtheria 123 58

Yellow Fever 14 1

SOURCE. Frederick L. Hoffman, “American Mortality Progress During the Last Half Century,” in Mazyck P. Ravenel, A Half Century of Public Health (New York: American Public Health Association, 1921), p. 102.

One way of dealing with such cases is through negotiation and mutual agreement, perhaps including pecuniary compensations, among the parties involved. When the number of involved persons is very large, however, as it typically is in urban public health problems, this kind of negotiated agreement is quite difficult and costly; such problems are therefore seldom resolved in this way.

An alternative manner of approaching these problems is through government action. Because of the government’s ability to coerce uncooperative minorities and to assure a minimum of “free riding” by taxing all the beneficiaries of a public investment, government actions have often taken the place of the market in cases where important interdependencies prevent individuals from acting effectively. In dealing with the problems of urban public health this approach was generally successful, even though it opened new avenues for corruption and political conflict. Sanitary regulations enforced by newly created urban health boards, compulsory vaccination against smallpox, tenement building codes, and public investments in water purification and sewage disposal furnish examples of the wide range of government actions undertaken in the field of urban public health during the post-Civil War era.

Water filtration provides a striking illustration. Before the late nineteenth century, people generally judged the quality of water according to its clarity and taste, without regard for the disease-carrying organisms it might harbor. With the development of bacteriology, the public increasingly demanded filters capable of straining out harmful bacteria, and inventors soon developed a variety of such devices. These reduced the incidence of many diseases, especially typhoid. Filtration lowered the typhoid death rate per 100,000 population from 121 to 26 in Lawrence, Massachusetts; from 104 to 26 in Albany, N. V.; from 49 to 11 in Binghamton, N. Y.; and from 68 to 20 in Watertown, N. Y.7 Table 3.4 shows by a dramatic contrast how powerful the impact of filtration could be: Albany installed its filter in 1899; Troy’s water supply came from the same source, the Hudson River, without filtration.

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