Water, Race and Disease

Review
“Troesken’s definitive history of the fight against water-borne disease in large American cities shows how the public’s fear of contagion made them willing to build expensive water and sewer systems that sharply reduced the disparity in black and white death rates. This book will be required reading for anyone interested in public health, political economy, demography, and the history of race relations.”
—Dora Costa, Professor of Economics, MIT

“Werner Troesken’s book is a meticulously argued case for a proposition that is at first far from obvious: that public provisions of water and sewage systems in American cities effected a dramatic improvement in health conditions of African Americans, during an era when they were largely denied access to political influence and suffered extreme discrimination in other public services. The book not only documents this claim but goes on to show the rationale behind it: namely, because whites had a strong self-interest in black health conditions, especially in cities where the level of residential segregation was low by modern standards. I consider this work a model of scholarship.”
—Gavin Wright, Coe Professor of American Economic History, Stanford University

“Werner Troesken’s detailed historical and statistical analysis of national data makes a major contribution to our understanding of twentieth-century improvements in African-American health and increased life expectancy. By examining the impact of measures intended to reduce the incidence of waterborne diseases, Water, Race, and Disease raises significant issues for the study of American race relations, public health, and, more generally, the politics and economics of social change.”
—Stanley Engerman, John H. Munro Professor of Economics and Professor of History, University of Rochester

Product Description
Why, at the peak of the Jim Crow era early in the twentieth century, did life expectancy for African Americans rise dramatically? And why, when public officials were denying African Americans access to many other public services, did public water and sewer service for African Americans improve and expand? Using the qualitative and quantitative tools of demography, economics, geography, history, law, and medicine, Werner Troesken shows that the answers to these questions are closely connected. Arguing that in this case, racism led public officials not to deny services but to improve them—the only way to “protect” white neighborhoods against waste from black neighborhoods was to install water and sewer systems in both—Troesken shows that when cities and towns had working water and sewer systems, typhoid and other waterborne diseases were virtually eradicated. This contributed to the great improvements in life expectancy (both in absolute terms and relative to whites) among urban blacks between 1900 and 1940. Citing recent demographic and medical research findings that early exposure to typhoid increases the probability of heart problems later in life, Troesken argues that building water and sewer systems not only reduced waterborne disease rates, it also improved overall health and reduced mortality from other diseases.

Troesken draws on many independent sources of evidence, including data from the Negro Mortality Project, econometric analysis of waterborne disease rates in blacks and whites, analysis of case law on discrimination in the provision of municipal services, and maps showing the location of black and white households. He argues that all evidence points to one conclusion: that there was much less discrimination in the provision of public water and sewer systems than would seem likely in the era of Jim Crow.

From the Inside Flap
“Werner Troesken’s detailed historical and statistical analysis of national data makes a major contribution to our understanding of twentieth-century improvements in African-American health and increased life expectancy. By examining the impact of measures intended to reduce the incidence of water-borne diseases, *Water, Race, And Disease* raises significant issues for the study of American race relations, public health, and, more generally, the politics and economics of social change.”
–Stanley Engerman, John H. Munro Professor of Economics and Professor of History, University of Rochester”Werner Troesken’s book is a meticulously argued case for a proposition that is at first far from obvious: that public provisions of water and sewage systems in American cities effected a dramatic improvement in health conditions of African-Americans, during an era when they were largely denied access to political influence and suffered extreme discrimination in other public services. The book not only documents this claim but goes on to show the rationale behind it: namely, because whites had a strong self-interest in black health conditions, especially in cities where the level of residential segregation was low by modern standards. I consider this work a model of scholarship.”
–Gavin Wright, Coe Professor of American Economic History, Stanford University

“Troesken’s definitive history of the fight against water-borne disease in large American cities shows how the public’s fear of contagion made them willing to build expensive water and sewer systems that sharply reduced the disparity in black and white death rates. This book will be required reading for anyone interested in public health, political economy, demography, and the history of race relations.”
–Dora Costa, Professor of Economics, MIT

About the Author
Werner Troesken is Professor of History at the University of Pittsburgh and Faculty Research Associate at NBER. He is the author of Water, Race, and Disease (MIT Press, 2004).

2 thoughts on “Water, Race and Disease

  1. Wow, I’m glad I stumbled on this book. Racism is fear of contamination — I’ve been looking for more examples of this. Only in this case it seems to have motivated racist whites to provide “colored” facilities for black Americans, which were, I guess, better than nothing. (By the way, though, another writer once observed that the contamination fears of whites didn’t prevent them from hiring black women to change their kids’ diapers and cook their dinners. Nobody’s claiming any of it made sense.) Racism motivates a lot of the assumptions behind AIDS, all the while wearing a label of anti-racism. Right over there on the right: “AmFAR Propaganda: Young, Black and Beautiful = AIDS.”

  2. It’s a fine book, and a very fine study: Decrease in disease (as was in Europe) declined most dramatically and quite exponentially because of…

    Vaccination?

    No, the effect of vaccination was, by comparison, just a blip…

    CDC Pandemic hysteria?

    No, no. Those recent ‘events’ don’t even register on a historical scale.

    The major driving force in reducing major illness in the US, and in Europe, was in fact: Clean Water, and the separation of waste from the human population. Sewage systems, garbage removal, water treatment plants, etc.

    You can find the same thing for 18th and 19th Century Europe. There are some tremendous books on Eugenics, some listed here, some searchable at your local library, or university library.

    There is, in fact, a recent medical journal study making this point, (which I will dig up and post), that disease prior to the building of clean water systems was higher by a factor of 10, 20, 30 times, or more, than even what was seen in Polio, SARS, etc. And AIDS barely ticks the meter, compared with pre-industrial/pre-water sanitizing cultures.

    So, what are ‘we’ in the West doing for Africa, for South-East Asia? We ought to be spending our time building sewage systems and digging wells. That should be job One of the “AIDS” establishment, if they are actually serious about reducing illness worldwide.

    After taking care of water needs, they’ll still be free to focus on fear, sex, shame and all the rest of what they’re so good at, and they’ll have a much healthier population to terrify and proselytize…

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