OVERCROWDING, ITS CAUSES AND EFFECTS
I have been at some pains to demonstrate the dangers and inconveniences
which are inseparable from houses built, as are the majority of town
houses, upon an area which is wholly insufficient when considered in
relation to their cubic contents.
Feeling, as I do, that the question of space round the dwelling is
of the greatest importance—so important that every other sanitary
regulation sinks into insignificance when compared with it—I have
endeavoured to show how detached houses may, to their great advantage,
be independent of the public sewers, and equally independent, if their
owner choose, of public water supplies; and this I have done in the
hope that in country places, and places which are developing, the
precious boon of living in a detached house may be recognised.
While I am not slow to admit that water under pressure is a great
advantage if it be wisely used, I have pointed out persistently for
some years that our present system of water-carried sewage gives a
'fatal facility' to the overcrowding of houses, and has made life, of a
sort, physically possible under conditions of overcrowding which have
never been equalled in the history of the world.
In China and the East generally, be it remembered, the large population
lives upon one plane. It has been left to Europe and America to try
the experiment of piling the city populations in heaps, of housing them
in many-storeyed buildings, some of which (in America) are fifty times
the height of a man.
The facilities for overcrowding which are afforded by big schemes of
water-supply and sewerage are now well understood, and have caused
the formation of 'Building Societies' throughout the country. A large
number of these societies during the past few years have been proved to
have been dishonestly managed, and have involved widespread financial
disaster amongst the poor and thrifty.
The mode of proceeding of these societies is to buy up, on the
outskirts of towns having a system of sewers and a common water-supply,
plots of land abutting on roads which have been sewered at the expense
of the ratepayers.
These plots are then sold to purchasers who pay 10 per cent. deposit
for possession, and pay the rest of the purchase money in monthly or
quarterly instalments for a term of years, 10 or 15, as the case may
be, with 5 per cent. interest. Thus the artisan, having paid a most
exorbitant price for a plot of ground, starts in life with a mortgage
round his neck, and probably finds, should anything interfere with the
regular payment of instalments, that he has a hard-faced usurer to deal
with, who merely concealed his identity behind the title of 'Company,
Limited.'
The accompanying diagram (fig. 31) gives a good idea of the development
of a district subsequent to sewering. It has been copied from the
prospectus of a Building Society. A A A is an old road having houses
on the north side only; B B B is an old road with houses on the south
side only, _i.e._, seven dwelling houses in a course of more than half
a mile.
The space between A A A and B B B was, until a few months ago, a
market garden full of fruit trees, and about nine acres in extent.
A few years ago A A A and B B B were sewered at the expense of the
ratepayers, and very soon afterwards this market garden was bought by a
'Building Society' and converted into a 'building estate.'
[Illustration: Fig. 31.]
It is obviously a very 'eligible' estate, for there is a Railway (R.),
with a Station (S.), a Post and Telegraph Office (P.O.), a Church
(Ch.), and two Public Houses (P.H.). None of the elements of modern
civilisation are wanting. After the sewering of roads A A A and B B B,
the District Council, in a fit of zealous extravagance, destroyed the
gravel paths at the side of B, and put a 12 by 6 inch kerb, and laid
half a mile of granolithic pavement for the benefit of the aforesaid
seven houses.
When the Building Society issued its prospectus the plots abutting on
the old roads A A A and B B B were sold at once, and the reason is
obvious, viz., that the roads are ready made and sewered; and a note
with regard to road B B B says, 'This road is a highway maintainable
by the local authorities, who will provide a proper footway in front
of the plots in due course.' The ratepayers as a whole are to provide
pavements for the speculative builder in this particular instance,
and it is evident that the owners of the plot and the Local Council
had come to an agreement in the matter. The houses abutting on the
new roads, Z Z Z, will, in addition to the purchase money for the
land, be charged 3_s._ per foot frontage for sewers, and 'also such a
proportion as their surveyor shall assess of the expense of repairing
and maintaining the road or roads, until the same shall be handed over
to the local authorities.' On an adjoining property the cost of 'making
up' a private road was estimated at 12_s._ per foot run, so that the
cost would amount to between 10_l._ and 11_l._ for a plot having a
frontage of 18 feet, and might form a ruinous charge on some of the
corner plots.
The ground will accommodate 177 plots, and the plots facing the old
roads fetched 3_l._ a foot. Of these there is room for fifty-nine,
having a frontage of 20 feet each, so that the price paid for these at
60_l._ per plot would be over 3,500_l._; and if the remaining 118 plots
fetched 40_l._ each (4,720_l._), the total price realised for this 9
acres would be over 8,000_l._, in addition to the charge for sewerage
and road-making.
When, moreover, it is remembered that the society may possibly hold a
mortgage on every plot and every house, for which they get 5 per cent.
and excellent security, it will be admitted that running a 'Building
Society' is a tolerably profitable business.
If all these plots are sold there will be a population of over 1,200
persons on 9 acres of ground, and the ratepayers will be at the charge
not only of educating the children, but of providing hospitals for the
segregation of infectious diseases, allotments, free libraries, open
spaces, and additions to the sewerage works for dealing with the sewage
of 1,200 persons.
When a 'progressive' municipality sets to work to 'develop' its
district (a speculative and hazardous process, which it should leave
to private enterprise), the ratepayer soon begins to see that a great
diversity of interests has to be served.
The little shopkeeper (and it is of this class that Boards and Councils
are largely composed) wants the greatest number of people on the
smallest space; and he sees that in proportion as the dwelling has an
insufficient curtilage, so are its inhabitants wholly and entirely
dependent on the shop.
The person with a fixed income who settles in a district wishes the
district to remain picturesque, rural, and quiet, and, above all, he
desires that the 'rates' may be kept down. He naturally objects to be
taxed for the sewering of country roads in order that the fields may be
covered with courts and alleys of jerry-built houses, and equally he
objects to be taxed in order that every railway station in the country
may display a large invitation to trippers to invade his solitude and
make his life a burden.
All sanitarians are agreed that mortality and density of populations
are directly proportional. The following figures, taken from Table
R (p. xlvii.) of the decennial supplement of the Registrar-General
(1895), show this very clearly, as does also the diagram of the
mortality figures for London (p. 144).
Persons to a square mile Death-rate (corrected)
138 12·70
187 14·48
307 16·47
662 18·55
1,803 20·43
3,299 22·30
4,295 24·51
19,584 33·00
The corrected death-rate for 'Urban England,' as given by the same
authority, is 22·32, as against 16·95 for 'Rural England.'
To form a just estimate of the comparative healthiness or unhealthiness
of a great city like London is no easy matter. The composition of the
population is, especially in the central parts, so abnormal in regard
to age and sex that unless corrections be made for this abnormality any
comparison of London with other places is futile. Such corrections are
now made by the Registrar-General.
It is probable that in no city are the annual variations of population
greater than in London. The population of June (the height of the
season) and the population of September (when 'everybody is out of
town') must be very different. In September the rich go to the country,
the shopkeepers go to the seaside, and the poorest of the poor go
hop-picking. The School Board attendances for the first week of
September show a deficit of 80,700 children, or 11·1 per cent., figures
which clearly demonstrate that the autumn exodus is not limited to the
wealthy classes.
It is at this season that we see paragraphs in the paper to the effect
that the death-rate of some London parish for the Michaelmas quarter
reached an incredibly low figure, and we are asked to infer that the
population, thanks to the wise policy pursued by the vestry, is fast
making for immortality. Of course such statements are not worth the
paper they are written on, because there are no data as to population,
and the period chosen is so short as to be valueless.
In estimating the death-rates of different sanitary areas of London
it has been customary for the last six years to distribute the deaths
occurring in institutions to the districts to which the deceased
'belonged,' and to exclude entirely the deaths of persons belonging
to districts outside registration London; in this way about 1·5 per
cent. of the deaths occurring in registration London may be excluded.
This manœuvre helps to diminish the London death-rate, but, as no
account is taken of sick people who leave London to die elsewhere, it
is manifestly an unjustifiable thing to do.
If the strangers who die in London institutions are to be excluded, it
is a question whether all strangers merely sojourning in London ought
not to be excluded from the estimate of population. Again, a man comes
from the country and is knocked down by a vehicle in the street and
dies in a London hospital; or during a sojourn in London he gets caught
in a London fog and dies of bronchitis; or he 'catches' influenza, or
pneumonia, or diphtheria in London and dies. Surely the deaths of these
three ought to be credited to London in all fairness. It is a very
dangerous thing to 'cook' statistics, and we do not get much nearer the
truth by doing so.
The best indication, probably, as to whether the conditions of life in
any locality are healthy or the reverse is the infant mortality; in
this way we exclude the fallacies due to abnormal age distribution,
because we compare identical age periods; and the proportion of the
sexes among children is practically the same everywhere. We exclude
also the influences of occupation. By studying the mortality of
children under five we are studying the influence of the home and home
surroundings on the incidence of disease, which is particularly what we
wish to do.
In the decennial supplement of the Registrar-General published in
1896, Dr. Tatham gives a table (Table II. p. lxxxii. _et seq._) of
the 'annual death-rate per million living among children under five
years of age, from all causes and from several causes, 1881-90.' This
valuable table ought to be most widely studied. Being based upon
statistics of ten years intervening between the censuses of 1881 and
1891, the estimates of population have a maximum of reliability,
because we are relieved of the errors inseparable from statistics
referring only to short periods of time.
It is constantly stated that London is the healthiest city in the
world, a statement which, if true, must make us very sorry for the
other cities. In Dr. Tatham's table, alluded to above, he first deals
with counties.
We find that the death-rate of children under five from all causes
in England was 56,825 per million; that the highest death-rate among
children was in Lancashire (72,795), and the next highest was in the
county of London (68,164). The lowest death-rate was in the county of
Dorset (35,651).
Table Legend:
A = Smallpox
B = Measles
C = Scarlet fever
D = Diphtheria
E = Whooping cough
F = Fever
G = Diarrhœa
H = Tuberculosis Disease
I = Respiratory Disease
-----------+------+---+-----+-----+-----+-----+----+-----+-----+------
| All | | | | | | | | |
|Causes| A | B | C | D | E | F | G | H | I
-----------+------+---+-----+-----+-----+-----+----+-----+-----+------
Lancashire |72,795| 37|5,053|2,454| 706|3,805|285 |6,461|5,364|17,037
London |68,164|240|4,743|1,780|1,371|5,342|165 |5,444|6,581|16,021
Hampshire |42,222| 10|2,005| 505| 939|2,508|280 |2,783|3,299| 9,011
Dorsetshire|35,651| 4|1,748| 488| 493|1,815| 62 |1,305|2,401| 9,390
-----------+------+---+-----+-----+-----+-----+----+-----+-----+------
I have also thrown in Hampshire, because not only is it my own county,
but it is a mixed county, largely rural, but also containing the big
towns of Southampton and Portsmouth.
Looking at these four in tabular form, we see that in Lancashire
the mortality from measles, scarlet fever, fever, diarrhœa, and
respiratory disease was greater than in London; and in London the
mortality from small-pox, diphtheria, whooping cough, and tuberculous
disease was greater than in Lancashire.
In Hampshire and Dorsetshire the mortality was very much less from
every cause than in either Lancashire or London.
It is important to point out that the deaths of children from
tuberculous disease are greater in London than in any other county, and
that the deaths from tuberculous and respiratory diseases combined are
greater in London than in Lancashire.
We have seen that the mortality of children under five averaged for the
whole of London 68,164 in the decennium 1881-90, while that for England
and Wales was 56,825, or, omitting the last three figures, let us say
they were 68 and 57.
Examining the various registration districts more closely, we find
that the child mortality was less than the average for England and
Wales in four London districts only, viz., Lewisham (44), Hampstead
(48), Woolwich (51), and Wandsworth (56), districts which are all on
the outskirts of the place we call London. Certain other districts
had a child mortality less than the average of London as a whole,
viz., Camberwell (59), Hackney (60), Islington (61), Paddington and
Kensington (63), Greenwich (63), St. Pancras (66), Fulham, Poplar, and
Lambeth (67).
All the other districts had a child mortality greater than the average
of London, viz., Mile End (69), St. George's, Hanover Square (71),
Westminster (72), Chelsea and St. Olave's (73), Marylebone (75),
Bethnal Green (76), Shoreditch (78), St. Saviour's (79), St. Giles's
(80), Holborn (82), Whitechapel (85), St. George's in the East (87),
the City (90), Stepney (99) and the Strand (109).
With the exception of the City, Stepney, and the Strand, there are
only two registration districts in the whole country which have a
child mortality over 90, viz., Manchester (93) and Liverpool (114).
To Liverpool therefore belongs the distinction of being the most
unwholesome place for little children in the whole country, and the
'Strand,' which constitutes the very centre of London, comes next.
Let us examine these figures more closely, and let us throw the child
mortality of Liverpool and the Strand into tabular form, and contrast
them with the registration district of Andover, in Hampshire, a
district which I select for reasons which will appear later.
Table Legend:
A = Smallpox
B = Measles
C = Scarlet fever
D = Diphtheria
E = Whooping cough
F = Fever
G = Diarrhœa
H = Tuberculosis Disease
I = Respiratory Disease
----------+-------+----+-----+-----+-----+-----+----+-----+------+------+
| All | | | | | | | | | |
|Causes | A | B | C | D | E | F | G | H | I |
----------+-------+----+-----+-----+-----+-----+----+-----+------+------+
Liverpool |114,253| 29|9,492|2,966| 852|5,894| 483|9,818| 7,138|26,080|
Strand |109,596| 38|6,626|1,828|4,760|6,359| 76|7,692|11,881|30,122|
Andover | 32,260| 0|1,227| 307| 225|2,505| 153|1,074| 2,096| 7,209|
----------+-------+----+-----+-----+-----+-----+----+-----+------+------+
From this table it appears that the mortality from measles,
scarlet-fever, and diarrhœa was greater in Liverpool than in the
Strand; but that the other diseases scheduled were more fatal in the
Strand than in Liverpool.
We have previously pointed out that the deaths of children from
tuberculous and respiratory diseases are greater in London than in any
other county, and now we find that the death-rate of children from
these two classes of diseases amounted in the 'Strand' to 42,003, far
and away the highest figure in the country, Liverpool coming second
with 33,218. The death-rate of children from the same causes in
Andover was only 9,305, considerably less than a quarter of the Strand
death-rate.
Thanks to vaccination and the purity of the water-supply the mortality
in the Strand from small-pox and fever is very small, but the mortality
of children from the acute air-borne contagia (measles, whooping
cough, scarlet-fever, and diphtheria), and still more from the chronic
air-borne contagia, is fearful to contemplate.
The big mortality from tuberculous disease forces upon us the
reflection that a large number of children who become tuberculous
in the 'Strand' do not die within the age limits with which we are
concerned, but drop off later in life after years of invalidism and
suffering. We have seen that children under five are decimated yearly
in the Strand. How many more are crippled for life?
The deaths of children under one year of age per 1,000 births is a
safe criterion of the health conditions of a locality. This figure for
the ten years 1881-90 was, for the whole of England and Wales, 142. In
London, we find that in five districts (Hampstead 117, Lewisham 121,
Woolwich 124, Hackney 137, and Wandsworth 141) this mortality was below
the average of the whole country, while in the remaining twenty-five
districts it was above the average.
In Paddington, Islington, Camberwell, Lambeth, Greenwich, Mile End,
Poplar, and Marylebone, it was above 142 and under 150. In St.
Pancras, Kensington, St. George's (Hanover Square), St. Giles's,
Bethnal Green, and St. Olave's, it was above 150 and under 160; in
Chelsea, Fulham, Westminster, Holborn, Shoreditch, and St. Saviour's,
it was over 160 and under 170. The City was 171, Whitechapel 173, St.
George's-in-the-East 182, Stepney 196, the Strand 226.
To show what this figure of 226—the infant mortality of the
Strand—means, I will give the infant mortality of some of the worst
towns in Lancashire: in Liverpool 219, Wigan 161, Bolton 163, Salford
183, Manchester 193, Ashton-under-Lyne 173, Oldham 169, Rochdale 145,
Burnley 184, Blackburn 178, Preston 203. On the other hand, one may
say that the infant mortality of Andover, which has just adopted a
great part of the London Building Act, with the approval of the Local
Government Board, was (for the ten years 1881-90) 91, or 23 per cent.
less than the best of the London districts, and nearly 60 per cent.
better than the Strand.
Glancing at the other Hampshire districts, one may note that in the
New Forest the infant mortality was as low as 80, and that it was
only in Portsea Island (139), Alverstoke (123), and Southampton (135)
that even the lowest of the metropolitan figures were approached. It
is interesting to note that even the worst districts in Hampshire
are below the average of the whole kingdom in the matter of infant
mortality.
THE STRAND
I have previously alluded to the high mortality of the Strand
registration district, and my remarks on one occasion were
contemptuously dismissed, with the criticism that it was unfair to
judge of the state of London by the health of the slums.
It becomes necessary therefore to say that the Strand registration
district includes the Temple, St. Clement Danes, the Precinct of the
Savoy, St. Mary-le-Strand, St. Paul, Covent Garden, and St. Martin's in
the Fields.
Its southern boundary extends from the Temple Stairs to Whitehall
Court, along the Thames Embankment. From Whitehall Court, the western
boundary runs through the 'Horse Guards' and through the middle of
Buckingham Palace to the top of Constitution Hill. It includes the
whole of the Green Park, but none of the houses abutting on it, with
the exception, I believe, of Stafford House. From Stafford House the
northern boundary runs south of Pall Mall, and includes Clarence House,
St. James's Palace, the War Office, Marlborough House, and Carlton
House Terrace. Thence the boundary runs up the Haymarket, along the
north side of Leicester Square and Long Acre to Drury Lane and by
Sardinia Street and the south side of Lincoln's Inn Fields to Chancery
Lane, the south end of which constitutes its eastern boundary.
This district includes parts of four royal palaces and also Somerset
House, Horse Guards, Admiralty, War Office, National Gallery, and
National Portrait Gallery. In it are to be found five churches (Temple,
St. Clement, St. Mary, St. Martin, St. Paul, Covent Garden), Exeter
Hall, and more than twenty of the largest and best known theatres and
music-halls. The Constitutional and National Liberal Clubs are within
its boundaries, and its numerous huge hotels are famous throughout the
world.
The worst parts of the district are in the north-east, but one must
mention that it does _not_ include the Seven Dials or the north half of
Drury Lane. Clare Market, the south end of Drury Lane, Drury Court and
Bedfordbury, are the slums of the Strand registration district. It is
not a poor district. The percentage of persons 'in poverty' in London
as a whole is given by Mr. Charles Booth as 30·7, while that for the
Strand is only 23·9.
Many of the labourers employed in Covent Garden Market and in the
theatres earn very good wages, but Mr. Booth specially mentions the
fact that in some of the lowest districts house rent is very dear.
Wages is a relative term, and the potential prosperity of a person is
only to be determined by subtracting from the earnings the cost of the
necessaries of life, inclusive of house rent.
It is obvious, however, that the prime necessary of life (fresh air) is
not to be had in the Strand at any price.
It may be well to add that the Strand _sanitary area_ is not
co-terminous with the Strand _registration district_, which we have
been considering. The chief difference is that the former includes St.
Anne's, Soho, and excludes St. Martin's in the Fields.
This district of the 'Strand,' which I have chosen because it is the
most unhealthy district in London, and in some respects the worst in
the whole country, is, so to say, the pulpit from which the British
have preached sanitation to the whole world. In it we find the offices
of the Registrar-General and the London County Council; the Temple,
where Sanitary Bills are drafted, and the Law Courts, where the
sanitary law is administered; the Royal College of Physicians; the
Examination Hall where candidates for diplomas of Public Health and
Medicine are examined, and also the offices of the 'Lancet' and the
'British Medical Journal.' The Royal College of Surgeons, the Local
Government Board and Imperial Parliament, if not within, are only just
outside its limits.
It is doubtful if any district in London or any other city is better
provided with open spaces than the Strand. St. James's Park and the
Green Park are both partly within its limits. It has the Embankment
and the Thames to the south, the Temple Gardens to the east, Lincoln's
Inn Fields to the north-east, and Trafalgar Square in the centre. It
is wonderfully provided with what are miscalled 'lungs,' but it is
evident that lungs are of little good if the blood only circulates in
them occasionally on a Sunday. It is well to bear this fact in mind,
because our municipal governors sometimes talk as if the provision of
'open spaces' at exorbitant and extravagant cost could compensate for
overcrowding in the dwelling, with a lack of light and air therein.
It is in the Strand, more than in any other district, that houses
have been built of great height and enormous cubic capacity without
any curtilage whatever. I have attended 'banquets' at more than one
hostelry in this district where 150 or 200 persons have been fed in
a room having no outside windows of any kind, and where, late in the
evening, the guests have been provided with a little fresh (!) air by
opening glass partitions communicating with a huge 'coffee-room' or
table d'hôte room. These rooms are made by enclosing what ought to be
open courts in the centre of these huge hotels, and their utilisation
is only possible because of the perfection to which the science of
artificial illumination has been brought. There can be no health
without daylight, and sunlight, and fresh air, but the electric light
is good enough to make money by.
To a greater or less extent, throughout London the height of the houses
has been gradually raised, and the available curtilage has been built
upon. This is seen in the dwellings of the rich, and there is no doubt
that the conditions which lead to overcrowding are all intensified in
the poorer quarters.
BUILDING REGULATIONS