Sanitationwaspoorornonexistent,sewagedisposalfromthegrowingpopulationwaslacking,citieswerefilthy,publiclawswereweakornonexistent,andcongestionofthecitiesinevitablybroughtpestsintheformofrats,lice,andbedbugs,whichtransmittedmanypathogens. Communicablediseasescontinuedtoplaguethepopulation,especiallythosewholivedintheseunsanitaryenvironments. Forexample,duringthemid 1700s,typhusandtyphoidfeverclaimedtwiceasmanyliveseachyearasdidtheBattleofWaterlooHanlonandPickett,1984. Throughforeigntradeandimmigration,infectiousdiseaseswerespreadtoallofEuropeandeventuallytothegrowingUnitedStates. TheChadwickReportEdwinChadwickbecameamajorfigureinthedevelopmentofthefieldofpublichealthinGreatBritainbydrawingattentiontothecostoftheunsanitaryconditionsthatshortenedthelifespanofthelaboringclassandthreatenedthewealthofBritain. Althoughthefirstsanitationlegislation,whichestablishedaNationalVaccinationBoard,waspassedin1837,Chadwickfoundinhisclassicstudy,ReportonanInquiryintotheSanitaryConditionsoftheLabouringPopulationofGreatBritain,thatdeathrateswerehighinlargeindustrialcities,suchasLiverpool.
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