Pandemics and Economics #7

Infection’s Legacies Remain

Pandemics and Economics in History, Episode #7: Infection’s Legacies Remain
Text version differs slightly from audio, with one paragraph omitted entirely (see below.)

In addition to public parks, many aspects of architecture that we might take for granted were designed originally in response to public health needs: Balconies and terraces, living and commercial spaces designed to open unto the air, flat roof-tops used for common spaces…even furnishings, like recliner chairs…were once deliberated added in order to prevent the spread of tuberculosis and help patients recovery.

In 2012, historian Margaret Campbell published “What Tuberculosis did for Modernism: The Influence of a Curative Environment on Modernist Design and Architecture.” She writes:

In 1878, the French architect Emile Trélat…stressed the need to provide an improved standard of housing for the rapidly expanding French urban working class. He also effectively used tuberculosis statistics to demonstrate that a lower rate of infection was present among a working-class population that had been rehoused in new “hygienic” dwellings. Such attempts to provide good social housing as an aspect of public health coincided with the emergence of architectural modernism.

Campbell also notes that materials and methods, like reinforced concrete and steel-frame construction, were employed in architectural modernism to promote “a more hygienic lifestyle.”

There has been much attention recently — even before our current pandemic — on ways in which architecture can help or hinder public health. One fascinating article, written by an undergraduate student at University of Oregon and published on the open access, peer-reviewed collaborative forum, “Nursing Clio,” explores some important cost-benefit analysis in building choices.

Writing in October 2020, Adriann Bechtle notes that Covid-19 is prompting the building industry to reconsider some aspects of architecture, particularly ventillation. She points out that improving public health saves money for society overall but does not necessarily immediately benefit building owners, adding that this situation is one reason it took the US decades to pass laws like the Americans with Disabilities Act.

She writes:

Most buildings were not designed with extra safety measures for the annual flu season because people are unlikely to pay for changes they don’t need themselves. For able-bodied people, it doesn’t make much of a difference to have a ramp outside the door. Similarly, for people with typical immune systems, flu season is no big deal and they don’t have to worry if their friend has a cold. But to protect the people with compromised immune systems, and the general public during pandemics, architects need to consider healthy building design more carefully.

Ms. Bechtle is writing her thesis on “accessible lighting design, which balances the needs of people with impaired vision and those with photophobia.” Her bio notes that she graduates in June of this year and hopes to work in sustainable or accessible design. Students with such sensibilities will doubtless have a big impact on future building.

As Bechtle notes, however, individual property owners and developers will not immediately benefit from decisions that support public health. And so, let us hope that legislators and funding sources will consider the health benefits of construction that aims to balance a variety of needs.

[following paragraph omitted in audio]

Bechtle, Campbell, and many others remind us that our architecture over the centuries was influenced by ideas then current about public health needs. Some of those influences are retained in our ideas about building, some are lost. From health movements of previous centuries, we retain a general belief that people are better off with access to fresh air and sunshine…and quiet. Both the March 16 “Community thru Covid” and next week’s focus on issues around quiet…so please check those out.

In popular understanding, Florence Nightingale, the 19th Century British nurse, is credited with giving us many of our ideas about the importance of space and light and quiet in patients’ recovery as well as the role of better hygiene in disease prevention. She is also credited with popularizing the idea of evidence-based planning. However, Nightingale’s legacy also includes colonial views on best medical practices, on what constitutes filth, and which populations are considered clean, which dirty. A future episode consider the economic and social effects of these beliefs, still felt today.


Bechtle, Adriann. Post-Pandemic Architecture Needs to Be Healthier. October 2020, Nursing Clio.

Campbell, Margaret. What Tuberculosis did for Modernism: The Influence of a Curative Environment on Modernist Design and Architecture. Medical History Journal, 2012.

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