Community Sanitation – some of the most farreaching improvements in public health have arisen not from laboratory experiments or technological discoveries but rather from the mundane aspects of everyday life. Community health DRINKING WATER STANDARDS, sewage treatment and disposal, and garbage collection and disposal influence health and LIFE EXPECTANCY as much as any medical intervention.
Ancient Rome provides the earliest archaeological evidence of the understanding of these correlations. The city’s design featured elaborate networks of aqueducts (water conduits), public toilets and baths, and sewage drainage systems. These infrastructures established and maintained separation among living areas, clean water, and waste management. Though perhaps implemented as much as for aesthetic purposes as for health reasons, the health benefits of such separations were clear to ancient Romans who wrote about them, such as Marcus Vitruvius Pollio (90–20 B.C.E.) who wrote extensively about Roman architecture and engineering.
Not until the 19th century and its many discoveries in microbiology did physicians finally connet community sanitation, PERSONAL HYGIENE, and public health. In the millennia between, unsanitary and crowded living conditions fostered ravaging epidemics of CHOLERA (from contaminated water); bubonic plague (from flea-infested rats); yellow FEVER (from mosquitoes); and infectious diseases such as TUBERCULOSIS, SMALLPOX, and FOODBORNE ILLNESSES. In such times and circumstances personal bathing was more likely to spread disease than result in cleanliness.
By the start of the 20th century most industrialized countries incorporated public sanitation practices to separate sewage from drinking water supplies and to promote community as well as personal hygiene. Throughout the United States today strict regulations govern community sanitation, establishing processes for disposing of garbage and sewage as well as for maintaining the purity of drinking water and controlling living conditions. However, inadequate sanitation remains a key cause of disease and death in developing parts of the world that lack appropriate mechanisms for community and personal hygiene.
See also HAND WASHING; HEALTH EDUCATION; HEALTH RISK FACTORS; WATERBORNE ILLNESSES.