The New Yorker:

Treating political violence as a contagion could help safeguard the future of American democracy.

By Michael Luo

In the middle of the nineteenth century, filth of every kind accumulated on the streets of New York. The land was boggy and lacked proper drainage. Epidemics ravaged many of the city’s impoverished neighborhoods. In the summer of 1864, an inspection undertaken by a committee of concerned physicians yielded a seventeen-volume report that catalogued the conditions. One inspector noted that, in his assigned district, refuse filled gutters, blocked sewage culverts, and sent forth “perennial emanations which generate pestiferous disease.” Another observed that certain streets better resembled “dung-hills rather than the thoroughfares in a civilized city.” In response to the report, state lawmakers introduced legislation that led to the establishment, in 1866, of the Metropolitan Board of Health, one of the country’s first municipal public-health authorities. Upon its formation, the board immediately confronted a potential cholera outbreak. It established quarantine measures and administered new health ordinances that helped to contain the spread of the disease. Support for the new agency soared, and other cities began organizing similar authorities. The modern-day public-health movement in the United States was born.

An important revelation from the “great sanitary awakening” of the nineteenth century, as it became known, was that social and environmental factors could significantly affect people’s health. During the second half of the twentieth century, policymakers began turning their attention to issues such as product and workplace safety as a way to save lives. In the mid-nineteen-fifties, nearly forty thousand people were dying every year from motor-vehicle accidents. Attention was primarily focussed on the responsibility of drivers, but physicians and engineers pointed out that most of these deaths were, in fact, preventable through changes in automobile design. In 1965, Ralph Nader, a young lawyer who later became an activist and a perpetual Presidential candidate, published “Unsafe at Any Speed,” a book examining the ways in which automakers had failed to prioritize safety. It became an unlikely nonfiction best-seller, alongside Truman Capote’s “In Cold Blood.” Nader’s reporting prompted congressional hearings and the formation of what is now known as the National Highway Traffic Safety Administration. William Haddon, a pioneering public-health scientist, became the agency’s first administrator and oversaw the first safety requirements for new cars, including energy-absorbing steering columns, shoulder harnesses, and side-door beams. The ratio of motor-vehicle deaths to miles travelled by drivers in the United States plummeted.

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