Stephen Rees's blog

Thoughts about the relationships between transport and the urban area it serves

The Most Important Medical Breakthrough

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Health

What was the most important medical breakthrough of the last 167 years? The structure of DNA? Nope. The invention of vaccines? Nope. Antibiotics? Sorry. According to a poll by the British Medical Journal, the answer is: Sewers. More than 11,000 readers responded, and sanitation won with 1,795 votes. London was one of the first modern cities to improve public sanitation after John Snow showed that cholera was spread by water, and Edwin Chadwick came up with the idea of sewage disposal and piping water into homes. Antibiotics was a close second with 1,642 votes.

Canadian Press

Published: Saturday, January 27, 2007

I would go one step further. And this is not something I came up with on my own. It was something I learned at the LSE when I had to take the compulsory Quantitative Methods course as part of my planning degree. The way that the link between water and cholera was established was by a combination of statistics and mapping. The cholera deaths were plotted on maps and the clusters were shown to be centred on certain public water pumps. It was a whole new way of thinking about urban problems and it is the basis of rational urban planning.

Sadly, it is a lesson that we seem to need to relearn. Our capabilities to manipulate data have expanded exponentially in recent years. I have now more computing power in my calculator than I had access to in the first mainframe computer I used in the late seventies. At the same time as computers have got cheaper and faster, our willingness to collect data has declined. I was studying the impact of big box retailers on established town centres when Mrs Thatcher abolished the decennial Census of Distribution. She said the small business should not be bothered with filling in government forms. She was the daughter of Alf Roberts, a grocer in Grantham, and his was the sort of corner store that my political masters were concerned about. The big supermarkets on the edge of town, accessible to those with cars doing the weekly shop, were putting the corner stores out of business hurting the carless and those who preferred to shop every day. As a planner, I wanted to demonstrate that, but without recent data, how could I do it? I presented a paper to the Planning and Transport Research and Computation annual meeting on a way it could be done using VAT (Europe’s name for GST) without compromising anyone’s confidentiality. The Treasury just said “no”. I suspect because then the loudest Tory voice in London came from Shirley Porter, the heir to Tesco’s – Britain’s biggest supermarket and the leader of Westminster City Council. She was later disgraced for electoral malfeasance.

The most frequent excuses for not collecting data are the need to cut government spending and concerns about privacy. But government spending without measurement of results is plainly stupid – and something that Canada is supposed to be tackling. And as for privacy, why is there not the same concern over data that we have to give up whenever we use a debit or credit card that is then stored (needlessly) by commercial operators who then “lose” it?

We have some very large medical problems. Among them obesity and diabetes – and plenty of evidence that car dependence is strongly linked to both. But we think health problems have to be dealt with by hospitals and drugs, even though there is plenty of evidence that shows that a more active lifestyle – walking and cycling more – is the key to preventing both these serious health concerns. But how much effort is devoted to this cause compared to getting more MRI machines or building freeways? And why is that?

And isn’t there an old political saw “there’s no votes in sewers”?

Written by Stephen Rees

January 27, 2007 at 11:42 am

Posted in Urban Planning

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