Riblet#36: Hand-washing as a Force for Growth

The physician Ignaz Semmelweiss studied the death rate of women in childbirth in 19th century Vienna.  He noted that the death rate was far higher when doctors assisted rather than just midwives, and he realised that this was because doctors would go straight from an autopsy to delivering a baby and thus doctors themselves transferred infection and caused death.  He promoted hand-washing for doctors, and for his pains, the doctors of Vienna had him committed to an asylum where he later died after being beaten by guards.  Nevertheless, his legacy comprises lower mortality in childbirth, and the understanding that hand-washing is a fundamental part of modern hygiene. 


Economic growth has been underpinned by the growth of cities.  Cities provide large markets and also a place for the exchange of ideas, and both of these promote growth.  However, for centuries, cities were dogged by poor health and sanitation such that they only ever grew by inward migration, the death rate of the existing population normally exceeding the birth rate.  In 1842, the average age at death of a tradesman in London was 22, and for labourers it was 16.  Improved hygiene led to a decline in mortality and as survival improved, families started having fewer children.  Demand for skilled workers and longer lifespans meant there was a better return on time and money spent on education.  Improving technology and education raised incomes, slowed population growth and ultimately led to a more knowledge-based economy.


Cities are engines of economic growth but they are more susceptible to epidemics than rural areas.  Simple sanitary controls can go a long way to ensuring prosperity.  And a failure of those simple sanitary controls can lead to economic decline…


Data Sources:Superfreakonomics – Steven D. Levitt & Stephen J. Dubner; WikipediaThe Economist magazine

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