You thought the germs on the subway pole were NYC’s biggest health threat? Nope — turns out the entire design of the city can affect your well-being, for better or worse.
That’s according to Sara Jensen Carr, an assistant professor in architecture, urbanism and landscape at the School of Architecture at Boston’s Northeastern University. In her upcoming book, “The Topography of Wellness: Health and the American Urban Landscape,” she examines the historical impact of an urban environment on wellness, including a deep-dive into how design has helped to spread and prevent disease throughout history.
“[Architecture] is not a cause, but it can be a very large contributing factor [to epidemics],” Carr tells The Post. “It’s something we’ve overlooked for a very long time.”
In her book, Carr zooms in on six historical epidemics, including the 19th-century cholera outbreak, and examines how they were affected by and ultimately transformed the American urban landscape.
Proof of that is all around you in New York City — starting with the pavement you’re walking on.
In its earliest days, Gotham was crisscrossed by dirt streets that were full of trash and horse dung. Some were eventually paved with stone blocks, but those tended to just trap the dirt and manure.
It was gross, and moreover, it was dangerous. That grime turned into dust that commuters breathed in, and it led to respiratory infections and lung disease for many. So, in the mid-19th century, health advocates began pushing to pave the streets with easier-to-clean asphalt — and the city sighed in relief.
Then, there’s Manhattan’s famous grid system. The plan, adopted in 1811, overlaid an orderly series of streets and avenues from Houston Street to 155th Street — land that, at the time, was made up of farms, forests, swampland and a few large estates.
But the grid was less about finding your way around than staying alive.
The crooked streets below Houston provided numerous places for water to pool, helping to spread cholera and other waterborne illnesses. An outbreak of the disease in the early 1830s killed some 3,515 people and led to a push to abandon private wells that could become contaminated with waste and to adopt a citywide water system. The Croton Aqueduct, completed in 1842, brought clean, fresh water from upstate, and the grid system better accommodated the laying of long, straight pipes for indoor plumbing.
Fear of disease also forced architects to rethink buildings.
“Cholera and yellow fever led to the razing of tenements, because people were afraid of density in housing and how that spread disease,” Carr says.
The paranoia led to designing buildings with more access to natural light and fresh air. It also led to the creation of Central Park and other green spaces, as many suspected back in the 1800s that fresh air might be a key to combating certain epidemics and respiratory ailments.
But what about now? Does NYC’s environment leave us vulnerable to new epidemics?
Quite possibly, says Carr. She believes that “the largest crisis New York City will face is climate change” and the scary health threats it brings.
The first problem will be the temperature itself. Due to the so-called “heat island” effect, urban areas — with their limited green spaces and miles of asphalt — are generally hotter than rural areas. So, during future, hotter heat waves, more New Yorkers could suffer heat stroke or have chronic conditions exacerbated, Carr says. Breathing problems could be more prevalent as well, because hotter temperatures lead to more of the pollutant ozone in the air.
‘The city’s [aged] water and sewage system is not designed to take on the heavier rainstorms and flooding that are going to come with climate change.’
Lyme disease could also become more prevalent, says Carr, since warmer winters in New York could lengthen the tick season, and the higher humidity that comes with climate change could provide an environment more conducive to the little critters.
Then, there’s the threat of water. Coastal cities like New York, Carr says, could see increased flooding in the future due to more frequent and severe storms.
Those would leave the city awash in standing water — all of which could lead to a rise in the mosquito population, which could, in turn, lead to an uptick in mosquito-borne illnesses. There’s a recent historical precedent of that, too, according to the World Health Organization: In the 1990s, heavy rains led to a surge in West Nile virus in Europe.
Another danger of flooding? Contaminated water.
“The city’s [aged] water and sewage system is not designed to take on the heavier rainstorms and flooding that are going to come with climate change,” Carr says. “You have the possibility of sickness from dirty water.”
In worst-case scenarios, as happened in Kansas City last spring, heavy rain can cause drinking water to become awash in parasites and bacteria that could cause gastrointestinal illnesses, a problem that can take weeks to fix.
Carr’s advice for New York City and all urban areas is to begin taking into account how design impacts citizens’ well-being.
“I want to bring health to the forefront of these decisions again,” she says.