Planning History: The Roman Empire and Public Health

The Roman Empire is highly regarded for their architectural splendor and advanced use of sound urban planning techniques to make their cities livable spaces. From the grand stadiums and parks, to public bathing houses and sewer systems, these cities advocated for hygiene and health that would surely improve the public health.

"The reality is that despite those amenities," reports Henry Grabar, "the Romans were as riddled with parasites as their predecessors. Fish tapeworm, which appears to have been endemic to a fermented fish stew that traveled the empire in clay jars, was more widely found in Roman times than before. Poor sanitation parasites like roundworm were just as common as before."

"The Romans invented multiseat latrines. They instituted laws where towns were responsible for cleaning up feces and taking it out of town in carts. It was quite a substantial package of sanitation reforms.” says Piers Mitchell, an ancient disease researcher at Cambridge University. Even he seems to be shocked that despite the array of laws in place to improve public sanitation there is no observable drop in levels of those endemic parasites.

The unfortunate truth behind the steady parasitic presence according to Morgan was that the Romans "did not understand the sanitary benefits of their own improvements. Thanks to toilets and sewers, the streets didn’t stink. Bathing was a social experience, and a pleasure. Their connection to good health, from a scientific perspective, was uncertain."

So, what is the takeaway for epidemiologists? Grabar forecasts that "for those who study our health in the future, our health might be viewed through our extensive medical records. But we too are leaving a kind of public health fingerprint in the earth. If Rome preserved the fossilized causes of illness, we are saving its cures...a geographically stamped record of a moment in public health."