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This blog is by assistant professor of community and regional development.

Reprinted from .

A �ٺ���Ƶ Community Development expert weighs in on past pandemics

New York City’s experience as the epicenter of the U.S. COVID-19 outbreak is . Quarantined residents  in a city known for its tight quarters and full theaters.

But cities have long had to transform themselves to overcome disease.

My  traces this pattern to the founding of the nation.

Yellow fever and cholera

In 1793, a yellow fever outbreak in Philadelphia killed 5,000 people – . At the time Philadelphia, like all American cities, had no municipal garbage services. Hogs roamed streets and .

On the advice of prominent doctors who redirected blame for the outbreak  – presciently, since germ theory had not yet been invented – Philadelphia’s mayor authorized emergency funding to treat the sick and .

Such efforts were a harbinger of urban planning reforms, as cities would take on the costly job of garbage removal and create sanitation departments over the next 50 years. These measures greatly improved residents’ health in the . They also added alleyways to cities, for garbage removal.

When contaminated water brought waves of cholera sweeping through the U.S. in the 1850s, cities across the country birthed the twin agencies of public health and urban planning to make and enforce regulations. In the same period, New York City’s  made way for Central Park – the nation’s first public park – on the  that open urban space improved human and environmental health.

The park housed a reservoir designed to deliver fresh, clean water to the burgeoning city. It received water from one of the nation’s first .

For the first time New York’s housing development was planned, with growth attached to funding for . By 1916, this patchwork of development directives was compiled into the U.S.‘s first citywide .

Cities everywhere followed New York’s example, taking control of land use and vanquishing waterborne pathogens like .

Battling airborne pathogens

Airborne illnesses, which , however, are proving difficult to combat.

When Egypt faced H1N1 swine flu in 2009, officials in Cairo misdiagnosed the problem, focused on  instead of breaking human-to-human transmission. Swine flu, an airborne illness, contains pig genes but .

Since many Cairo neighborhoods rely on a Coptic Christian group called the Zabaleen to remove waste – which they later  – the streets soon filled with garbage. Rat populations boomed.  and other diseases resurged.

Breaking airborne disease transmission requires reducing  through physical distancing and business closures, for example, and wearing masks to impede infectious droplets. Shelter-in-place orders, like those in place in , prevent travel-related disease spread.

Because lockdowns are difficult to maintain over time, policymakers are searching for longer-term solutions.

“,” tweeted New York Governor Andrew Cuomo on March 22, reviving a longstanding argument that density contributes to greater human-to-human contact and illness.

New York’s 9 million residents can’t stay inside forever. 

Yet while dense major cities are more likely  for disease, history shows suburbs and rural areas fare  – and after.

According to the , when there are fewer potential hosts – that is, people – the deadliest strains of a pathogen have better chances of being passed on.

This “selection pressure” theory explains partly why rural villages were hardest hit during the 1918 Spanish flu pandemic.

Per capita, more people  than anywhere else in the country.

Lower-density areas may also suffer more during pandemics because they have . And because they are not as  as large cities, post-crisis economic recovery takes longer.

Unpaving the way

Common-sense steps cities can take to fight the coronavirus are emerging.

One promising pilot involves , as  and , among others, have done. This allows city dwellers to get outside and walk — but not too close together — as .

Such pilot closures may eventually “unpave the way,” creating urban greenbelts for walking and biking at a safe distance in even the densest of places.  has , among them keeping  supply nearby.

Another coronavirus initiative focuses on protecting the most exposed city residents.

, city agencies launched after the 2008 Great Recession, are now focused on  and  to prevent homelessness during the pandemic. Keeping people safely inside helps to stop the spread of this virus and will likely  beyond the pandemic.

For centuries  — to innovate in ways that ended up benefiting all future residents.

Pandemic-related urban policy advances like ceding more terrain to pedestrians or structurally addressing homelessness take time to emerge. My  identifies some reflexive denial early in an outbreak.

But, ultimately, American cities have triumphed over infectious diseases many times before. I’m hopeful we can do it again.