The European Background

One of the most important questions raised by critical sociologists is, how do social conditions cause disease? Their research (along with research conducted by historians and others) demonstrates that, across history, social factors such as poverty, urbanization, and living conditions have fostered illness. This section provides a brief overview of disease throughout Western history, highlighting the role played by social forces.

To understand health in the modern world, it helps to begin with the Middle Ages (approximately a.d. 800 to 1300), when commerce, trade, and cities began to swell. These shifts sparked a devastating series of epidemics. The term epidemic refers to both any significant increase in the numbers affected by a disease and the first appearance of a new disease. In the fledgling European cities, people lived in close and filthy quarters, along with rats, fleas, and lice—perfect conditions for transmitting infectious diseases such as bubonic plague and smallpox. In addition, because cities lacked sewer systems, families would dump human waste into the streets, where it eventually would be washed into local rivers. As a result, typhoid, cholera, and other waterborne diseases that live in human waste flourished. Simulta- neously, the growth of long-distance trade helped epidemics spread to Europe from the Middle East, where cities had long existed and many diseases were endemic (established within the population at a fairly stable level). In addition, religious pil- grimages and crusades to Jerusalem helped spread diseases to Europe.