来源：《BBC历史》2023年6月刊
The invention of the steam engine in the 18th century allowed humans to utilise the power of fossil fuels on an industrial scale for the first time. As industrialisation transformed manufacturing, Britain’s annual economic growth reached an unprecedented 2.5 per cent in the first half of the 19th century, before falling back to 2 per cent. In a world where economic growth had been close to zero since the adoption of agriculture, the impact was extraordinary.
18世纪蒸汽机的发明使人类第一次在工业规模上利用化石燃料作为动力。随着工业化改变了制造业，英国的年经济增长率在19世纪上半叶达到了前所未有的2.5%，随后回落至2%。在一个自采用农业以来经济增长接近于零的世界，这种影响是非同寻常的。
As public-health historian Simon Szreter has pointed out, economic growth didn’t automatically lead to better health. People flooded into the towns from the countryside to work in factories. For most of the 19th century at least, though, British politicians – who were elected by a small number of wealthy voters – weren’t interested in improving water and sanitation in urban slums. Such crowded and insanitary conditions created new habitats in which pathogens thrived. In the mid-19th century, infectious diseases accounted for about 60 per cent of deaths in parts of Liverpool and Manchester.
正如公共卫生历史学家西蒙•斯雷特所指出的，经济增长并不会自动带来更好的健康状况。人们从农村涌入城镇到工厂工作。然而，至少在19世纪的大部分时间里，由少数富有选民选出的英国政治家对改善城市贫民窟的供水和卫生设施不感兴趣。这种拥挤和不卫生的条件为病原体的繁殖创造了新的栖息地。19世纪中期，利物浦和曼彻斯特部分地区60%的死亡是由传染病造成的。
Between the 1820s and 1870 – a time of unprecedented technological development and wealth creation – average life expectancy in Britain remained stagnant at around 41 years. National figures were dragged down by the new industrial towns. In the central areas of Manchester and Liverpool, life expectancy during that period was around 25 years – lower than at any time since the Black Death. For factory labourers in Manchester and Liverpool, it was just 17 and 15 years, respectively.
在19世纪20年代到1870年之间——这是一个前所未有的科技发展和财富创造的时期——英国人的平均预期寿命一直停滞在41岁左右。新兴工业城镇拖累了全国数据。在曼彻斯特和利物浦的中心地区，这一时期的预期寿命约为25岁——比黑死病以来的任何时候都要低。对于曼彻斯特和利物浦的工厂工人来说，预期寿命分别只有17年和15年。
Health in towns and cities began to improve only after political reforms in the late 1860s. Suddenly, more than 60 per cent of working-class men could vote in urban local elections. The new voters were far more receptive to city leaders’ ambitious plans to build vast, expensive water and sewerage infrastructure. These projects transformed public health, and deaths from water-borne infectious diseases began to fall. In the 1870s, life expectancy in Britain’s towns and cities finally rose above 1820s levels, and kept rising.
直到19世纪60年代末的政治改革之后，城镇的卫生状况才开始改善。突然间，超过60%的工薪阶层男性可以在城市地方选举中投票。新选民更容易接受城市领导人建设庞大、昂贵的供水和污水基础设施的雄心勃勃的计划。这些项目改变了公共卫生，水传播传染病的死亡人数开始下降。19世纪70年代，英国城镇的预期寿命终于超过了19世纪20年代的水平，并不断上升。