Impact of diet on health and longevity in London 1850-1880.

This study examines the impact of diet on health in different districts of mid-19th century London. Surveys of London diets and living condition were compared with mortality data between 1851 and 1880. Despite an abundance of fresh foods reaching London, the very poor labouring population living in the inner boroughs between 1850 and 1861 had great difficulty obtaining sufficient nourishment because of its cost. This population showed high death rates from infectious diseases, notably pulmonary tuberculosis, which was endemic and is typically associated with poor nutrition. This high death rate was exacerbated by more deaths from gastrointestinal infections associated with a polluted water supply from the river Thames. By contrast, the poor in the outer suburbs enjoyed both more nutritious diets and cleaner water which was associated with lower death rates comparable to those in rural Britain. Outer suburbs retained a relatively rural life-style associated with cleaner water and an abundance of locally grown food. In the following two decades, there was a significant reduction in the death rates from gastrointestinal infections in the inner boroughs which correlated with the major improvements in London's water supply. The decline in death rates from tuberculosis and other infectious disease was inconsistent and increased in some boroughs, suggesting patchy economic improvement and a persisting limited ability of many of London's poor to afford a nutritious diet.