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Lemuel Shattuck’s Report of the Massachusett’s Sanitary Commission (1850) and John Griscom’s The Sanitary Condition of the Labouring Population of New York (1848) called attention to the relationship between poor living conditions and the threat of disease. Shattuck also identified immoral life-style as a factor in disease transmission.

Shattuck’s report has come to be considered one of the most farsighted and influential documents in the history of the American public health system. The Future of Public Health, Institute of Medicine, 1988. (pp. 59-61)

The effects of living conditions on health are clearly evident in this picture from the 1940s. It clearly shows other linked health determinants, such as poverty.