Survival of the city

BBC-podcast on suurin jälkeen. Täällä on tullut. Täällä on tullut. Täällä on tullut. in which people live only for the day because they do not expect to see tomorrow. Perhaps one-fourth of Athens population died over a two-year period, and the sheen of its golden age is lost forever. Athens would soldier on for another quarter century in the war against Sparta before finally losing, and it would have begun its long-slow decline to be coming, and forgive me for the American analogy, to move from becoming perhaps the New York of the Eastern Mediterranean to becoming the Philadelphia, and then perhaps the New Haven city defined really by a university and not much else. The Athenian example reminds us that the impact of plagues in history has always been mediated by the strength and stability of society at the time that it struck. So when plague hits Athens in 430 BC, the city is already at war, and so conditions are already unstable. Five centuries later, when the Athenian plague hits Rome during the second century AD, it strikes a period in which the historian had given described as essentially the most felicitous in human history prior to his own age, and the strength of the Empire under Athenian's pious has no problem weathering the terrible demographic loss. A century later, the plague of Cyprian comes to the urban world of Rome. It's a much more unstable political period, and the plague is much more harmful. But perhaps the worst example is the plague of Justinian. The backstory for that, of course, is in the fifth century Rome itself falls to Gothic conquest. But the Eastern Roman Empire soldiers on, it's the stronger half. It has this great capital and constant noble, and it watches as Italy itself is conquered, and it gathers its forces and waits for the first generation of mighty Austro-Gothic kings to be replaced by quite mediocre sons and grandsons. And so finally, in the five thirties, Justinian the Great sends out his great warlord, Bellissarius, to reconquer Northern Africa, to reconquer Italy. It's going splendidly from a Byzantine perspective. The conquest is moving along. It looks as if the Paxtromania may be reimposed on the Mediterranean world, and instead of having a millennium of darkness, we will have a century. And just at that moment, your Sinia Pestus, the Black Death itself, the Bubonic plague, strikes at constant noble. Again, it lays ways. It comes and comes again for two centuries. And in some sense, it is at least arguably the force that propels Europe towards 800 years of poverty, warfare, rural living, and arguably darkness. It prompts me to ask the question about the relative success of different regimes in tackling the transmission of infectious disease. I mean, the argument is still going on in this country, and I'm sure it is in the states as the relative efficacy of the measures which are taken in these countries against COVID. But historically, can we talk about some regimes which are more successful than others? And perhaps why they have been more successful than others? Absolutely. So, your Sinia Pestus then dies off for a bit, and then reappears, of course, in the 14th century, Black Death. Devastating demographic event, perhaps a third of Europe dies, not a devastating political or economic event. In fact, in those regimes, they were quite stable. The borders were strong. Castles could be defended by smaller armies. And the population who remained after the Black Death got richer, because you had more land per person, because wages rose for this scarce craftsman who remained. And you started to see cities, city states that were able to devise defenses. The first is Raguso, a Dubrovnik now, smart mercantile city, which starts the institution of quarantine, of keeping ships out for time when there is word plague. It's an imperfect solution, but it starts and it starts to give us some degree of a tool to fight back. Venice, a greater mercantile power, then makes quarantine into a way of life almost. I mean, it's quarantine becomes central. And again, Venice is arguably the best run state in Europe in the 15th century. So it's not surprising that this highly competent, relatively allegaric regime, not ruled by a single dynasty, not prone to sort of great sways of power, comes up with a sensible solution. Of course, in the book, we highlight the 19th century fight against plagues of that era. And Disraeli is really part of that. The backstory for that is the globalization of the 19th century, the sea lanes, which Liverpool is such a crucial part of, allows plague to spread across the world. First, that's yellow fever, makes its way from Africa to the Caribbean, then to the cities of the Northeast in the 18th century. And then after 1817, cholera emerges in a particularly virulent form in the Ganges delta. And it lays waste to India and moves along with the English army, it moves along with the Russian army, it moves its way across sea. And it starts devastating England, it starts at devastating the cities of the US as well. There are great breakthroughs that occur. Of course, one of the most famous, of course, four years before Disraeli speech in Soho, when Dr. John Snow uses the map of London uses the information that the city has given him to figure out what's causing car to figure out that it's coming from from a polluted well. But the connection between water and cholera, it's even before it's understood, there is a school of thought, an erroneous one scientifically, but one that gets the public health right that says that we need to fight these plagues by draining the swamps. We need to fight them by getting rid of our waste and by bringing in clean water. They believe that my asthma causes the illness, which is totally wrong, but it leads them to the right conclusions. And so I view this, David and I view this as this moment when city governments start investing in clean water, start investing in aqueducts and sewers. In the US, it's really a starts in the 1820s. And it's really a hinge of history where if you think about what countries mostly did, what governments mostly did prior to 1800, mostly they killed people. Right, one way or another, starting in the 19th century through these investments in water, they started saving people's lives. Right, governments became agents of life rather than agents of death. And it's a remarkable moment in human history. And it occurs with very sensible pragmatic governments that are very focused on trying to solve basic engineering problems in a really pragmatic way. Despite the excellent examples you give of 19th century public health advances, sewers and clean water, but you feel that you are necessary to indict the American health system when you turn to the responses to the recent pandemic. What went wrong? You know, it's amazing how haphazard the responses really were, you know, first of all, it's my co-author, David Cutler, who is the health health economist. So I think he's he's largely responsible for those chapters, but we have never been good at having a national response to health. Right. We designed in our Medicare and Medicare systems, insurance systems, not public health systems. And so they are designed to pay for any reasonable treatment that the private sector can devise. And so they cost trillions and trillions of dollars because the public's private sector has been very keen on devising expensive systems. But no part of those systems were ever meant to produce obesity or to, you know, ensure healthy behavior or to create bodies that were strong enough to resist disease. And that's a big part of it. On top of this, we were quite weak in terms of defending our most vulnerable people as America is often. And, you know, in particular, I think the most flaring error, the one sort of obvious thing that we did wrong was not to protect our nursing homes. And the sort of tragedies of the mass deaths, it very poorly run nursing homes is really, you know, an absolutely shameful incident in American history. Yes, but we could also sort of hear about the discharge of infected patients into our nursing homes. But let me move on to is there a sort of blueprint for how modern cities should respond to global health challenges? Well, much of this has to be done at the national or even global level. So David and I advocate, which is something which we call NATO for health, which we thought of, you know, two years ago as a quaint metaphor, if you will. Today, given the increased importance of NATO, thanks to Ukraine, you know, maybe we're thinking actually NATO itself should be taking this on. But we really think that there needs to be a global alliance that is involved in investing in preemptive monitoring, investing perhaps in preemptive vaccine development, and a great global swap where rich countries invest in the sanitary infrastructure in the poor world, like sores and piped water in exchange for increased monitoring and increased separation of people from the wild animals that can create diseases. So we think those are the most important steps of creating a global alliance that builds defenses that make sure we don't treat this pandemic lightly and make sure it doesn't happen again anytime soon. You're anxious to say that your book is really not about disease, but rather about the problems that can come with urban scale and proximity. Now, as I understand it, as I read you, you are a fan of urban density, but what's the downside? What are the demons? Sadly, contagious disease is not the only one. There's also crime, there's also traffic congestion, there's also high housing costs. I mean, if two people are close enough to exchange a newspaper, there's also close enough, one of them is also close enough to mug the other one to rob them at knife point or gunpoint. And cities have been dealing with these downsides for thousands of years. Of course, the most important of them is contagion, but in the US, at least the COVID pandemic has been accompanied by the Black Lives Matter movement and unhappiness about police brutality. America really has to figure it away so that it's cities can be both safe from crime and where young people, especially young people of color, can wander the streets with the people. without being harassed by the police. This is essentially good management of the demons of density. - Most of the neighborhoods, I think you say, failed to provide economic mobility, but failed to provide that chance of moving up, moving out. - Absolutely, and some neighborhoods are much more likely to create children who end up being in jail when they're adults. These inequalities, both in the US and in the UK, are shocking and problematic. And it comes in part from the social isolation that children often experience in cities. So if you think about an adult who's living in, let's say, a relatively poor part of London or Liverpool or New York, that adult will typically go to work in an economically integrated firm. That adult will interact with educated people, they will be part of some urban mixing, if you will. By contrast, the child who may live in a public housing project and go to an economically segregated, if not racially segregated school, will live in a world that is segregated as a rural village can be. And so all of the advantages of city which come from interactions are lost on the kids. And that is, in some sense, a crime of the city. And it's something that we need to fight very much against. I don't think that there's a clear answer. I mean, we push forward the idea of vocational training, training, you know, electricians and computer programmers that wraps around traditional education that's done on an experimental basis with lots of innovation and competition. But we're open to lots of different experiments. But we need to recognize that cities, even as they provide economic opportunity for their adults too often, they're failing their children. You do say that some cities are healthier, generally healthier than others. And this too, throughout the world. Let's talk about a few examples, can we? In general, more educated cities are tend to be much healthier than less educated cities. And if you're looking for, you know, one variable, years of education tends to be a pretty good one, which doesn't just reflect that more educated people have themselves healthier behaviors. They tend to smoke less, they tend to drink less, they tend to be less obese. But also that being around healthy people seems to be associated with your habits being healthier as well. So when we see sort of the city differences, a lot of them have to do with just the education level and the education level of people's peers. It's also true that just within cities, they're astonishing differences. I mean, we talk about in the book of these two neighborhoods in New York and you can find equivalents in London as well, where there's a 10-year life expectancy gap between a place that's 10 miles away from another. Most of that is about health behaviors. Yes, you do have some dramatic examples, then you can talk about, then in the encampment in the borough of London, life expectancy for women is 87 years of age. If you go 16 miles to the east to barking and dagging and the life expectancy is five years lower there, your optimistic Edward that cities can flourish again, not simply in terms of health and preventing sort of preventing contagions like COVID, what are the grounds for your optimism? I mean, what are your main prescriptions to ensure that they do flourish? I'm optimistic because in the past 650 years, cities have endured much worse than this and they have reinvented themselves time and time again. It doesn't mean that I'm optimistic about every city, but we are a social species. We thrive by being around other people. We learn by being around other smart people. For my entire adult life, I have been listening to the cyber seers and the techno profits prognosticate the fall of cities and the role that electronic interactions will play in causing us to just shelter in our electronic cottages and dilatant in. For 40 of those years, right, since between 1980 and 2020, they have been completely and totally wrong. And what new technologies did was they increased the returns to being smart, they increased the return to innovation and guess what, we are social species that learns how to innovate by being around other people. And we saw great urban renaissance in London, in New York, in Copenhagen, in Paris, all of which were associated with being part of this technological world, I do not think that COVID-19 is going to change that. In terms of prescriptions, I think we need to be much more pragmatic than we've been. We need to be wary of future pandemics. Our cities need to be places where we focus on providing opportunity for poorer children and health for poorer adults. But at the same time, we need to be smart about it. We need to recognize that cities are machines that need to produce human interactions and to enable those interactions and to do so in a safe and healthy environment. And that requires an enormous focus on that task rather than being distracted by all sorts of political and ideological waves of the present. What other thing I want to throw at you? Edward, I think you yourself are suburbanites. And that fact does remind me of how, at least in London, the suburbs or some suburbs, no doubt influenced by brute economic facts have almost become, well, almost fashionable, but again. I mean, a relatively close relation of mine is a 40-year-old. It was only recently telling me how delighted he and his wife were with living in Serboton. Now, that's not only a suburb, which sounds like a suburb, but it's a suburb that, in the past, was often the bus of jokes and the theme of sitcoms. I mean, suburb doesn't now seem, well, quite such a pejorative term. I wonder if this might be another threat to cities of rival the renaissance of the suburb. Well, suburbs looked good in a time of social distancing where people were doing more at home, and so they wanted more space. Just to sort of be clear, I'm an economist, right? And I believe very strongly that it's a great thing when human beings have choices. I think it's a great thing that people have the option to move to suburbs as well as to reside in cities. And for many of us who sleep at night and a suburb, we go to work in a city. And so in some sense, our lives are hybrid, which is a perfectly reasonable way of living, if we figure out how to do this in a relatively low carbon manner. But yes, I think that at this moment, cities need to realize that they are as vulnerable as they have ever been, which means they really need to put on their A game and make sure that they deliver an urban experience that is attractive to people. I think though in the long run, urban density will continue to be attractive. It may be attractive to slightly different people. So one of the things that's happened over the last 20 years was that cities became too expensive for young people for people who are on the margins of economic prosperity. If people start moving out to the suburbs, if 40-year-old prosperous, 40-year-old start moving out to the suburbs, this will reduce the demand for urban space and make it possible for younger, scrappier people to come into London. That's not all bad. Many of the largest benefits of urban life flow to the young. And so I think that despite the fact that there is a current rise in the suburban access, I don't see this as being an existential threat to urban living. And certainly not a different one that's been going on for much of the past 75 years, where the move to car-based living in the excerpts has been a huge part of American life and a modest part of UK life as well. But there's room in that suburban world for cities to continue to thrive and triumph. It would be a-- thank you so much. Thank you for your book. And thank you for your insights. We began this program. We talk of the destruction of cities, and we're hardly going to need to watch the evening use to find contemporary examples of urban bombardment. Examples that somehow I can still manage to watch despite my very real memories of the actual air raids, the sirens, the searchlights, the thundering crashes, waking in the morning to find that houses on the other side of the street had simply disappeared like-- well, like pulled teeth. I think a reminder is in order. September 1940. And I suppose we shall all remember the emotions of this heavy summer. What our new Prime Minister called our darkest hour. When it seemed that any day we might be invaded by the Nazi hordes, but we weren't downhearted, we worked and waited. Weighted for the terror we knew was coming. Then it came. This was the sound that became part of the daily life of every man, woman, and child in Britain. The bombing of London began at five o'clock on the afternoon of September the 7th, 1940, for 12 hours in senderies and high explosives rained down. In an attempt to break British morale, thousands of homes were destroyed on that first night. 430 people died. That was a thinking-aloud podcast from BBC Radio 4. You'll find a treasure trove of other thinking-aloud programs on BBC Sounds. The news was that the Liberian Uden study was over. The 70th century-old, the first-year-old has been able to find a new one. The scientists were able to find the treasure, the secret weapon that was found in the lab. The target was to find the treasure, the treasure, and the secret weapon that was found in the lab. The discovery was found. Liber, here's the news. Now it's the energy of the Kodilla. Yeah, that's a great deal. Yeah, that's a good thing. - That's what we're talking about. - Yes, we're talking about the story.