Ideas,Municipal Sanitation,and the Transformation of Public Health

Abstract

The transition from private, individual garbage disposal practices to public responsibility for sanitation marked a durable shift in governing authority, which advanced local governments’ control over public health at the same time it transformed public health outcomes in American cities. How did political actors at the time advocate for, win, and maintain cities’ public health authority and capacity? We show the development of municipal garbage programs was predicated on the bedrock of ideas about garbage as a sanitary issue. Further, we illustrate how power was exercised through the idea of sanitation, whether in casting filth as a threat to public health, persuading politicians to adopt sanitary measures, or in inducing residents to comply with new practices. The ideas sanitary experts promoted, the policies they advocated for, and the waste management infrastructure they helped to develop remain evident in the acceptance, location, and methods of garbage collection and disposal today.

As urban populations increased in the late-19th century, the growing density created what economic historian Michael Haines describes as “virtual charnel houses” (Haines 2001, 37). Human, animal, and industrial wastes were rampant, and the uncontrolled spread of ill health and disease contributed to rising mortality in the United States as a whole. Citywide responses were urged by sanitarians (medical experts concerned with promoting public health), engineers trained in sanitary science, businessmen, and civic reformers. With a wave of ordinances in cities across the United States in the mid-1890s, garbage collection and disposal became core functions of municipal governments (Melosi 2004). The transition from private, individual disposal practices to public responsibility for sanitation, then, marked a durable shift in governing authority, which advanced local governments’ control over public health at the same time it transformed public health outcomes in American cities. Although public health has long been a fundamental function of local governments, political science has not focused on it. So, how did political actors at the time advocate for, win, and maintain cities’ public health authority and capacity? We show the development of municipal garbage programs was predicated on the bedrock of ideas about garbage as a sanitary—rather than, for example, a business or engineering—issue. Further, we illustrate how power was exercised through the idea of sanitation, whether in casting filth as a threat to public health, persuading politicians to adopt sanitary measures, or in inducing residents to comply with new practices. The ideas about health sanitary experts promoted in American cities, the policies they advocated for, and the waste management infrastructure they helped to develop remain evident in the acceptance, location, and methods of garbage collection and disposal today, animated by the idea of sanitation (Garrick 2004; Pollans 2021).

To examine how the idea of sanitation has been so long lasting, we identified constituencies originally opposed to the cause of sanitation and those who vied for control of sanitation programs. We then inductively analyzed the ways that they engaged the idea of sanitation, using the theoretical tools of American Political Development research. We draw our data from contemporaneous accounts of sanitary experts, secondary histories of municipal sanitation, and government documents, newspaper accounts, and archival papers in six major US cities. We find that sanitarians not only established the idea of sanitation as way to address garbage in American cities, entrenching their professional authority to promote garbage collection efforts, they also maintained sanitation as an idea that was pliable enough to invite new participants and to reject others. The resultant political contests were not a clash of political orders but challenges around an idea and its institutional benefits as different interests joined in, cashed in, were cast aside, or lost out. Our case illustrates both the stability and malleability of ideas. Ideas can promote stability precisely because they are not fixed, allowing different constituencies to tap into them for political gain. They may become attractive to new interests, be deployed in political challenges, and be used to denigrate some as not living up to the idea. Ultimately, we show how long-term gains in municipal public health and the consistency of city garbage programs were the result of a pliable idea of sanitation.

Political Development and the Role of Ideas in the Transformation of Public Health

To understand the role of ideas in the transformation in municipal authority over public health, we draw on literature from American political development (APD). A great deal of political development research looks at national-level institutions or statebuilding from the subnational to national level, but local governments are important in their own right, and the ability to address public health is fundamentally grounded in local governments (Jarman et al. n.d.; Kuo and Kelly 2025; Moreira et al. n.d.). Local government structures themselves rest on the history and composition of a community (Jarman et al. n.d.), and they create inequalities that reproduce over time. Some communities leverage unequal wealth (Jarman et al. n.d.), commitment to equality (Moreira et al. n.d.), or relationships with non-state actors (Kuo and Kelly 2025) to improve the quality of life for local communities while others do not. Local governments also have various degrees of political will (Moreira et al. n.d.) and capacity (Jarman et al. n.d.; Kuo and Kelly 2025) to address a problem.

Of all the local governments in the United States, we focus on cities because they are critically important actor in political development (Dilworth 2014; 2009). As Richardson Dilworth explains, cities and urbanization occupy a place of “larger theoretical significance” to American political development (Dilworth 2014, 389; 2003). Cities matter not merely because insights learned from analysis of cities can be applied to other governments or because new theories can be developed to understand and explain politics in cities. When it comes to public health, many of the most important health measures were created and enforced in municipalities. Important public health issues often lack political salience, however, until they are clearly problems that can no longer be ignored (Jarman et al. n.d.; Kuo and Kelly 2025) or until they are identified as a particular kind of problem.

Identifying and solving such problems was the task of Progressive Era urban reforms, whether reforming city charters, cleaning up corruption, or relying on experts to deliver public works or beautification projects. Municipal efforts transformed American public health, increasing the overall life expectancy in the United States (from 47 to 63 years), altering municipal authority over public health from ad-hoc and underfunded public health resources to permanent municipal agencies, and reshaping Americans’ relationship to local government when municipalities induced compliance with new health ordinances (Cutler and Miller 2005; Duffy 1992; Haines 2001). City efforts shrank the urban disadvantage in reduced life expectancy and higher infant mortality so that it largely disappeared by 1940 (Haines 2001). More than just improving life in American cities, changes in municipal public health increased US life expectancy overall and altered American health outcomes (Cutler and Miller 2005). In keeping with the tenets of the Progressive Era, these new government programs were beneficial for the public good. Progressives shared a belief in the ability of the state to operate, free from corruption, to serve human progress and the public good (Gendzel 2011). Even well-intended goals, however, require public authority to garner support, expend resources, and allocate land use (Strach and Sullivan 2023). Any of these can result in the reproduction of social inequalities (Gordon 1995; Jenkins 2021). Progressive ideas of sanitation could just as easily cast things or people as filth as they could remove it (Zimring 2015). Recognizing the role of sanitation as an “emulsifier” (Dilworth and Weaver 2020, 12) or “common carrier” (Schickler 2001) of various and possibly competing interests allows us to identify the malleability, power relations, and endurance embedded into an idea that, on its face, tends to the public good.

American political development offers the theoretical tools to address lasting change, like the one we see in the transformation of American public health through municipal garbage collection and disposal programs. APD examines durable shifts in governing authority, defined as “change in the locus or direction of control” over “persons or things that is designated and enforceable by the state” (Orren and Skowronek 2004, 123). More than a change, even an important and long lasting one, political development requires a new distribution of authority, setting the stage for future politics. Cities transformed private practices of disposal into publicly provided or required services, relying on state authority to instill compliance. Erecting and carrying out these programs, across the nation, was a significant and enduring development, and municipal garbage collection, today, operates not much differently than it did in the 1890s.

Durable change rarely involves fully dismantling old forms of authority and old institutions and the creation of new ones, rather it entails replacement of some parts of past policies, conversion of past practices, and layering new arrangements on top of old ones (Lucas 2017, 341; Skowronek and Orren 2014, 30). Development does not take place uniformly across cities or even within them; and it does not create consistent institutions (Weaver 2022). Political development can occur in the friction between multiple orders that have developed at different times, running in contradictory currents (Orren and Skowronek 2004; Rast 2015). Contradictory pressures can bring about conflict, which then invites development to a new order (Lucas 2017; Rast 2015, 142–43). This focus on the mechanisms of change has encouraged attention to ideas, which establish the purposes of each order, providing a basis for policies and institutional development (Weaver 2022, 325). When the expectations of that order fail to be met, ideas make incongruities apparent (Dilworth and Weaver 2020; Rast 2015; Smith 2014; Weaver 2018, 239–40).

Importantly in a field focused on change, ideas not only are catalysts, they may also maintain an order. Dilworth and Weaver explain how ideas are “emulsifiers,” and they “are precisely the ingredient that smooths contradictions and frictions and provides the language of the future world that explains changes as more complete and definitive breaks from the past” (Dilworth and Weaver 2020, 12). Ideas promote political development, then, both by fostering a rupture from a pre-existing order and by sustaining a new one. This new order does not need to be a “wholesale, city-wide, institutionally-deep transformation” (Weaver 2022, 330), and may be found in specific areas such as garbage collection and disposal.

The Idea of Sanitation

The idea of sanitation reshaped what was seen as the private behavior of residents accustomed to disposing of waste informally in yards, streets, and waterways to a public problem requiring a public health solution. When governments took on municipal garbage collection, however, it was not a foregone conclusion that they would address it as sanitary concern. Garbage collection could have been driven by any number of ideas. In his 1901 review of refuse collection in cities across the United States, the sanitarian Charles Chapin listed the variety of city departments that oversaw garbage collection, including health departments, streets departments, departments of public safety, and departments of public works (Chapin 1901, 689). That variety reflects the types of interests that were invested in cleaning cities. Streets were the space of public concern when residents were responsible for their own garbage disposal, and streets were a site of early innovative capacity (Waring 1897). Early street cleaning could belong to the police department as a means to clear streets for safe passage (Waring 1897, 13). As a consequence, some cities housed garbage in a department of public safety, with public health subsumed under it. In the early 20th century, public safety retained a broader understanding of protection, whether from crime, accident, or health hazards (Friedman 2022). In 1900, Columbus’ Department of Public Safety included the police, fire, markets, health, and charities department and the inspector of buildings (Annual Reports of Columbus 1900 1901). Pittsburgh's Department of Public Safety in 1900 included the bureau of health, division of bacteriology, division of sanitary inspection, division of food inspection, division of plumbing and house drainage, plumbers’ examining board, and municipal hospital. The gravitation of such sanitary functions away from public safety indicates a shift in understanding of public safety.

Attention to streets could likewise have led to garbage addressed as a commercial issue with a business solution. Things that were dirty could be commodified: The waste of horses was removed by farmers for manure, and horse carcasses left in streets were retrieved by rendering plants (Tarr and Mcshane 2008, 12–13). The need to keep commerce literally moving on the streets could have made waste removal a commercial idea. In her study of yellow fever, Margaret Humphreys pointed out that the interruptions to commerce brought about by epidemics “made yellow fever above all a commercial problem” (Humphreys 1999, 2). If garbage presented a problem for commerce, the solutions could have been framed as commercial.

The infrastructural needs of garbage collection and disposal led to some garbage collection programs being housed in departments of public works. Given the need for the engineering profession as public works projects expanded in the late 19th century, garbage could have been an engineering issue, with all of the ingenuity, utility, and efficiency characterizing the profession. Yet sanitarians pushed for the idea of garbage as a sanitary concern, and the idea endures. Municipal garbage collection continues—for the most part—to be thought of in terms of sanitation with some cities still housing garbage collection in a department of sanitation, reflecting the authority of cities to protect residents from public health threats by removing filth from concentrated populations. Even as the progressive notions of municipal services are being supplanted by outsourcing and neoliberalism sanitation remains salient as an idea that governments have an obligation to guard public health (Pollans 2021; Weaver 2021).

Given that garbage collection and disposal programs—and the underlying idea of sanitation—have been so enduring, we do not look for change across political orders. Instead, we examine the relationship between constituencies and the idea of sanitation. We identified groups who were opposed to sanitation programs and those who vied for control, charting the relationship between these constituencies and the idea of sanitation. We inductively analyzed our data drawn from three sources: 19th-century experts’ catalog of sanitary practices; secondary histories of sanitation in cities across the United States; and historical documents, including official reports, papers of individuals and groups with a stake in collection and disposal, professional and trade journals, and contemporaneous newspaper stories from six large, important cities dispersed geographically across the United States (Charleston, Columbus, New Orleans, Pittsburgh, San Francisco, and St. Louis). Together these data allow us to describe the creation of municipal garbage collection and disposal programs, to study the constituencies involved, and to identify the ideas associated with the development of municipal sanitation. We demonstrate how, as an idea, sanitation was malleable enough to allow and even incorporate or shape challengers.

Even a progressive idea like sanitation engaged in its own power relations—asserting it as the expert animating idea, displacing challengers, and fending off further challenge by being flexible enough to invite new parties in. The sanitation idea involved not only the authority of the (local) state, but also the power relations bound up in that idea. Sanitation emerged as a discursive form, achieving epistemological authority that brought new ideas and occupations (whether engineering or civic reform) into its categories and responses (Deleuze 1986; Foucault 1972). Carl Zimring's study of the displacement of scavengers because it was “dirty work” points to the ability of the idea of sanitation to cast others as unsuitably unsanitary and replace their work with public sanitation programs (Zimring 2015). In her findings on the operation of ideas in urban political development, similarly, Sally Lawton notes the use of blight as a political metaphor, getting “people to see things in a different way” (Lawton 2020, 37), serving both to encourage urban renewal programs and to reinforce racial inequality for those who live in “so-called blight” (Lawton 2020, 39–42). Corburn (2007) points out that urban planning studies overlook issues of power and governance. Kuo and Kelly (2025) recover dynamics of power by identifying a local public health agency's relationships with non-state actors (Kuo and Kell 2025). Moreira et al. (n.d.) look to existing commitments to racial equality to see how well localities follow through in making statements about race and inclusion (Moreira et al. n.d.). Jarman et al. (n.d.) point out that local governance structures rest on such varied factors as history, landscape, and wealth disparities (Jarman et al. n.d.) An idea can see various permutations within a political order, calibrated to promote policies, advance statebuilding, and shape citizen status. The idea of sanitation established the professional authority of sanitarians to promote garbage collection efforts while being pliable enough to invite new participants.

Political Development of Sanitation

Sanitation was driven by the understanding of cities as dirty. Human waste presented “a major sanitary problem,” entering local wells, streams, and rivers, threatening the water supply, and concerns for disease were “a major impetus for the movement for sanitary reform,” inviting sanitarians to make claims for defining problems and identifying reforms (Duffy 1992, 75, 48). 19^th-Century cities had high mortality rates and disease outbreaks were common. In some cases, evident filth in homes, streets, and water led to deadly diseases such as cholera, which was spread by water tainted with raw sewage (Rosenberg 1987). In other cases, it did not.

For much of the 19th century, doctors, scientists, and sanitarians did not agree on what caused disease. Contagionists believed that disease was spread person-to-person and, as a result, they advocated for quarantine, keeping affected individuals from infecting others (Duffy 1992; Ogle 1999). Anti-contagionists believed that disease was caused by the environment, which included both filthy surroundings and filthy (poor) people (Ogle 1999, 324–5). The primary environmental cause was miasma, in which vapors released from the ground led to corrupt air, poisoning people who breathed it in, with the solution being sanitary clean-up of cities (Bloom 1993, 13; Ogle 1999). When Memphis suffered its historic yellow fever epidemic of 1878, it hired George Waring, renowned as the greatest sanitary engineer of his day, who attributed disease transmission to gas from raw sewage. This would later be disproven, but Waring nevertheless built a state-of-the-art sewerage system (Duffy 1992, 144–6; Schultz and McShane 1978). More definitive accounts of germ theory would not gain ground until late in the 19th into early 20th centuries and would challenge the filth theory and environmental solutions (Humphreys 1999, 25). In the meantime, however, many cities implemented policies aimed at clean water and streets. Even if public works sanitation projects did not combat epidemics, they did secure general community health, a rising standard of living, and higher life expectancy (Duffy 1992, 193).

Sanitarians were instrumental in introducing ideas about filth and in promoting public health, defined as “organized and institutionalized efforts to improve community health” (Duffy 1992, 2). Early 19th-century cities responded to episodic disease outbreaks by setting up boards of health and health offices. But those offices were limited in their powers and “sporadic in their operation,” restoring cities to their usual conditions and not to bettering community health (Marcus 1980, 4). Removal of waste had been left to individual householders or private enterprise (Duffy 1968, 274). Because residents and contractors were likely to leave dirt and other refuse in the street when they removed waste from the premises, the scope of early public waste programs was largely limited to streets, with street commissioners in charge of removing garbage, manure, and rubbish, and the sale of manure covering collection costs (Duffy 1992, 71).

The sanitary movement itself developed from local physicians to doctors specializing in public health and engineers trained in public health infrastructure (Duffy 1992, 129). Sanitary engineers could be trained in programs at universities, such as Harvard and Massachusetts Institute of Technology, or join public health programs (Melosi 2004, 73). Sanitary knowledge and ideas to address disease epidemics led to an emphasis on cleaning. Sanitarians brought attention to lack of sewerage, unclean drinking water, accumulating filth in streets and gutters, and tainted milk. While European sanitarians worked to influence national governments, the structure of American government meant that US sanitarians addressed problems in municipalities (Duffy 1992). The organized public health movement began with John Griscom's publication of The Sanitary Condition of the Laboring Population in 1845 (Kiechle 2021, 777). Doctors organized the American Medical Association in 1847 and the American Public Health Association in 1872. They met regularly to discuss how best to collect data demonstrating the effects of filth, to prioritize threats to public health, and to establish the most promising solutions. The APHA appointed a committee in 1887 to study municipal practices in garbage disposal and continued to collect statistics on local practices in ensuing decades (Hering 1911). While sanitarians favored disposal methods such as reduction and incineration over dumping, they were reticent to prescribe a single method, given the vagaries of local conditions, which ranged from the climate conditions to funding amounts to the will of political regimes (Hering 1911, 910; Hering and Greeley 1921, 2).

By the 1890s, cities across the country passed garbage ordinances, establishing garbage collection by the city, by contract, or they had no municipal collection, leaving it to private contractors (Chapin 1901). Cities took on new roles, developed new capacities, channeled resources, required residents to change their own behavior in their homes in order to comply. Garbage collection programs continue to look much like they did in the 1890s, and they continue to operate along the logic of sanitation. How did sanitary reformers build and then maintain long-term support for sanitation? The answer lies in the idea of sanitation itself, which could be used to build support from constituencies who might otherwise be opposed (businessmen buying in) or who vied for control of public health programs (engineers cashing in). At the same time, it could be used to wrest control of public health measures from existing constituencies (scavengers cast aside) and impose costs on others (residents losing out). Tracing the idea of sanitation allows us to see in which ways the lines were expanded or contracted and for whom, which has implications for the stability of the idea as well as the programs that promote it.

Buying Into the Idea of Sanitation: Businessmen

When the idea of sanitation was associated with disease caused by person-to-person transmission (contagionism) and quarantine the solution, businessmen were strongly opposed to it. After all, holding ships in port and trains in towns was costly to shipowners and merchants. Such reactions comport with the late 20th-century understanding that businesses resist regulation. 19^th-Century local officials had the authority to protect public health, but they could expect to face resistance from business interests, especially for quarantine. As yellow fever outbreaks hobbled New Orleans, the commercial gateway to the Mississippi Valley, inland communities imposed their own quarantines on the Crescent City and encouraged the state of Louisiana to impose a general maritime quarantine. Businessmen “chafed” at the idea as “not only useless but in the highest degree oppressive and injurious to the commerce of this city” (Bloom 1993, 36–7 citing Carrigan 1959).

The relation between businesses and local governments was more complex than that, however. Garbage, horse manure, dead carcasses, and other matter were literal obstructions to the flow of commerce on city streets. Prior to cities developing the capacity to clean streets, local business organizations were known to muster private resources to clean the streets. St. Louis, for example, had a Citizens’ Sanitary Aid Association in the 1880s, and New Orleans an Auxiliary Sanitary Association in the mid-1800s (Health Commissioner, St. Louis 1885; Sanitary Commission of New Orleans 1854). Businessmen did not resist regulation. Instead, local businesses can be better understood as engaging in partnerships with local governments. When the idea of sanitation was associated with environmental concerns caused by “filth” (anticontagionism) and clean streets were the solution, businessmen could be more or less enthusiastic about the response. The malleability of the idea of sanitation to encompass both quarantine and environmental clean-up allowed sanitarians and other health proponents to build support in the business community. Some sanitary experts went so far as to sell the idea of sanitation as good for business and not just good for public health.

The abatement of public nuisances, including disease, was a basic authority under the common law tradition (Blackstone 1765, 216–7). Protection of public health has been one of the most fundamental functions of American government, historically operating at the local level. If the police powers are “the ability of a state or locality to enact and enforce public laws regulating or even destroying private right, interest, liberty, or property for the common good (i.e. for the public safety, comfort, welfare, morals or health),” then public health can be recognized as intrinsic in American governance (Novak 1996, 13). It was practiced in the 18th century, with local governments requiring smallpox inoculations governing people's private behavior around mobility and concealment of the disease (Wehrman 2022). In the yellow fever era (1793–1806), cities organized in response to epidemics with measures carried out by voluntary associations, health committees, or boards of health (Rosenberg 1987, 84–92; Duffy 1992, 7–8, 41–2). Cholera outbreaks turned attention to “filth and stench,” inviting cities to clean streets, removing rotting garbage, dead animals, and human waste (Rosenberg 1987, 20, 94).

Medical experts led the institution building. Their success came not simply in creating these institutions but in what Daniel Carpenter has pointed to as the understudied aspect of “institutional transformation” (Carpenter 2001, 11). The response to diseases such as yellow fever saw the administrative innovation, established through state authority, that passed along discretionary authority to local boards of health (Novak 1996, 202). Although these boards of health were legitimate uses of authority, they operated “in name only” (Ellis 1992, 34). Early boards of health tended to be erected quickly in response to epidemics, and then disbanded soon thereafter (Carrigan 1959, 342; Duffy 1992). That pattern continued into the later 19th century. New Orleans’ board of health dated back to 1804, but it was not consistently maintained. It carried out a swamp-draining program during a 5-year stretch of yellow fever in 1852, but then its members were let go. When an epidemic erupted the next year, the board of health was staffed only by a secretary (Carrigan 1959, 345). While they were in operation, however, they were quite effective at establishing quarantines. Board of health officials developed questionnaires about the passengers and goods, producing an early form of vital statistics (Novak 1996, 207). This development in administrative capacity drew the ire of shipowners and local merchants whose goods were held up in port (Novak 1996, 209). They complained about obstacles to commerce and favoritism among officials (Duffy 1968, 331, 333). As John Duffy explains, a ship could be held in port 30 or 60 days, at great cost to shipowners and importers. Boards of health, facing political pressure from local business leaders, would be reticent to enforce quarantine, leading to the issuing of quarantines once it was too late (Duffy 1992, 49). With their ability to hold up goods and trade, epidemics and their quarantining became a commercial problem, leading to resistance by businesses (Humphreys 1999, 2).

By the late 19th century, however, when the idea of sanitation was associated with environmental cleanup rather than quarantine, businessmen began to see sanitation as a way to promote rather than inhibit commerce. The devastating yellow fever epidemic in 1878 ravaged Memphis and New Orleans and spread throughout the Mississippi valley. Quarantines imposed by neighboring cities to protect themselves from disease shut down commerce including mail, and contemporaneous accounts put pecuniary losses at $200,000,000 (Bloom 1993, 2). Business leaders came to appreciate how “health and prosperity were intimately related” (Duffy 1992, 146). Many dropped their opposition and joined public health efforts, instigating campaigns to clean city streets (Humphreys 1999, 77). Business interest in sanitation, especially in southern cities, helped secure the support needed for more lasting boards of health. The Southern Chemical Convention, which met in New Orleans, was “instrumental” in the creation of the Louisiana state board of health because of the high costs of epidemics to the merchants. Businessmen were even added to some boards of health by state legislators when they erected city boards of health (Humphreys 1999, 55–7). They continued to place their own interests as primary when establishing stronger boards of health. By 1880, when the Department of the Interior conducted a census of cities, 94% had a board of health, health commissioner or health officer, and nearly half of these health offices had control over garbage collection and disposal (Melosi 1980, 111).

Even as knowledge of epidemic disease developed from the miasma theory to germ theory, sanitary responses continued to build on existing systems (Melosi 2008). To address disease outbreaks that swept across the country but were dealt with by state and local health authorities, Congress created a national board of health in 1879. It was short-lived. States were opposed to increasing authority of the federal government, while business interests feared it would be “coercive and restrictive of trade” (Rosner, Lauterstein, and Michael 2011, 127). John Billings, U.S. Army Surgeon, acknowledged that public health would entail some restriction on individual liberty, but the problem with a national board of health was that it lacked the police powers of the states, and could only collect information (Billings 1876, 51). Public health was a state and local matter, and local sanitarians continued in their position as the locus of authority.

Eager to maintain the cooperation of business interests, sanitarians were willing to reshape the idea of sanitation so that it was not the end in and of itself but was a means to achieve the ends that businessmen cared about. New York's city inspector John Griscom invited this approach in speaking about the utility of the health of the people in terms of available labor, as a way to appeal to business interests in 1842 (Kiechle 2021, 756). Collaboration with businessmen helped sanitarians to secure more political support for their reforms, but at some cost to the sanitary mission. John Duffy pointed out that these collaborations invited internal disagreement that limited the effectiveness of sanitary policies (Duffy 1968, 540). Michelle Kiechle sees this appeal to the profit/loss dimensions of public health as inviting “capitalism's command over American cities,” justifying public health with its economic utility rather than on the basis of community wellbeing (Kiechle 2021, 776).

As cities established municipal garbage programs, businessmen connected sanitary improvements to their own interests. Chicago's Society for the Prevention of Smoke was organized by businessmen representing a variety of occupations, including dry goods merchants, stockyard companies, and manufacturers (Rosen 1995). It was city business leaders who initiated a sanitary response to Memphis’ 1878 yellow fever epidemic, inviting Col. Waring to build a new sewer system (Duffy 1992, 145). The Auxiliary Sanitary Association, formed in New Orleans in 1879, was an organization of businessmen who turned attention to uncollected garbage, dirty streets, and untended privies (Humphreys 1999, 89). The ASA paid the wages of sanitary inspectors within the city's board of health and encouraged innovations of sanitary technology, until the city was able to take over in 1895 (Humphreys 1999, 99). But businessmen also benefitted personally from improved sanitation. In Milwaukee, a group of businessmen saw an opportunity to capitalize on garbage and won the right to dispose of garbage outside city limits. As the only organization (public or private) able to carry Milwaukee's garbage outside of its boundaries, these businessmen had a distinct advantage over other contractors and even the city itself (Leavitt 1996, 133–34). Business communities joined the sanitary movement when the idea of sanitation was good for business.

While cities had authority to address public health, they could receive greater opposition or support based on the animating idea behind their efforts. When sanitation was associated with quarantine, business interests were often actively opposed because these extraordinary measures were particularly harmful to their livelihoods. When sanitation was associated with environmental measures, and integrated into the ordinary caretaking of the city, business opposition softened. Indeed, many businessmen came to see sanitation as aligned with, and even beneficial to, their interests. Sanitation became the background condition to facilitate the flow of commerce and to bring local business interests on board with municipal garbage collection services.

Cashing In on the Idea of Sanitation: Engineers

Solving the garbage problem required technical solutions: new garbage receptacles that were water-tight yet light enough to lift, new garbage wagons to carry waste to disposal facilities without spilling their contents, and new plants to burn garbage that would not offend residents. With so many technical issues involved in cleaning cities, it's no wonder that engineers played a significant role. Yet garbage did not become an engineering problem. Although engineers could have vied for control over sanitary programs, the idea of sanitation expanded to incorporate them, and it was the source of new expertise and opportunities. The engineering profession developed at this time, in no small part due to cities’ embrace of sanitation, which allowed them to land lucrative public works contracts and jobs in city departments.

In 1901, US cities had $262.5 million in municipal budgets available for public works (“Bulletin of the Department of Labor” 1901, 914; cited in Whinery 1903, 3–4). In each city, there were miles of streets to be paved, miles of streets to be dug up, sewers laid, and then repaved and street railway track laid. Those streets would be cleaned by work crews and lit by lamps. The passage of garbage would proceed on these various layers of public works. New public works initiatives were a lucrative venture for engineers, who were ready to land contracts for the construction of streets, sewers, water supply, lighting, parks, schools, libraries, fire departments, docks, ferries, bridges, and garbage collection and disposal infrastructure.

Sanitarians, engineers, and municipal reformers coordinated with one another on this work. In their mission to remove corruption from municipal government, these reformers and interests promoted quality city services. When John Billings, M.D., spoke to the National Conference for Good City Government in 1894, he explained that there were two kinds of expert knowledge needed for “good city government”: the sanitarians who should be consulted on projects for water supply, sewage disposal, collecting vital statistics and other such sanitary measures, and those who would execute the projects, which included city officials, health officers, and engineers (Billings 1895, 493–4). Nevertheless, they were not in full support of one another's methods. Engineers questioned the scientific methods of sanitarians (“The Latest Garbage Disposal Statistics” 1903). And engineers thought the answer to city engineering problems was more engineering (“Needed Reforms in the Collection and Disposal of City Refuse” 1908).

When there was a lack of engineering expertise, engineers pointed out, cities took on public works with improper paving stones or improper street grading or other such blunders (Baker 1902, 3–4). City officials could not be expected to know how long a contract should be let in order for a project to succeed, or the proper temperature of furnaces, or the maintenance conditions for equipment (Baker 1902, 165, 238–9). Hering and Greeley suggested “systematizing the entire work under competent engineering advice and management, with the intimate co-operation of the health officers, and, under carefully drawn ordinances, regulating such community work” (Hering and Greeley 1921, 3).

Had garbage collection been conceptualized as an engineering problem, it likely would have centered as a technical issue (Pollans 2021, 20). The associate editor of Engineering News, M.N. Baker, lamented that city decisions were made in a policy diffusion process in which city leaders traveled on junkets to other cities, sharing information about best practices, and being influenced by whomever hosted them. Instead, as an engineer he would have removed decision-making from city councils to technical experts in engineering, chemistry, biology, finance, and scavengers, who knew how to do the work, on the ground (Baker 1902, 5–6, 164–5, 157). Not only would these experts center the scientific issues, they would have a sense of how long a contract would be needed in order to meet the investment required of contractors to build the operation to carry out a citywide garbage collection and disposal program (Baker 1902, 165).

Had engineering been the driver of garbage collection programs, it is likely that some of the many innovative ideas, from household practices to large disposal plants, would have come into fruition. Inventers had ideas such as a machine traveling around cities, grinding and drying garbage as it traveled, or unloading garbage cans with more efficiency (The Garbaget, 34). Services would likely have reflected the ingenuity of cans, carts, and disposal plants that turn-of-the-century engineers devised. Household garbage may have been destructed in the home, or entire cans transported across cities, or disposal plants may have followed through in the effort to profit off of waste. There likely would have been more contraptions, and other primary values, such as innovation, efficiency, or profitmaking (Analytic Study of Garbage, Rubbish and Ashes 1916; Edy 1917; Miller 1916). Instead, the idea of sanitation, which privileged removing waste from city centers, led to household garbage cans being put at the curb, emptied by collectors into carts, and whisked away. That is what garbage collection continues to look like, well into the 21st century (Pollans 2021). World War I made the federal government interested in the utilization of garbage, which could have privileged engineering interests, as the sanitary idea was considered “archaic” (Bamman 1919, 373). Federal interest waned after the war, however, and the idea of sanitation resumed as garbage was left to local governments.

Rather than control city projects like garbage collection and disposal, engineers joined the project of sanitation and engineering was put to the service of sanitary goals. The new field of sanitary engineering developed to address widescale responses to waste, as well as broader public works projects that protected public health. Sanitary engineers made advances in water filtration, drainage, sewerage, sewage disposal, street cleaning, and garbage disposal plants, overseeing the erection of large plants with attention to sanitation (Fuller 1922). The field of sanitary engineering added public health considerations to engineers’ training. George Waring, born in 1833, was trained as an agricultural scientist. His work in drainage led him to sewerage systems. His Memphis sewer system rescued the city from its use of privies and stagnant wastewater. In New York City, Waring erected a fleet of street cleaners, famously clad in white duck coats, in a Department of Street Cleaning (Waring 1897). George Soper started as a civil engineer. While serving as sanitary engineer in the New York City Department of Health in 1902, he identified “Typhoid Mary” after inspecting the plumbing and milk supply as cause of a typhoid spread. The sanitation consultant Rudolph Hering was trained as a civil engineer in Germany. His protege Samuel Greeley was trained in sanitary engineering at MIT.

The development of this profession produced experts that could imagine and implement large-scale public works projects. The engineering profession was becoming more specialized. Rather than work as a generalist chief engineer on a project, an engineer might specialize in water provision, sewage, street cleaning, or garbage. Housed in departments of public works or related departments, city engineers gained experience in administrative and legal municipal questions (“The Prospects for Young Engineers: A Symposium” 1894; see Schultz and McShane 1978, 401). Where medical professionals suggested the need for sanitary measures, sanitary engineers knew how to choose the bricks for streets, how to test the operation of sewer pipes, how to carry out a street cleaning project, how to flush sewers, and what carts and disposal plants were suitable for garbage collection, making sure that any city improvements were of a “permanent and durable character” (“Meeting of American Society of Municipal Improvements” 1896, 278–9). As Melosi summarized, “health officials could uncover the source of the refuse problem, but it was the new professional, the sanitary engineer, who would be called upon to find a solution” (Melosi 1980, 120).

Sanitary engineers believed that waste could be profitable. It was “not something intrinsically useless, but something which, when properly collected and transported to some other locality, may be of considerable value” (Soper 1909, 29). Sanitary engineers considered the utility and efficiency of disposal plants. They expected that this infrastructure could fund its own operations or even generate profits by picking out marketable materials, such as paper, and selling to a paper manufacturer (“Money from New York's Waste” 1903), the type of profit that scavengers and rag-pickers had traditionally made. Engineers were able to envision profits in their own garbage works. Colonel William F. Morse, a New York City sanitary engineer, pointed to the English practice of disposal via the destructor, which was in operation in Boston. This method of disposal started with a conveyor plant that separated garbage. Workers on the line would pick out rags, paper, cardboard, glass, leather, twine. The rest of the refuse was sent to a destructor, which had a boiler positioned so that the heat of the destructor boiled the water, which produced steam that provided a surplus of power. The source of energy could provide the energy for this which could power this operation (W.F. Morse 1901a, 1901b). Some cities even sought to rely on this source of steam to power their municipal electrical lighting stations (“Electrical Power from City Garbage and Refuse” 1905).

Sanitary engineers stood to benefit from the myriad projects promised by cities who contracted out. Upcoming contracts were advertised in trade publications, and the sanitary engineers advertised their services and their products in the same pages of the trade journals that provided news about the latest developments. Many sanitary engineers, such as Rudolph Hering and George Waring, personally benefitted through consulting contracts with various cities. Some advocated for sanitary solutions that they had close ties to. For example, Col. Morse was a critic of many incineration methods and promoted the English destructor as the best, most sanitary solution. Yet Morse also owned the company with rights to the technology. City engineers promoted themselves as neutral professionals. They were “the earliest municipal officials to achieve anything like job security,” which was reinforced by courts that decided engineers had title to their plans (Schultz and McShane 1978, 399). Firing a city engineer might leave a municipality without the ability to manage the infrastructure it relied on.

Engineering ideas welcomed ingenuity at every stage of garbage collection and disposal, even back to garbage cans and carts. The traditional practice of hauling away garbage in uncovered carts spewed debris away from the cart as it traversed the streets. Sanitary measures required covered carts. Engineers were ready to advance garbage cart innovation much further. The Shadbolt garbage wagon overcame the problem of iron wagons, which allowed for acids from the garbage to seep into bolts and rivets, by making the wagon half wood and half iron. An oiled canvas cover allowed garbage in the cart to be covered while making it easier to load and unload material out of and into the cart (“Sanitary Garbage Wagons” 1901). Those innovations perfected the sanitary condition of carts, but engineers were willing to make them even more efficient. Both the Watson Wagon Company and the Studebaker Brothers Manufacturing Company produced carts that could dump without stopping so that a driver would simply pull a lever while driving (“Dumping without Stopping” 1901). Had sanitary engineers had their way, there might be carts that picked up entire garbage cans, leaving an empty, clean one at the householder's curb side. There might be a garbaget, the portable disposal method, which turned garbage and processing it into powder before even getting to a plant to extract grease for future use (“The Garbaget” 1917). That garbage collection programs resisted such ingenuity suggests that engineering ideas did not come to dominate garbage collection. Nor did municipal garbage collection take on engineers’ ideas to make programs profitable or run on their own energy.

Engineers’ ideas did not replace the basic premise of sanitation, which dictated that waste be moved out of sight. Once cities took on sanitation programs, the idea of sanitation acted as an emulsifier (Dilworth and Weaver 2020, 12), inviting engineers to take up sanitation in order to serve their interests and even create the profession of sanitary engineer.

Cast Aside by the Idea of Sanitation: Scavengers

While the idea of sanitation was broad enough to incorporate businessmen, who bought in, and engineers, who cashed in, it was also used narrowly to keep scavengers, the original waste collectors, out of public health. Sanitarians established their authority to deal with threats to public health with reforms resting on the theory of filth, “an elastic conception” that accommodated various ideas of what constituted it (Peterson 1979). Filth could include offensive odors, cesspools, privy vaults, sewers, drainage, or plumbing as well as the visible matter that tended to accumulate around homes—putrid meat, decaying vegetables, manure, ash heaps, garbage, offal, rubbish, dirt (Chapin 1901, 126, 144). Boards of health relied on local scavengers to aid them in clearing up streets, empty lots, and other depositories of waste. Once city offices gained capacity, filth went from a description of objects to a description of people—those scavengers who were no longer considered suitable for sanitary work.

Prior to the establishment of municipal garbage collection programs, entrepreneurs might have made one-on-one arrangements with a householder. A farmer might pick up food waste to feed to hogs. Or a scavenger might bring household trash to a river or empty lot. Those scavengers, who collected and sold post industrial waste to scrap firms, might collect iron, lead, copper, waste paper, or rags. Such peddlers proliferated in the final decades of the 19th century in response to rising industry (Zimring 2009, 29). They played an important role in gathering trash of all sorts. Sanitarians relied on such scavengers because boards of health tended to lack capacity to collect garbage. Once sanitarians gained formal garbage collection capacity, they would move these entrepreneurs out of the way by directing notions of filth toward the scavengers themselves. Progressive reformers painted scavengers xenophobically as dirty as the materials they collected, and governments regulated scavengers and junk collectors as nuisances (Zimring 2004, 86–7).While state legislatures empowered local boards of health to deal with sanitation, they did not generally follow through with the resources to carry out early sanitation programs. The board of health could respond to unkempt waste by invoking nuisance law, which could reach “manure piles, slaughterhouses, dairies, stables, burial grounds, obnoxious trades, overflowing privies, stagnant pools, filthy gutters” (Duffy 1968, 376). Pittsburgh relied on such authority early on with an ordinance that provided for a fine for anyone who disposed of “dead carcasses, garbage, noxious liquor, or other offensive matter on any street, square, lane or alley, or along the rivers, or within an enclosure” (Duffy 1963, 297). An 1848 ordinance fined anyone who threw garbage into the canal (A Digest of the Ordinances of the City of Pittsburgh 1849, 149). While there was authority to shape people's behavior, there was inadequate enforcement power to follow through. The salary of New York's city inspector matched neither his experience nor the salary of the streets superintendent (Duffy 1968, 302). In Cincinnati, a city marshal could fine residents for nuisances, but the city marshal only acted in response to individuals’ reports (Marcus 1980). Boards of health also lacked capacity to directly remove garbage. Pittsburgh's board of health was given the authority “to employ, from time to time, as many scavengers as they may deem necessary, upon such terms and with such appliances and conveyances as they may deem expedient, and to make, from time to time, such rules and regulations for the conduct of such scavengers, as they may deem necessary” (Digest of the Acts of Assembly of Pittsburgh 1887, 445). As with quarantining, this authority was fleeting, enlisted in response to emergencies. Scavengers’ work was not up to sanitarians’ professional standards (Larsen 1969, 243). Pittsburgh's ordinance required scavengers to ensure their carts were cleaned and disinfected and covered, so that the garbage they transported did not blow off the cart (Digest of the Acts of Assembly of Pittsburgh 1887, 446).

The board of health was able to document deadly disease and link it to infrastructure. When Pittsburgh faced a particularly devastating epidemic of typhoid fever in 1880, the South Side was hit particularly hard. This area of immigrants and people of color was poorly drained. Because it had been collecting vital statistics, the board of health could document the pattern of nine new deaths reported each day. The board of health turned its attention to the emissions of solid waste from poorly constructed sewers (Pittsburgh Daily Post 1880a). Garbage was dumped on empty lots, with refuse running downhill (Pittsburgh Daily Post 1880c, 1880d, 1880e). This situation occasioned a call to clean the sewers, streets, and alleys and license a boat to remove garbage from the city, provide him with free wharfage, and pay his high cost (Pittsburgh Daily Post 1880d, 1880e).

Singling out the poor allowed the board of health to justify its sanitary measures, but it also cast that district as unhygienic. Board of health officials used that vulnerability to their advantage to claim control of garbage collection. Prior to municipal garbage collection, scavengers were important resources for boards of health. They made one-on-one contracts with residents and could be employed by the board of health for any large jobs. In an era of industry, with metal, cloth, and other scraps available as industrial waste and capable of being reused, scavengers were readily available (Zimring 2009, 16, 11).

When boards of health wanted to take over garbage collection, sanitarians established professional crews of sanitation workers. Sanitary officials would have to displace scavengers as the likely garbage collectors. Given that scavenging was such dirty work, and that a scavenger was likely to be an immigrant or a person of color, the scavengers themselves were readily cast as being dirty (Zimring 2004). In a profile of scavengers, the Pittsburgh Post described their living quarters as dark, dingy, and dusty because they brought rags home with them to be sorted before taken to paper warehouses (Pittsburgh Daily Post 1880b). Pittsburgh's sanitarians did not win their bid to take over garbage collection after the typhoid epidemic of 1880, but they did make headway in casting aspersions on scavengers and placing themselves as the experts who could set the standards of sanitation for the city and its workers.

The idea of sanitation gave sanitarians the power to define and eradicate filth, which included not only the messes in streets, yards, and homes, but also in the people that had toiled for years to collect and dispose of such waste. Carl Zimring sees in this focus on scavengers a shift in the notion of scrap recycling, from reuse of postconsumer waste to something that was dirty and unseemly in urban space. In doing so, sanitarians relied on changing notions of filth (Zimring 2009). The field of Discard Studies points to those patterns of activity that discard what is considered to be wasteful, and that may include people, businesses, and community expectations (Liboiron and Lepawsky 2022). The idea of sanitation rested on the notion of filth, but what—and who—constituted filth could be shaped by sanitarians. This was not just construction of waste; Zimring places the contingent notion of waste in its role in the construction of racial identity, as middle-class whiteness distanced itself from the notions of dirt in cities (Zimring 2015). William Novak explains that “public health was closely entwined with the politics of social order and the policing of dangerous classes” (Novak 1996, 216). Cleaning cities and protecting health were not mere technical matters. They were commitments to the use of state authority and a society that falls into place to advance these public goals. Sanitation involves state power, in holding up commerce, encouraging and discouraging businesses, marking out social classes. As Novak points out, serving the public good “did not mean that everyone's welfare and safety was being pursued equally” (Novak 1996, 216).

Losing Out to the Idea of Sanitation: Residents

The idea of sanitation was similarly pliable to justify the costs to a few for the benefits to accumulate to many. Garbage presented a classic public nuisance, inviting a response with sanitary public works. When those responses generated their own annoyances, such as noxious fumes from incineration plants, sanitarians leveraged the idea of sanitation to exempt their own public works projects from being classed as nuisances. The idea of sanitation gave power to sanitarians at the expense of residents near neighborhoods where sanitary works were located (Sullivan and Strach 2024).

Dating back to the common law, a nuisance, “or annoyance, signifies any thing that worketh hurt, inconvenience, or damage” (Blackstone and Sharswood 1875, 215). A private nuisance might be a situation in which one person harms the person or property of another. A public nuisance affected the wider public and counted like a public wrong such as a crime or misdemeanor. Public nuisances warranted judicial intervention until 19th-century state legislation incorporated the principle (Morag-Levine 2005, 71–73). The principles underlying the common law doctrine of nuisance established governance in the well-regulated society and provided a significant source of authority to use government for pursuit of the public good. A local government—through the police power—was empowered to uphold the welfare of the people through regulations that shaped and limited private behavior (Novak 1996). This powerful source of authority to interfere in the name of public health was lodged in local governing in boards of health, as a sanitary idea. In 1901, the sanitarian Charles Chapin asserted, “Nuisances which more or less directly affect health, and particularly nuisances which consist of foul, offensive or otherwise dangerous odors or gases, or which are in any way due to decaying matter, or to impurities of any kind in the air, are the kind, the control of which is usually placed under the jurisdiction of the sanitary authority” (Chapin 1901, 108).

In assessing the power of boards of health in 1905, Thomas Babson, Boston's Corporation Counsel, listed the variety of situations that could be cast as a nuisance: any source of sickness on a person's land, such as swamp lands that need to be drained; certain trades; the number of animals that could be housed on land, such as pigs and horses; obstructing a pond. Even things that the homeowner did not bring or invite onto his land, such as gypsy moths or ground squirrels, could be the homeowner's responsibility to exterminate. Such a litany indicates the scope of authority that boards of health had to regulate behavior and conditions of a private property (Babson 1905).

The concept of nuisance was readily taken up by sanitary engineers. Some were readily apparent, such as the health hazards invited by the dumping of a city's sewage in the local bay (“Houston Sewage Disposal Plant” 1902, 267). Engineers included the carelessness of merchants and their employees who swept paper, store refuse, and other matter into the streets (Iglehart 1901). When business and hotels sent waste into the street and made it a public problem, engineers identified such practices as a public nuisance. Engineers cast smoke as a nuisance and suggested the use of devices to mitigate it (“To Abolish the Smoke Nuisance” 1902; “Smoke Prevention Devices” 1902). By calling out sanitary threats as nuisances, cities were likely to respond, and an engineer would land the contract to upgrade the device or construct a new plant.

Engineers extended their identification of nuisance to the merely annoying. Nuisances could be aesthetic, such as a loud factory whistle (“Municipal Matters Determined in Court” 1900). At a time when it was possible to bury telephone wires, telephone poles and overhead wires were referred to as a nuisance (“Baltimore Wins in Conduit Controversy” 1901; “Editorial Comment” 1902). The variety of nuisances indicates where nuisance could be directed, and who could be affected. Catherine McNeur explains that, as New York residents fled yellow fever into new neighborhoods, they confronted hog farming. Eager to get rid of it, they complained about threats to public health, as well as danger to women and girls (McNeur 2017). Stricter rules about smells and waste pushed out livestock to the outer suburbs of expanding cities (Robichaud 2022). Urban pig keeping was a way of life in cities until it gave way to sanitarians’ and residents’ castigation of it as a nuisance, to be relegated to the further outskirts of the city (McNeur 2017). Nuisance gave sanitary engineers tremendous authority to establish state intervention into private property and new public works and to shape the status of neighborhoods and occupations.

Sanitary experts declared garbage—“animal and vegetable waste matter, subject to rapid decay”—“the most offensive form of a city's wastes and the necessity for its removal is the most pressing” (Chapin 1901, 665, 669). Although cities might pick up rubbish, street sweeping, or ashes, for sanitarians, the pertinent waste was the putrefying matter produced by households that presented a health hazard (Melosi 1980, 107). It was one of the most basic city practices that warranted public intervention, but that public response could itself cause a nuisance. Despite all the advances in collecting and disposing of garbage, “it has never been found possible to get rid of it without some expense and usually not without some nuisance” (Chapin 1901, 697). Requiring residents to place their household garbage in cans to await pickup by a collector presented opportunities for noncompliance. Residents were unlikely to wash their cans, or they were likely to use a can that was watertight, or lacked a tight-fitting lid. They were unlikely to keep it clean. As a result, Chapin lamented, “The garbage receptacle, especially when separation of true garbage is made, is usually one of the commonest forms of nuisance to be found” (Chapin 1901, 170).

Importantly, garbage collection and disposal practices—the answer to the nuisance of waste—could generate their own nuisances. The wagons that collected the garbage threatened to present nuisances if wooden carts were to leak through the bottom, or debris were to fly out of an uncovered cart, or the cart itself overloaded (Chapin 1901, 678–84). Municipal ordinances could account for these practices by enforcing requirements upon householders, collectors, drivers, and their supervisors.

Responding to sanitation-generated nuisance was not as straightforward when the nuisance issued from disposal plants. When cities chose dumping as a method of disposal, it was likely to emit offensive odors, and Chapin “never knew or heard of such a dump which was not bitterly complained of by all who dwelt or worked in its vicinity” (Chapin 1901, 698). Dumping in water invariably injured others, likely in another city (Chapin 1901, 699). Feeding to farm animals was an option, but it was known that garbage-fed cows produced poor milk (Chapin 1901, 699–700). More modern forms of disposal relied on plants that incinerated garbage or reduced it, extracting grease as a byproduct that could be sold, which gave off an offensive odor. Sanitarians were hopeful that reduction could be carried out in a less offensive manner, but that depended on the supply of garbage being “very carefully separated” (Chapin 1901, 704–8). Cremating garbage could be a sanitary form of disposal, but that, too, depended on carefully constructed processes and furnace construction to avoid generating a nuisance (Chapin 1901, 714).

When dumping grounds, reduction plants, or crematories were placed in the vicinity of property owners, they suffered the effects. Nearby residents could avail themselves of nuisance law to complain of the public works’ interference with enjoyment of their property. These challenges invited sanitarians to rest on their intellectual authority to characterize sanitation as eradicating nuisances, defined as filth, and not the annoyance of sanitary measures. Cities tried to reduce the harm to local residents by locating disposal plants in low-population areas, but that required a long haul, which raised the costs of disposal and did little to mitigate the stench produced by the production of grease and fertilizers from the disposal plant (Chapin 1901, 709–10).

Sanitarians had long been aware of the nuisances generated by their own sanitary measures, but they were not particularly invested in addressing them. In a report to the APHA, an 1892 committee report notes that “inhabitants in the vicinity of the works will bitterly complain of it as a nuisance, and rightfully so, too, unless extra precautions are taken to keep the premises in a state of cleanliness” (Edward Clark 1892, 107). Although engineers devised chimneys, boilers and airtight containers to mitigate the offending odors from garbage plants (Morse 1908, 240), such devices did not always fix the problem. Garbage disposal plants came to be understood as legalized nuisances—those municipal operations for which a nuisance was unavoidable. Even though cities needed to take reasonable care to reduce the nuisance (Overton and Denno 1919, 411), at the end of the day local residents still bore the costs. When Pittsburgh's contracted reduction plant produced odors that bothered the residents on the bluff above the plant, a court ordered the plant to mitigate the odors, yet the court also noted that these odors were offensive and annoying—not a health hazard. “But,” the judge pronounced, “the onward march of the business of the city cannot be arrested because it may be an annoyance to some of those living on the bluff” (Fisher v. American Reduction Company 1899).

As a tool of state power, traditional nuisance law provided a basis for sanitary interventions and even aesthetic bases for interfering in private property, but when those public sanitary measures produced their own interference into the enjoyment of private property by residents near disposal plants, the threat to public health could be parsed out from the merely annoying. Those directly affected by the output would have to put up with it for the public good. While nuisance law was available to a wide variety of interests to use and benefit from public works projects, the idea of sanitation continued to be the touchpoint, and sanitarians retained their own professional and intellectual authority in defining sanitation.

Conclusion: The Local Politics of Public Health

Public health is fundamentally political, and it illustrates the heart of power in local governing. Local governments—counties, cities, and special districts—play a primary role in promoting public health, and in doing so they can create and replicate inequalities in society (Jarman et al. n.d.; Kuo and Kelly 2025; Madeira et al. n.d.). In the late-nineteenth and early-twentieth centuries, municipal advancements in sanitation transformed American public health. Once locations where disease and ill health were common, cities became places where individuals could live, work, or travel, and overall life expectancy in the country increased as a result. Today, garbage collection and disposal still operate under the logic of sanitation from the 19th century when they were created.

Like scholars who study how coalitions come together and shape outcomes (e.g. Schickler 2001), we identify the constituencies who were opposed to or vied for control of garbage collection and disposal programs, and we trace their relationship with the idea of sanitation, showing how ideas create winners and losers. Our research shows how the idea of sanitation became a “common carrier” (Schickler 2001), allowing multiple groups to come together to pursue garbage collection and disposal, albeit for very different reasons. When sanitation became the animating idea, it gave sanitarians and sanitary engineers authority to define and solve the garbage problem. There were other potential animating ideas at the time, however, such as garbage as a commercial or engineering concern, which would have differently sorted these constituencies. As a commercial concern, business leaders would have played a dominant role, and they would likely have included engineers, sanitarians, and also (low-paid) scavengers. Business interests could still have claimed a public good. Just as smoke in Pittsburgh signaled a strong economy and thus, a public good (Tarr 2002, 524), so, too, could businessmen have marked clean streets and lots as good for commerce and good enough overall. As an engineering concern, engineers would work with business leaders and sanitarians, but they would likely also have cast aside scavengers and their more basic tools and practices as unprofessional as they sought inventions and large-scale public works projects that were funded by city budgets. It is likely that the devices and practices they designed for more efficient and innovative garbage collection would have been adopted and would have advanced over time, privileging profit, utilization, and efficiency over public health.

Unlike theories that tie static ideas to unchanging institutional structures, such as punctuated equilibrium where “a definable institutional structure is responsible for policymaking” and “a powerful supporting idea is associated with the institution” (Baumgartner and Jones 1993, 7), we show how the idea of sanitation was malleable enough to win over some constituencies and to push others out. When it was associated with cleaning cities through garbage, sewerage, and water programs, businesses bought in to the idea of sanitation in ways they did not when it was associated with quarantine. Engineers, who saw mounting garbage as a problem to be solved with technical solutions, could have challenged and replaced the idea of sanitation with the idea of engineering. Instead, with a pliable idea of sanitation, they cashed in by creating the new field of sanitary engineering.

If sanitation was flexible enough to expand and absorb some of its early challengers, it was also malleable enough to contract and push others out. As a motivating idea, the goal of sanitation was to eradicate filth. But sanitary experts defined filth as objects—putrid meat, decaying vegetables, manure, ash heaps, garbage, offal, rubbish, dirt—as well as people, including private scavengers who had long collected cities’ waste. In this way, sanitation generated both the authority to engage in public health programs as well as put this authority in the hands of sanitary reformers. The idea of sanitation similarly allowed sanitary experts to define nuisances as annoyances associated with filth and not annoyances associated with garbage removal and disposal. In short, sanitary measures that benefitted many could have costs borne by a few residents who lost out when they had to put up with the stench of disposal plants.

Although sanitarians originally defined sanitation and pushed for programs to address it, they did not own the idea. Business interests, engineers, and civic groups could join in and use the idea of their own purposes. Courts could invoke sanitation to decide who wins and who loses. Ideas in American political development are often treated as the kernel around which institutions are built. Like theories of punctuated equilibrium, ideas promote change from one order to the next. Building on Weaver and Dilworth's concept of ideas as “emulsifiers,” we show the relationship between key constituencies (business, engineers, sanitarians, residents) and the idea of sanitation. Rather than being static, we demonstrate how ideas are malleable enough to define winners and losers within a political order and to generate stability over time.

The revolution in American public health did not start or stop at the national level. Instead, in municipalities across the country, experts drew on the idea of sanitation to give them the authority to address waste and to build support in otherwise skeptical constituencies and to reject challenges to their authority or solutions.