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12 Ways Past Epidemics Changed Everyday Life in America

From beauty standards to home design, previous health crises had a major influence on the modern world.

Red Cross volunteers fighting against the spanish flu epidemy in United States in 1918Apic/Getty Images

Things weren’t always the way they are today

Though we’re only a few weeks into the novel coronavirus pandemic, there have already been plenty of changes made to our everyday life. Handshakes and hugs are out; social distancing is in. Crowded in-person events have been put on hold in favor of group Zoom calls. Face masks have become ubiquitous and may become a permanent lifestyle accessory, even once the pandemic is over. We’ve gotten into the habit of thoroughly washing our hands for at least 20 seconds, one of the developments that will ideally be the norm from now on. But this isn’t the first time an infectious disease has had a major impact on people’s daily habits. In fact, some things that are commonplace today weren’t always that way and actually have origins in major health crises.

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White tile and linoleum became popular in houses

The widespread acceptance of germ theory in the late 19th and early 20th centuries resulted in a shift in interior design—both in public buildings like hospitals and in private homes. Victorian-era homes were known for their ornate wooden decorations, heavy draperies, and patterned wallpaper and flooring designed to hide dirt and grime. But once people understood that dirt and dust could contain germs that cause infectious disease, there was a shift from dark colors, fabrics, wallpaper, and flooring to stark white interiors, where any dirt was clearly visible.

“I think common sense dictates that if you want to know if the surface is clean, the visual cue is that you’ve used a light color and there are now dark spots on it. [You can see if] it’s looking grimy,” explains Kelly Wright, PhD, who teaches American history at the University of Cincinnati and specializes in the historic use of color in architecture. In addition to that, white tiles and linoleum floors were easier to clean than wood, with its natural crevices. No matter what you’re cleaning, make sure you know the difference between sanitizing and disinfecting.

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Tuberculosis influenced women’s makeup trends

When a person came down with tuberculosis—once known as “consumption”—their skin became pale, and they lost weight as they literally wasted away. While that doesn’t sound like something anyone would find aspirational, between 1780 and 1850, there was “an increasing aestheticization of tuberculosis that [became] entwined with feminine beauty,” Carolyn Day, PhD, an assistant professor of history at Furman University in South Carolina and the author of Consumptive Chic: A History of Fashion, Beauty and Disease, told Smithsonian Magazine. Why? Partially because upper-class women’s predisposition to developing tuberculosis was thought to be based on their appearance. “Tuberculosis enhances those things that are already established as beautiful in women,” she explained, such as thinness and pale skin.

As a result, the rise of the “consumptive chic” look became popular in the mid-1800s. It involved women trying to look as though they had tuberculosis by using makeup to make their skin appear paler, putting blush on their cheeks and red color on their lips. Once doctors started to prescribe sunbathing as a treatment for consumption, makeup trends went the other way, favoring more tanned skin. Beauty trends come and go, and these are some of the more recent ones that should have never happened.

Empty built-in wardrobes. New house, empty rooms.tacstef/Getty Images

Homes started being built with closets

If you’ve been inside an old house and noticed that it doesn’t have much in the way of closets, you’re not imagining things: Built-in closets are a relatively new addition to the home. Prior to that, people kept clothing and other belongings in stand-alone furniture, like armoires. “It used to be that almost everything was [kept] in armoires,” Lloyd Alter, a former architect and design historian who now teaches sustainable design at the Ryerson School of Interior Design, tells Reader’s Digest. “When you look at the plans from the turn of the century, the closets are tiny, tiny, tiny—if they exist at all.” The idea behind the built-in closet was that it provided more open space in a room, making it easier to clean during a time when dust was thought to transmit germs. This is the best way to clean your house to avoid getting sick.

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Immigrant screenings became more thorough

When Ellis Island opened in 1892, there were six doctors on staff to screen the 200,000 immigrants who passed through the island in its first year. But as public-health officials got a better grasp on germ theory and infectious disease, these screenings increased and became more thorough. There were eight physicians examining 500,000 yearly immigrants by 1902. That doubled to 16 doctors three years later, as the number of immigrants jumped to 900,000 per year. By 1916, the medical screenings were a well-oiled machine, and 25 doctors saw immigrants via four inspection lines that ran simultaneously.

But for many immigrants passing through Ellis Island, the most traumatic part of the inspection was the screening for trachoma—a highly infectious eye disease that could cause blindness and even death. In order to check for this condition, doctors would use a buttonhook to flip a person’s eyelid open to check for signs of the disease. Though the test for trachoma is no longer part of the screening process, the U.S. government has continued to perform medical checks on immigrants.

The modern world, however, has never seen a disease quite like the one we’re facing today. Here are 13 ways coronavirus is different from all epidemics through history.

Tombstones On Grassy Field In Cemetery Against SkyEdgar Bibian / EyeEm/Getty Images

Digging graves six feet deep

Epidemics result in an increase in deaths, which makes it necessary to figure out how to deal with the influx of human remains. Because of the long-held (and now debunked) belief that dead bodies transmit infectious disease, it has made societies over the past several centuries rethink how they bury its dead. Probably the best-known example of a change in burial customs is the tradition of burying human remains six feet underground. This practice originated during an outbreak of the plague in 1665 in England. The mayor of London stipulated that “all the graves shall be at least six feet deep” in the “Orders Conceived and Published by the Lord Mayor and Aldermen of the City of London, Concerning the Infection of the Plague.” Though pop culture still relies heavily upon the “six feet under” tradition, most states in America only require a minimum of 18 inches of soil on top of the casket or burial vault.

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Corsets were in, then out

Having a tiny waist was another part of the “consumptive chic” look. At first, this was a boon for the already-popular corset, as well as dresses that emphasized protruding collarbones. But soon, corsets became the target of doctors who believed that the tight-fitting, restrictive garments could harm those with tuberculosis. In 1793, Samuel Thomas Von Sömmerring, a physician and well-known anatomist, took this one step further, writing that the compression of ribs and internal organs due to wearing a corset could lead to tuberculosis, cancer, and scoliosis.

But corsets didn’t disappear overnight. Instead, women began wearing so-called “health corsets,” which featured a looser fit, before they fell out of fashion altogether around the turn of the century. Though we may not wear corsets anymore, foundation garments are still an essential part of our wardrobe. This is the best shapewear for every type of dress.

Toilet Bowl In BathroomKasipat Phonlamai / EyeEm/Getty Images

Second bathrooms were added to homes

When new homes were first designed to include indoor plumbing, there was typically one bathroom for the entire family located on the second floor of the house, near the bedrooms. But as infectious diseases like tuberculosis and influenza became increasingly problematic, some homeowners decided to install a second half-bathroom near the entrance to the house. At this point, most homes had daily deliveries of coal and ice, meaning that the delivery people were not only entering your home but also your neighbors’ homes—potentially bringing germs with them. “The iceman is coming right into your kitchen, and if the iceman needs to use the bathroom, you don’t want him using your family bathroom,” Wright explains. “So the half-bath made perfect sense for visitors to the house.”

Dr.Edward Jenner Vaccinating Young BoyBettmann/Getty Images
Dr. Edward Jenner, British physician performing his first vaccination on James Phipps, 8, on May 14, 1796.

Vaccines were developed

Though vaccines appear to be a product of modern science, it’s existed in some form for centuries. Specifically, there’s evidence that the Chinese developed a method of smallpox inoculation as early as 1000 BCE. This practice first spread to Africa and Turkey, and later to Europe and the Americas, according to the College of Physicians of Philadelphia. More commonly, Edward Jenner gets credit for the first smallpox vaccine in 1796, when he took material from a blister of someone infected with cowpox and inoculated it into another person’s skin, in an attempt to control the smallpox epidemic in England.

Large-scale inoculation—in the form of the shot we know today—began in the 1940s, as scientists began developing vaccines for other infectious diseases like diphtheria and whooping cough. By the 1960s, there were vaccines for other infectious diseases, including measles, mumps, and rubella. And though an early version of the flu shot was developed in the 1940s, there were initial problems with efficacy. Several decades of research later, the Centers for Disease Control (CDC) began recommending annual flu shots for people in high-risk groups (older adults and the immunocompromised) in 1984. By 2010, the CDC recommended that all people six months or older get the influenza vaccine.

Man holding razor shaving face in front of mirror with foam on faceYifei Fang/Getty Images

Tuberculosis also influenced men’s facial hair trends

Tuberculosis didn’t only affect women’s beauty and fashion. It also impacted men’s grooming—namely, their beards. Around the turn of the century, beards were all the rage. But once doctors and the public better understood how germ theory worked and how infectious diseases spread, beards became a major public-health target. In 1901, William H. Park, a doctor at the New York Board of Health, banned milk-delivery men from having beards, specifying that “there is real menace to the milk if the dairyman is bearded” because “he may have tuberculosis and the dried sputum may accumulate on his beard and drop from it into the milk.”

But it wasn’t only milkmen who had to worry about beards transmitting the disease. According to Park, “The beard, particularly when damp, may become an ideal germ carrier, and on an unclean man would have great facility for the transmission of disease.” As a result, a clean-shaven look was preferable. To make it easier to maintain that look without having to visit a barbershop, Gillette invented disposable razors in 1900, allowing men to remove their facial hair themselves. If you find facial hair fascinating, check out these 10 proper names for beard styles that you need to know.

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Skirts went up and shoes came out

If you picture a woman dressed in Victorian apparel, a long dress or skirt gently grazing the ground probably comes to mind. And as elegant as that look was, it was also pretty disgusting when you think about it. Any time women left their homes, they were walking on streets full of garbage, human and animal waste, and general dirt and grime. This left the bottom of their dresses filthy.

Once people had a better understanding of how infectious diseases spread, these long, trailing skirts were also seen as being unhealthy, given that the wearer could literally sweep dirt and germs into a home. As a result, hemlines began to come up. And when that happened, women’s shoes were on display for the first time, meaning that footwear became an essential part of fashion, instead of simply something functional. Find out what your favorite shoes say about your personality.

Mountain biker relaxes to enjoy view over mountains, lakeMilo Zanecchia/ Ascent Xmedia/Getty Images

There was an emphasis on getting fresh air

Back in the day, most people thought that infectious diseases were spread by “miasmas,” or poisonous vapors that could invade a human body and make a person ill. At that point, there was fear surrounding “bad air” that could come into your home and bring disease with it. But once germ theory became widely accepted and replaced concern over miasmas, the attitude toward fresh air changed dramatically. Before antibiotics were used to treat conditions like tuberculosis beginning in the 1940s and 1950s, doctors prescribed fresh air and sunlight as cures. As a result, there were public-health campaigns urging people to open their windows. One such ad appeared in trolley cars in Cincinnati during the 1918 flu pandemic and read: “Keep Your Bed Room Windows Open! Prevent Influenza, Pneumonia, Tuberculosis.”

Women Electric WeldersPhotoQuest/Getty Images

The 1918 flu pandemic brought more women into the workforce

World War II is typically credited with bringing women out of the home and into the workplace, but before that, the 1918 flu pandemic had a similar effect. Between men fighting World War I and falling ill with influenza, there was a shortage of manufacturing workers, and women filled that void. By 1920—at which point World War I had come to an end and the influenza pandemic had calmed down—women made up 21 percent of all gainfully employed individuals in the country. The impact went beyond simply having more women in the workforce: Because of their indispensable role filling traditionally male jobs during the pandemic, women had more leverage when seeking equal pay and the right to vote. This is what women’s workplaces looked like 100 years ago.

Elizabeth Yuko
Dr. Elizabeth Yuko is a bioethicist and writer specializing in health and the intersection of bioethics and popular culture. She is an adjunct professor of ethics at Fordham University and has written for print and online publications including The New York Times, The Washington Post, The Atlantic, Rolling Stone, Salon and Playboy, and has given a TEDX talk on The Golden Girls and bioethics.