Abstract

Atmospheric pollution in nineteenth- and early-twentieth-century cities was extremely bad, driven by the vast expansion of coal consumption for industrial and domestic use. London was particularly famous for its fogs, which occurred on cool, still days, trapping the existing pollution in place. This paper seeks to understand the extent to which this pollution caused ill health in the past and the extent to which changes in pollution contributed to the health transition, the vast improvements in health over the past couple of centuries. Based on a thorough review of the historical literature and new evidence on London children, it argues that atmospheric pollution was not a major source of ill health in the late nineteenth century and that changes in atmospheric pollution were more likely a countervailing force to the health transition rather than an important driver of the transition.