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Before there were regular street cleanings and trash pick-up, garbage and filth accumulated on the streets and alleyways of big cities. Diseases like tuberculosis, dysentery, and cholera were rampant. In 1850, the average age of death in New York City was younger than 21. However, through the use of laws and policies, public health practitioners of the 19th and 20th centuries turned these trends around. This legacy of using legal tools to ensure the health and wellbeing of people and their communities continues today.

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