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Public Health Sanitation

Course Number
5400 (Epidemiology)
Course Instructor(s)
James A Scott, Christine Oliver

CO-INSTRUCTORS: Dr. James Scott & Dr. Christine Oliver, Dalla Lana School of Public Health, University of Toronto





Although the study of public health is just over a century old, many fundamental practices within it have roots in the earliest human civilizations. These include ensuring access to clean water, managing sewage, and safeguarding the food supply. Together, these endeavors form the basis of sanitation whose tools encompass the application of technological and engineering solutions to uphold public well-being. Sanitary guidelines and prohibitions can be traced throughout various religious traditions, such as the Abrahamic, Dharmic, Taoic, and other faiths. These guidelines cover a range of activities including personal hygiene, waste disposal, food handling, and quarantine measures. Over time, some of these directives were formalized into sanitary laws, which emerged in Europe and England during the medieval period. By the late 19th century, the modern concept of public health sanitation took shape due to three pivotal events: the insightful analysis of living conditions among the working poor by Sir Edwin Chadwick in England (1842), the profound impacts of the industrial revolution, and the acceptance of the germ theory of disease.

From this juncture, public health sanitation evolved. Its practices grew ever more refined for a century until the proliferation of antibiotic drugs in the 1970s spawned the misbelief that because infectious diseases could be cured, the old-fashioned sanitary efforts employed to prevent them were longer necessary, and modern public health distanced itself from sanitation in favour of more pressing challenges like those posed by social inequities. But infectious diseases didn’t disappear, and the formerly miraculous capabilities of antibiotics gradually diminished. Added to these problems were those created by a changing climate, straining the increasing demands of the food supply and access to clean water while promulgating old diseases and fostering new ones. In the midst of these contemporary challenges, the significance of sanitation has resurfaced, and its relevance is now more pronounced than ever before.

Through a series of readings and group discussions, this course will trace the history of public health sanitation and examine the relevance of sanitary practice in the context of modern challenges. The topics we will be covering include:

  • Drinking water
    • water quality
    • ground water
    • water treatment
    • sustainability
  • Wastewater
    • sanitation
    • sewage treatment
  • Solid waste
    • trash
    • pests
  • Agricultural systems
    • field crops: pre- & post-harvest pest & disease management
    • meat: hygienic husbandry, slaughter, processing & preparation


  • Class will be held weekly at a location TBA
  • Assigned readings must be completed prior to scheduled class times.
  • Class time will be used for discussion of reading materials.
  • Students will participate in person unless circumstances require remote meetings.
  • Class attendance and participation is mandatory.


Five sizeable readings will be assigned for course. It will be essential to complete assigned readings prior to each class session.

  • Solomon, S. 2011. Water: The Epic Struggle for Wealth, Power, and Civilization. New York: Harper Collins, 624 pp.
  • George, R. 2008. The Big Necessity: The Unmentionable World of Human Waste and Why It Matters. New York: Henry Holt & Co., 320 pp.
  • Sinclair, U. 1906. The Jungle. New York: Doubleday, 435 pp.
  • Wright, R. 2004. A Short History of Progress. CBC Massey Lectures. Toronto: House of Anansi Press, 214 pp.
  • Kolbert, E. 2014. The Sixth Extinction: An Unnatural History. New York: Holt, 336 pp.


There are no lectures for this course. You will not need to write any papers or assignments. You do not even need to take any notes. All you need to do is complete the readings and come to class prepared to discuss them! I know this may sound daunting but don’t be discouraged, it should be pretty easy! To prepare for each week’s class, you need to do 2 things:

  1. You need to read (or listen to) the assigned portion of the book before the class. Four of the readings are available as audiobooks (George, Kolbert, Sinclair, Wright – these are posted on the CBC website), though I would encourage reading or following along on paper (or digital) copies as it may be easier if you want to highlight or take notes. Altogether the course workload required to get through these readings should take you a maximum of 5-6 hours per week. I base this on the fact that listening to each of the three audiobooks I mentioned takes an average of 10-11 hr (George is 10.5 hr, Kolbert is 10 hr, Sinclair is 13.25 hr [but you don’t need to read the last several chapters so it works out closer to 11 hr], and Wright is 4.5 hr), and these readings are each spread over 2 weeks. In my experience of reading the other books, the effort should be about the same.
  2. After you have completed the week’s reading, you will draft 6-8 discussion questions. These should be guided by the reading but can extend to current-day issues that are in the news or otherwise of interest. Your questions should be though-provoking rather than just quizzing facts in the reading. For example, for the first part of the Solomon reading, instead of asking “What were the four most important crops cultivated in early human civilizations?” you might ask “In what ways did the control of water serve as a main facilitator of prosperity in antiquity and how has this changed in modern civilizations?”. You will be graded both on your questions as well as your leadership of the discussion.

During each week’s class, I will call on one of you to provide a recap of the reading. This recap should last 10-15 minutes. I do not want you to provide a ‘play-by-play’ description of the reading; rather, I want you to summarize the major points to refresh everyone. Then the person I selected to give the recap will lead a class discussion of the reading starting with their own discussion questions. Once those are exhausted, we will open up the discussion to questions and topics others have identified. Each student will need to present and lead class discussion at least once (and possibly multiple times), and these activities will account for 50% of your overall mark in the course.

If for some reason you are unable to give the recap and lead the discussion when I call on you, I will give you a one-time exception and call on someone else. If it happens to you a second time, I will score as zero the fraction of your grade the activity would have represented. Therefore, please come prepared to each class.

Students who are not presenting and leading the class discussion will be graded on their participation and contribution to the discussion, scored out of 5 marks for each class. Collectively, student participation will account for 20% of your final grade. There is one test at the end of the course worth 30%. It is open-book and will cover the course contents very broadly (e.g., I may ask you things like “List and describe three points of similarity between the themes and/or content in the books authored by George and Sinclair?”).


Week 1 Introduction
Week 2 Water, Chapters 1-6 (note that chapters 7-9 are not required)
Week 3 Water, Chapters 10-13
Week 4 Water, Chapters 14-17
Week 5 The Big Necessity, Chapters 1-5
Week 6 The Big Necessity, Chapters 6-10
Week 7 The Jungle, Chapters 1-13
Week 8 The Jungle, Chapters 14-28 (note that chapters 29-31 are not required)
Week 9 A Short History of Progress, Parts 1-2
Week 10 A Short History of Progress, Parts 3-5
Week 11 Sixth Extinction, Chapters Prologue-7
Week 12 Sixth Extinction, Chapters 8-13


Each class will consist of a student-led discussion on the material of the readings. The student I select to lead the discussion will be graded out of 50 marks for their ability to develop thoughtful questions and lead other students in an in-depth, scholarly discussion of the questions. Leadership of the weekly discussion will be approximately equally rotated amongst students. Students selected multiple times to provide a recap and lead the class discussion will have their ‘leadership’ grades will averaged. Students not leading the discussion will be graded for their participation out of 5 marks. Grading rubrics will be provided for both activities. Leadership of discussions will account for 50% of your overall grade in the course, and participation will account for 20%. A final, written examination will account for 30% of your final mark. All reading materials covered in the course will be tested.

General Requirements