In The Condition of the Working Class in England in 1844 Friedrich Engels described backstreet sections of Manchester and other mill towns, where people lived in crude shanties and shacks, some not completely enclosed, some with dirt floors. These shantytowns had narrow walkways between irregularly shaped lots and dwellings. There were no sanitary facilities. Population density was extremely high. Eight to ten unrelated mill workers often shared a room, often with no furniture, and slept on a pile of straw or sawdust.[73] Toilet facilities were shared if they existed. Disease spread through a contaminated water supply. Also, people were at risk of developing pathologies due to persistent dampness.
The famines that troubled rural areas did not happen in industrial areas. But urban people—especially small children—died due to diseases spreading through the cramped living conditions. Tuberculosis (spread in congested dwellings), lung diseases from the mines, cholera from polluted water and typhoid were also common.
Not everyone lived in such poor conditions. The Industrial Revolution also created a middle class of professionals, such as lawyers and doctors, who lived in much better conditions.
Conditions improved over the course of the 19th century due to new public health acts regulating things such as sewage, hygiene and home construction. In the introduction of his 1892 edition, Engels notes that most of the conditions he wrote about in 1844 had been greatly improved.