In the medieval period it was said that you could smell a town long before you could see it. In Exeter, for example, you entered the town by a bridge crossing a river know locally as 'shitebrook', where the night-soil men dumped their waste into the river. Mortality was higher in the towns and cities than in the countryside. people lived closer together, alongside their animals and their filth.
yet there had been some attempts to improve public health. Henry VII recognised the menace to health from the slaughterhouses and passed a law forbidding them within cites or towns.
people had to live close to where they worked, and there were very few building's regulations. The supply of water, gas and later electricity was all left to private companies who needed to make a profit.