The cities of Birmingham and Liverpool, where thousands of back-to-backs were built, both chose to retain a single example as a tourist attraction.
Sanitation comprised earth toilets in whatever available space existed, which may have been underneath bedrooms, and a public water supply from intermittent standpipes.
[7] The passage of the Artisans' and Labourers' Dwellings Improvement Act 1875 gave councils permission to compulsory purchase slum housing, but few took advantage of the opportunity.
Advocates of the design suggested that they were easier to keep warm owing to their single outside wall, but the absence of rear yards meant there was no space for exterior toilets, only communal ones that spread diseases rapidly.
[9] In the oldest parts of Birmingham, early back-to-back houses were associated with filth, poor ventilation and pools of stagnant water, despite being home to the greatest number of working-class people within the city.
[2] Rapid urbanisation led to fields and allotments disappearing in favour of cheaply built houses, often packed tight into minimal space.
[10] By the 1830s, back-to-back houses had a reputation nationwide for spreading disease, and major cities including Manchester and Liverpool prohibited their construction during the mid-19th century.
The Medical Officer for Health unsuccessfully sought to abolish back-to-back construction in about 1880,[5] by which time population density had improved to 200 people living in 50–60 houses per acre.
[11] However, Leeds was an exception, with figures from 1899 showing 72 percent of all houses constructed annually in the city being back-to-back, similar to 15 years prior, which didn't decrease until 1914.
[13] By the turn of the 20th century, back-to-back houses had become unpopular with residents and the government, who sought to ban their construction and eradicate existing properties nationwide due to concerns about health and ventilation.
In Manchester, Dr James Niven noted that mortality rates among those living in back-to-back houses exceeded those from through-houses by 40%.
[16] By 1926, Leeds had 72,000 of these houses, of which 32,000 were described by Dr Christoper Addison as being "abominations", having been condemned as unfit for many years by that time, despite still being lived in;[17] only 12,000 (less than 17 per cent) were given a moderate health pass by Neville Chamberlain's[18] Unhealthy Areas Committee.
[21] Following the Second World War and the Blitz aerial bombing of industrial cities, Britain was ready for a new wave of slum demolition and construction of more suitable housing.
The pre-1844 houses were by that time in a state of disrepair and overcrowding was a concern, particularly when families were occupying what was originally intended for single or dual occupancy.
[26] William Wheeldon, a Labour and Co-operative MP, pointed out that "the most distressing thing" was that little had changed in generations: Its chief defect, in addition to its lack of size, its dampness and its dilapidation, is that it is not self-contained.
Leeds and its surrounding region is the only area where back-to-back houses still exist in large numbers, having been refurbished to include "mod cons" such as indoor bathrooms and central heating.
The house style is also popular among student populations, as little exterior maintenance is required and they are often close to universities and colleges, particularly in the areas of Headingley, Burley and Kirkstall.
[31] A proposal to preserve and restore the city's last surviving court housing block was made in 2016, with structural work taking place to secure the building, as well as a new roof to prevent further water damage.
The project would complement the existing court dwellings at the Museum of Liverpool which opened in 2011 and recreates a former street from 1870 in the area around Scotland Road.