The slums of Hygiene City are a dangerous place to live. The immorality and lack of cleanliness in the area are a large part of the problem. People living in slums were prone to ill health, and Shattuck believed these conditions posed a serious health risk to everyone. However, he also recognized that those most responsible for slum conditions were also those who were least likely to take personal responsibility for cleanliness. This is why Shattuck argued that the city or state should be responsible for ensuring the cleanliness of the environment. To do so, he recommended creating a state-wide public health system.
The eastern and western parts of the city have higher proportions of BPL households, which make them a more slum-like environment. They also contain higher percentages of marginal workers and uneducated people. The slums of Kolkata are also more likely to have poorly maintained community latrines, which further increase the risk of transmission of disease.