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For the first four decades of the 20th century, infectious diseases were the main cause for the high mortality Greek cities witnessed in their rather late urbanization period. Urban sprawl, combined with the absence of consistent urban planning policies led to a deterioration of living conditions and sanitation, which was ultimately translated in excessive infectious disease related deaths. Patras being a major port-city was heavily struck by a number of infectious diseases (many of which had become endemic to the city) although deaths were not distributed evenly among its population, showing instead a strong relation between income and health.It was only after the arrival of the Asia Minor/Pontus refugees (1922) and the frequent epidemic outbreaks that followed when both central government and municipal authorities would initiate many sanitation schemes that would help in the prevention of large scale epidemics in the 1930’s.