The Roman towns were also much better planned and built than those in the Middle Ages, which often placed wells and sources of drinking and bathing water in close proximity to cesspits and sewers, which led to infected water and cholera and typhoid outbreaks. Furthermore, many Medieval streets were filled with filth, such as animal carcasses, human and animal excrement, waste from butchers and tanners, and many more sources of disease, as bacteria could grow freely and infect people very easily.
As well as this, there were also very poor food standards, and it was not unusual for dishonest meat sellers to sell low-quality meat which could have caused disease, although a law was instated, decreeing that distributors of bad meat would be locked in the pillory. The Romans also had better waste disposal and water transportation systems, which allowed people to obtain clean drinking water, although there may still have been a risk of illness, as most pipes were made of lead, which is toxic.
Their medical skills were also slightly better than those of Medieval doctors, as most Roman doctors were much better trained and taught about natural causes of disease, which gave them a considerable advantage over the mostly Church-educated doctors of the Middle Ages, who believed more extensively in supernatural ideas and religion-based methods of prevention and treatment of disease.
An example of this is the Black Death, which killed 50 000 people in Europe, and was spread very quickly due to poor sanitation, ineffective cures, which would in many cases have made the patient worse, such as ingesting bile or faeces, or relying solely on prayers or religious ideas, rather than actively seeking a reliable cure, which was impossible without a knowledge of the true cause of diseases, although they did attempt to limit its spread by locking up houses which were infected with the disease. However, the Roman Empire was also poorly quipped to deal with plagues, such as the one which occurred in AD 80, and claimed hundreds of lives. However, public health in the Middle Ages did have some benefits: the towns often employed people such as gong farmers and muck rakers to survey and clean the streets to prevent disease, and remove sewage, although it was not possible to employ enough to maintain the cleanliness. The Romans had a similar system which worked to much greater advantage. Medieval towns also developed regulations and fines for littering and dirtying the streets, although these could not be easily enforced.
As well as this, the rich were happy to pay the fines and continue to deposit refuse in the streets. Moreover, near the end of the Dark Ages, butchers were banned from working in the inner city, which prevented pollution and assisted in keeping the streets clean. In conclusion, I believe that public health was much better under Roman rule, although the Medieval government did endeavour to improve the situation (albeit without much success. ) This is further evidenced by the average life expectancy in each era: it fell from 42 in the Roman era to 35, proving that standards had dropped dramatically since the Roman period.