From the mid-nineteenth to the mid-twentieth century, specialist institutions such as sanatoria and asylums were established. In these, patients could be separated and isolated from the community and provided with the control and management of specific medical conditions such as tuberculosis and lunacy. At the start of this period, tuberculosis was a disease closely associated with the rapid growth of industrialization and a poorly nourished urban working class who lived in insalubrious, overcrowded conditions. By the early twentieth century, despite attempts by reforming socialist organizations such as the Garden City movement in England or the Life Reform movement in Germany to introduce healthier housing, these conditions had changed little. As the disease was more prevalent in younger men and women of working age, the financial drain on the European economy was considerable. By this time, research and treatment of the disease had coincided with the advent of modernism. This was a cultural movement that in architecture and applied design involved the integration of form with social purpose. It also attempted to create a new classless and hygienic lifestyle with socialist values.